Correspondence (letter to the editor): Additional Risks

We thank Dieckmann and colleagues for their important—and long overdue—article (1). We agree with their conclusion, that people should probably refrain from having tattoos altogether, in order to avoid health risks but also to avoid experiencing socioeconomic problems. We have been issuing warnings of the potential risks associated with tattoos for many years (2).

Further to the more obvious risks of tattooing, such as infections and allergies, other medically relevant aspects of the procedures are almost unknown. Delayed complications that potentially threaten eyesight have included iris bombe, retinal detachment, and macular edema (3). Tattoos can also be medically relevant in the context of diagnostic measures. In MRI investigations, for example, the iron oxides in the tattoo inks may heat up and cause burns. Furthermore, there is a chance of examination artefacts.

Tattoos should also be regarded critically in the socioeconomic context. Professional starter and promotion opportunities may be negatively affected. Vacancies in many lines of work are preferentially given to persons without body modifications, rather than to applicants with tattoos or piercings (4).

Tattoo removal is also problematic. Laser treatment is associated with breakdown and decomposition products that can be toxic or carcinogenic. In our practice we therefore prefer (serial) excision of the affected areas if this is justifiable and practicable from a functional and esthetic perspective.