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Red ink tattoos have become very popular in recent years. Due to this increase in popularity, there have been increased reports of people obtaining reactions to red pigments being used; discomfort and Itchiness are symptoms that look a lot like an allergic response.
While the aesthetics of red pigment cannot be doubted, the knowledge surrounding red ink allergies is still not fully understood. This article will go over what we know about red ink, allergies, and what causes these symptoms. We also have a video at the end of the article that covers patch testing and why it is important.
Table of Contents
What is in Red Tattoo Inks That Make Them Unsafe?
Red inks used in tattooing are made of many different ingredients. They are often comprised of a dry pigment, a carrier fluid/solution, and a biocidal agent/shelf stabilizer. These ingredients are commonly found on the labeling of the bottle but sometimes don’t include everything in them.
While the carrier fluids, stabilizers, and surfactants may cause issues during the healing, the pigment used can make for long-term problems for tattoo clientele. According to a recent report released by the JRC commission in the EU, red tattoo inks are most associated with allergic reactions. Throughout the historical use of these pigments, red inks have been shown to have impurities that are bad for human health.
Red Tattoo Ink Impurities.
The most commonly reported impurities in red tattoo inks are mercury sulfide, iron oxides, Cadmium based additives, lead, and arsenic. Each impurity has the chance to make the healing of a tattoo worse, if not impossible. Some reports by those suffering from a red ink allergy while healing a tattoo include:
- Redness
- Itching
- Swelling
- Pain
- Feeling of extreme heat
- Multiple peels during the healing process
- Hives
- Delayed healing (up to 6 months)
- Photosensitivity (the skin becomes irritated when light hits the tattooed area)
- Accelerated skin sloughing (where the skin sheds fast enough to look like it is melting off)
Why Does This Happen?
To be honest, we don’t have any idea. Science has been creating hypotheses to start answering this question, but research is in its infancy right now. In some cases, a person’s reaction is transient (it doesn’t last long or only happens once) and cannot be replicated to be a part of a study. In other cases, the person suffering from the reaction may have other health problems which aggravate the problem. Since the resulting allergy is not consistent, many complex mechanisms are most likely responsible for this allergy.
What Else Can Go Wrong with Red Ink Allergies?
While the symptoms above are not a complete list of what can go wrong, you can tell that the reactions are nasty! These symptoms are also only what you can expect if you react to a fresh tattoo. There are also chronic issues surrounding a tattoo when you are allergic to the pigment used. Most of these conditions are so severe the only recourse towards healing is to: Remove the entire section of skin where the tattoo is. This means a doctor excises the skin, removing it and the effective pigment. Then a skin graft is installed to repair the removed section of skin.
If these symptoms are such a threat to the wellness of a tattoo client, why are there not testing protocols in place to determine how safe a pigment is? Well, it is twofold. First, there are no regulations in the US currently to validate the safety of tattoo pigments. The second is that because there is no regulation, scientists are reactionary to issues that arise from tattoo ink allergies.
Issues With Testing Tattoo Pigment Safety.
The amounts recorded in each pigment used in tattooing are not constant. The consistency of a pigment is not a thing that a mixer can count on. Impurities reported on each raw pigment product used change based on how each was produced and by what company made the raw pigments. Due to this variability, tattoo pigments being used on clientele are never consistent enough to create a viable testing protocol or measures to ensure quality pigments are released for use in tattooing.
How do Scientists Test Tattoo Inks for Safety?
Only assumptions about the safety and efficacy of a pigment can be made currently. Why do you ask? Because it is ethically reprehensible to test knowingly carcinogenic compounds on a living human being. Due to this lack of testing, scientists are left with two ways of discovering what happens when a pigment is used on a person. 
Meta-Analysis of Tattoo Pigment Reactions.
The first is a meta-analysis of self-reported symptoms. Over time, people who get tattoos and have a reaction report the issues to a doctor. Reports are then aggregated into a test to see correlations between a symptom and possible ink/additive. The problem with this type of testing is that most results will be underreported or not reported at all. This is even more common in places like the USA, where the cost of medical treatment dissuades people suffering from non-life-threatening symptoms from going to a doctor for treatment. So, researchers can only make assumptions about how prevalent a problem is based on data given with an incomplete set of data points (reported issues surrounding tattoo pigment allergies).
Another issue with this type of research is that the results always come long after reported health problems. Because there needs to be so many people reporting the issue for science to study the effects, those who suffer from a reaction are not going to benefit from protective research. Those who suffer from a tattoo ink allergy may never get the best treatment available. This is because results of studies may only come available after the disease progresses where treatment isn’t viable.
In Vitro Studies of Tattoo Pigments.
The second way of scientific discovery is to use in vitro studies. These types of studies are done by utilizing animal models, cell-on-chip models, or petri dish models (to name a few). These types of studies are what we commonly known as test-tube studies. Much like meta-analysis, in vitro studies lack the exactness of human subjects. In vitro studies focus on a single thing, or very few things, associated with the study at hand. The goal is to create enough data to start comparing ideas (also known as hypotheses) to see if the results work together or have nothing to do with each other. In vitro studies of tattoo pigment safety also suffer from inefficiency. The time necessary to gather enough data to create viable testing protocols or treatment protocols is more significant than necessary to treat those suffering now.
What To Do Before You Suffer from a Red Ink Allergy?
The best thing to do before getting a red ink tattoo or a color you haven’t had before is to get a patch test. We made a video explaining it and have it linked below.
If a patch test isn’t offered in your area, take a chance, and talk to a doctor before getting inked. The effort you put in before getting a tattoo can improve your enjoyment of it once it is completed. For more information about healing a tattoo, you can check out our article: How Much Lotion Should I Use to Heal My New Tattoo?
Why Does My Red Tattoo Look Pink While It Heals?
The colors of your tattoo pigment should not change much during the healing of the trauma introduced by the procedure.
This is true if, and only if, the trauma sustained to the skin is light to moderate.
If the skin was traumatized to a higher degree than normally required, the skin may create a filtering effect on the pigment while it is repairing. The process of epithelialization can create a thicker layer of skin over the wound when compared to like tissue thicknesses of the same person.
If My Tattoo Is Healing and Looks Rough.
Increased healing factors may be tied to the proliferation of melanocytes during the healing process, this in turn may decrease the ability of light energy to reach the pigment implanted in the skin. The melanin light absorption value (leaning towards ultraviolet, infrared, or neutral) will also influence this effect, especially if the client is from a more arctic (northern or southern) ancestral/genetic background as their skin will more commonly absorb infrared radiation more effectively than ultraviolet, causing the pigment to look less lustrous.
Another factor to consider is the chance of sensitivity or allergic response to the pigment being implanted into the skin. While the most sensitive responses may not be expressed by the individual who shows a lightening effect during healing, there may still be an effort of the body’s immune system to remove or expel certain additives or pigments utilized during the procedure.
Take for instance a red pigment that has been augmented with multiple additives, TiO2, or additional pigments to create a more vivid color when implanted into the skin. If one of the additives, surfactants, or pigments are necessary to make the pigment “appear” red when implanted in the skin, but the body is sensitive to them and effectively removes them from the body during the healing process, the color of the pigment will look different than what was implanted. This degradation may continue to occur for the life of the tattoo/client.
What Happens if My Skin Is Light Colored?
Inversely, the body may have a decreased quantity of melanin surrounding the site of tattooing which in turn may increase the quantity of light energy reaching the tattoo pigment implanted in the skin. If AZO pigments, or other augmented acrylic pigments have been used in the skin, as well as if the client has lighter pigmented skin to begin with; the pigment may break down more rapidly showing a lighter tonal value than is expected.
This effect is why most clients assume colors fade.
Taking Care of a Tattoo Done with Red Ink.
If your aftercare includes an oil-based moisturizer you may be over-caring for the tattoo. This over caring can make your skin look milky, which in turn can make red tattoo pigment appear pink during the healing. Think about switching to another product.
More information about aftercare products can be found here:
Types of Tattoo Aftercare Products and What’s the Difference
and
How Much Lotion Should I Use On My New Tattoo
Past all this crazy science stuff, if your skin was overly traumatized during the tattoo procedure, and you have a history of hypertrophic tissue formations, the color will look lighter until fully healed.
How Long Until Red Tattoo Ink Fades?
Tattoo pigments, like most colors, degrade with time. This degradation is accelerated when these pigments interact with natural light (or light energy).
Modern “organic” pigments used in tattooing (with the exception of a few colors, such as blacks and white pigments) are not the same as mineral bases that were used historically. They age differently, can release harmful compounds when they degrade, and become increasingly transparent the longer they are in the skin.
This natural phenomenon of degradation is limited or amplified by an individual’s biology. The undertones of a skin show the balance of natural light that the skin absorbs more effectively – from a range of warm to cool. Here is a working hypothesis that I am currently dragging through some research:
→Undertone can effectively modify the degradation of pigments inserted into the skin.
How Do Undertones Influence Red Ink Viewability?
Example → When looking at a warm undertone individual we can assume the tone that is influenced by lack of absorption of a range of visible light. Much like using ski goggles on the mountain so your eyes don’t burn from sunlight bouncing off the reflective snow, our skin controls a certain amount of reflection within a boundary of visible light.
Regarding the degrading of “red pigments” in the skin:
Based on what types of pigments are used and your individual biology – as well as what climate or location on the planet you live in – your tattoos may degrade at different rates.
For most of us out there, the degradation can be seen within the first six months of the tattoo being implanted in the skin. It becomes more apparent the further from the origination of the tattoo procedure you go.
The Extra Stuff.
We also have a YouTube channel that breaks down commonly asked tattoo questions. You can find it by following this link:
Better Tattooing YouTube Channel
As always, we appreciate feedback:
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Citations:
https://publications.jrc.ec.europa.eu/repository/bitstream/JRC99882/jrc99882_wp3_report_on_tattoos_final_amended%20by%20ipo.pdf Tattoo allergy. Can we identify the allergen? – ScienceDirect How to advise a patient who wants a tattoo? – ScienceDirect
