Explore the vast range of titles available.

Long perceived as a form of exotic self-expression in some social fringe groups, tattoos have left their maverick image behind and become mainstream, particularly for young people. Historically, tattoo-related health and safety regulations have focused on rules of hygiene and prevention of infections. Meanwhile, the increasing popularity of tattooing has led to the development of many new colours, allowing tattoos to be more spectacular than ever before. However, little is known about the toxicological risks of the ingredients used. For risk assessment, safe intradermal application of these pigments needs data for toxicity and biokinetics and increased knowledge about the removal of tattoos. Other concerns are the potential for phototoxicity, substance migration, and the possible metabolic conversion of tattoo ink ingredients into toxic substances. Similar considerations apply to cleavage products that are formed during laser-assisted tattoo removal. In this Review, we summarise the issues of concern, putting them into context, and provide perspectives for the assessment of the acute and chronic health effects associated with tattooing.

As mpox spreads, different potential modes of MPXV transmission are possible. In this report, spread from a tattoo parlor was identified.

Ear tattooing is a routine procedure performed on laboratory, commercial and companion rabbits for the purpose of identification. Although this procedure is potentially painful, it is usually performed without the provision of analgesia, so compromising animal welfare. Furthermore, current means to assess pain in rabbits are poor and more reliable methods are required. The objectives of this study were to assess the physiological and behavioural effects of ear tattooing on rabbits, evaluate the analgesic efficacy of topical local anaesthetic cream application prior to this procedure, and to develop a scale to assess pain in rabbits based on changes in facial expression. In a crossover study, eight New Zealand White rabbits each underwent four different treatments of actual or sham ear tattooing, with and without prior application of a topical local anaesthetic (lidocaine/prilocaine). Changes in immediate behaviour, heart rate, arterial blood pressure, serum corticosterone concentrations, facial expression and home pen behaviours were assessed. Changes in facial expression were examined to develop the Rabbit Grimace Scale in order to assess acute pain. Tattooing without EMLA cream resulted in significantly greater struggling behaviour and vocalisation, greater facial expression scores of pain, higher peak heart rate, as well as higher systolic and mean arterial blood pressure compared to all other treatments. Physiological and behavioural changes following tattooing with EMLA cream were similar to those in animals receiving sham tattoos with or without EMLA cream. Behavioural changes 1 hour post-treatment were minimal with no pain behaviours identifiable in any group. Serum corticosterone responses did not differ between sham and tattoo treatments. Ear tattooing causes transient and potentially severe pain in rabbits, which is almost completely prevented by prior application of local anaesthetic cream. The Rabbit Grimace Scale developed appears to be a reliable and accurate way to assess acute pain in rabbits.

The continuous increase in the popularity of tattoos and permanent make-up (PMU) has led to substantial changes in their societal perception. Besides a better understanding of pathological conditions associated with the injection of highly diverse substances into subepidermal layers of the skin, their regulation has occupied regulatory bodies around the globe. In that sense, current regulatory progress in the European Union is an exemplary initiative for improving the safety of tattooing. On one hand, the compilation of market surveillance data has provided knowledge on hazardous substances present in tattoo inks. On the other hand, clinical data gathered from patients enabled correlation of adverse reactions with certain substances. Nevertheless, the assessment of risks remains a challenge due to knowledge gaps on the biokinetics of highly complex inks and their degradation products. This review article examines the strategies for regulating substances in tattoo inks and PMU in light of their potential future restriction in the frame of the REACH regulation. Substance categories are discussed in terms of their risk assessment and proposed concentration limits.

BACKGROUND: The popularity of tattoos has increased significantly, particularly among younger demographics. However, the implications of tattoos on medical procedures, such as spinal or epidural anesthesia, are not well established. There is a need to understand the potential risks and complications associated with administering anesthesia through tattooed skin. OBJECTIVES: This narrative review aims to explore the principles of tattooing, the composition of tattoo pigments, the immune response to tattoos, the complications arising from tattoos, and the impact of tattoos on spinal or epidural anesthesia. STUDY DESIGN: A comprehensive literature review was conducted to gather information on the interaction between tattoos and anesthesia. The review included studies that examined the effects of tattoos on anesthesia outcomes and patient safety. SETTING: The review spans both clinical and research environments, focusing on the interactions of tattooed skin and anesthesia administration, particularly in regions where tattoos are prevalent. METHODS: Relevant databases were searched for studies discussing the relationship between tattoos and anesthesia. The analysis included examination of tattoo pigments, immune responses, and the potential for complications during the administration of anesthesia through tattooed skin. RESULTS: The review found that tattoos could lead to various complications, including infections, allergic reactions, and skin lesions. The presence of tattoos does not preclude the use of spinal or epidural anesthesia but may necessitate modifications in anesthetic technique. The pigments used in tattoos, especially organic compounds, can potentially cause neurotoxic reactions if introduced into the spinal canal. Additionally, tattoos may interfere with the body’s immune response, leading to localized inflammation and potential nerve injury. LIMITATIONS: The review is limited by the scarcity of studies specifically addressing the interactions between tattoos and anesthesia. The variability in tattoo pigments and individual patient responses further complicates the establishment of standardized guidelines. CONCLUSIONS: While tattoos present potential risks when considering spinal or epidural anesthesia, they do not absolutely contraindicate these procedures. Anesthesia providers should be aware of the possible complications and adapt their practices accordingly. These adjustments may include selecting alternative puncture sites, using caution with MRI and high-frequency electrosurgery, and obtaining detailed information about the tattoo’s pigment composition. Further research is needed to establish clear guidelines and to better understand the long-term implications of tattoos on anesthesia safety and efficacy. KEY WORDS: Tattoo, intraspinal anesthesia, complication, anesthesia method

On July 23, 2022, WHO declared that the 2022 monkeypox outbreak was a public health emergency of international concern.1 To date, the most commonly described mechanism of viral transmission in this outbreak is close contact in the context of high-risk sexual behaviour, mainly between men who have sex with men.2,3 The monkeypox virus belongs to the orthopoxvirus genus of the Poxviridae family, which is known to have long-lasting stability in the environment. A second sampling was performed on July 27, focusing on sharps and work tools. 15 (94%) of 16 samples were found to be positive for the virus, with tweezers and scissors tips having the highest viral load according to cycle threshold values. Together, these findings suggest that monkeypox virus can be transmitted through exposure to contaminated piercing or tattoo material and, potentially through contaminated hands, due to poor aseptic measures and handling of materials.8 The epidemiological curve and the finding of monkeypox virus DNA on fomites and surfaces—more than 2 weeks after the probable index case attended the establishment—suggest an extended infectivity period of the virus.9 Of note, a rash first developed at the site of exposure, similar to what was observed for genital lesions in individuals with confirmed infection after sexual intercourse.10 To minimise the risk of further transmission, we continue to actively work with the community.

Tattoos and permanent make-up (PMU) gain increasing popularity among the general population. There are indications that pigments or their fragments may translocate within the body, however knowledge about possible systemic adverse effects related to tattoos is very limited. We investigated the prevalence of systemic chronic health effects including cardiovascular diseases, cancer and liver toxicity and their relationship with the presence and characteristics of tattoos and PMU as part of the LIFE-Adult-study, a population-based cohort study. The control group without tattoos was from the same cohort and adjusted for confounders based on age, sex, smoking-status, body mass index, alcohol consumption and socioeconomic status. Of 4,248 participants, 7.4% (n = 320) had either a tattoo (4.7%; n = 199) or a permanent make-up (3.1%; n = 135), or both (n = 14). Thereof 5% (16/320) reported medical complications, i.e. pain, itch, swelling, infections, or allergic reactions, in relation to their tattoos or PMUs. Regarding systemic chronic health effects, increased risk ratios among the tattooed population were found for cardiovascular diseases and liver toxicity. For non-melanoma skin cancer, results from the tattoo questionnaire gave no indication for any tumour development at the site of the tattoo. Our results demonstrate an increased risk for cardiovascular and liver effects in participants bearing a tattoo. Strong differences in the observed effects between men and women point on the presence of a sex-specific bias. Even if no statistically robust conclusion can be drawn due to the small sample size, the results suggest that cardiovascular outcomes and liver toxicity in tattooed individuals should be investigated further using prospective designs in larger cohorts.

Background We aim to study the potential association between tattoo ink exposure and development of certain types of cancers in the recently established Danish Twin Tattoo Cohort. Tattoo ink is known to transfer from skin to blood and accumulate in regional lymph nodes. We are concerned that tattoo ink induces inflammation at the deposit site, leading to chronic inflammation and increasing risk of abnormal cell proliferation, especially skin cancer and lymphoma. Methods We conducted two designs of twin studies to improve confounder control: A cohort study of 2,367 randomly selected twins and a case-control study of 316 twins born in the period 1960–1996. Cancer diagnoses (ICD-10) were retrieved from the Danish Cancer Registry and tattoo ink exposure from the Danish Twin Tattoo survey from 2021. The analysis addressed effects of time-varying exposure. Results In the case-control study, individual-level analysis resulted in a hazard of skin cancer (of any type except basal cell carcinoma) that was 1.62 times higher among tattooed individuals (95% CI: 1.08–2.41). Twin-matched analysis of 14 twin pairs discordant for tattoo ink exposure and skin cancer showed HR = 1.33 (95% CI: 0.46–3.84). For skin cancer and lymphoma, increased hazards were found for tattoos larger than the palm of a hand: HR = 2.37 (95% CI: 1.11–5.06) and HR = 2.73 (95% CI: 1.33–5.60), respectively. In the cohort study design, individual-level analysis resulted in a hazard ratio of 3.91 (95% CI: 1.42–10.8) for skin cancer and 2.83 (95% CI: 1.30–6.16) for basal cell carcinoma. Conclusion In conclusion, our study suggests an increased hazard of lymphoma and skin cancers among tattooed individuals, demonstrated through two designs: a twin cohort and a case-cotwin study. We are concerned that tattoo ink interacting with surrounding cells may have severe consequences. Studies that pinpoint the etiological pathway of tattoo ink induced carcinogenesis are recommended to benefit public health.

Tattoos have been culturally significant throughout history and continue to serve as an avenue for self-expression, cosmetic enhancement, and medical applications in the modern era. Despite their popularity, tattoos are not without clinical implications, including inflammatory reactions, infections, scarring, and even associations with cutaneous malignancies. This review explores the natural course of tattoo-related skin reactions, focusing on the acute and chronic inflammatory responses to pigment deposition, including allergic contact dermatitis, lichenoid reactions, and granulomatous inflammation. Tattoo-related infections, ranging from bacterial to viral and fungal, are also discussed, highlighting the importance of sterile tattooing practices. Further, the potential for scarring, including hypertrophic scars, keloids, and dermatofibromas, is evaluated, particularly in individuals with a predisposition for abnormal wound healing. Although no direct causative link between tattoos and skin cancers has been established, tattoos can obscure early detection of malignancies, potentially delaying diagnosis and increasing morbidity. This article also examines emerging trends in cosmetic tattooing, such as scleral tattoos, microblading, and scar camouflage, noting both the benefits and potential complications. Management strategies for tattoo complications, including medical and procedural interventions, are outlined. Treatments include corticosteroids for inflammatory reactions, laser therapy for pigment alteration, and surgical options for severe scarring. The growing field of cosmetic tattooing requires continued research into the long-term outcomes and management of tattoo-related complications to ensure both aesthetic and medical safety for individuals seeking these modifications.