If you’re itching to scratch at your tattoo, you’re certainly not alone.

A tattoo is most susceptible to itchiness when it’s fresh, but this can occur at any stage of the healing process. When you get a new tattoo, the skin is damaged with needles and ink, which can cause itchiness at some point.

Still, no matter what the cause, you should never scratch at your tattoo — especially if it’s new ink that’s still healing. This can lead to serious damage to the tattoo, as well as the surrounding skin.

Read on to learn more about the multiple causes of itchy tattoos and what you can do to treat them without giving in to the urge to scratch.

Itchiness is more common with new tattoos, but it can happen with old tattoos, too. An itchy tattoo can be attributed to one or more of the following causes.

Normal healing process

When you get a new tattoo, your skin is literally recovering from a wound. The skin is inflamed and working on preventing infection and repairing itself. As the skin tissues heal, it’s normal to experience some itchiness.

Infection

A new tattoo exposes deep layers of the epidermis (upper layer) and dermis (middle layer) of skin tissues. Your new ink is most vulnerable to getting infected within the first couple of weeks of the healing process.

If the area does become infected, you might experience itchiness along with swelling, redness, and discharge. Severe infections can cause fever and chills. An infection will likely warrant a visit to the doctor.

Allergic reaction to pigment

Some people have an allergic reaction to the actual ink used in tattooing. Tattoo pigments may be made from dyes that are made from plastic materials. According to the American Academy of Dermatology (AAD), an allergic reaction can occur right away or even several years after getting your tattoo. As a result, you might have severe itching along with redness and hive-like bumps.

Ink contamination

Aside from allergic reactions to tattoo ink, it’s also possible to develop symptoms from tattoo ink that’s been contaminated. You can be at risk even if the ink is labeled “sterile,” according to the U.S. Food and Drug Administration (FDA).

Preexisting skin conditions

If you have a preexisting skin condition, such as eczema or psoriasis, you may not be the best candidate to get a tattoo. However, it’s also possible to have a flare-up after you’ve already gotten a tattoo. This can cause red, itchy patches of skin anywhere on your body; a tattooed area of skin is no exception. Learn more about tattoo safety when you have psoriasis.

Sarcoidosis

Sarcoidosis is a condition that can affect older tattoos. In fact, this autoimmune condition can occur decades later, and even affect internal organs, according to the AAD. While not directly related to tattoo ink, sarcoidosis is known to cause extreme itching and inflammation in old tattoos.

MRI reactions

Doctors sometimes order magnetic resonance imaging (MRI) scans to diagnose certain health conditions. While rare, the FDA has reports of MRI scans affecting old tattoos. Symptoms can include itchiness along with swelling. These tend to clear up on their own after a short period of time without any further medical intervention.

The right treatment for an itchy tattoo depends on the underlying cause. New tattoos are especially prone to damage and infection, so extreme care must be taken so you don’t mess up the ink or the surrounding skin. Older tattoos may also be vulnerable to skin damage in some cases.

OTC creams and ointments

As a rule of thumb, you don’t want to apply over-the-counter (OTC) creams and ointments to new tattoos because these can interfere with your skin’s natural healing process. You can, however, apply topical hydrocortisone to an itchy, older tattoo.

Cool compresses

Cool compresses can ease itchiness while also reducing swelling. Ask your doctor before using any compresses around recent tattoos. It can take about two weeks for new tattoos to heal, according to The Nemours Foundation.

Keep the area moisturized

If your skin is both itchy and dry, the solution may rest in moisturizing. For old tattoos, choose either an oatmeal-based lotion or a thicker moisturizer made from cocoa butter. Stay away from products with colors and fragrances, as these may cause further irritation and may inadvertently increase the itch.

For new tattoos, check with your artist about how to best keep them moisturized. Some tattoo artists recommend against certain moisturizers or ingredients based on the theory that they can pull out new ink. Usually, a fragrance-free, unscented hand lotion is considered best.

Oatmeal bath (for old tattoos only)

Colloidal oatmeal baths can provide soothing relief for itchy skin all around, including your older tattoos. Never use this method for new tattoos, as you shouldn’t submerge them in water for at least a couple of weeks.

Medications for skin conditions

If a preexisting skin condition is making your tattoo itch, your doctor may prescribe topical creams. This includes eczema, rosacea, and psoriasis. If you’re diagnosed with sarcoidosis, you’ll need to take immunosuppressants to prevent itchiness and further complications to your immune system.

Drawing out old ink

Unfortunately, if the ink itself is the cause of your itchy tattoo, you can’t just simply take it out. You’ll need to see a dermatologist for professional tattoo removal. This usually involves laser treatments, or other skin treatments such as dermabrasion. Sometimes you may be left with a permanent scar. It’s also more difficult to remove darker pigments.

An itchy tattoo can have several causes, but most of these are treatable. Above all else, you must resist the urge to scratch. This will make matters worse, and you may even distort your tattoo.

If you suspect an infection, it’s important to see your doctor. Do not delay if you have a fever, chills, and feel unwell. Your doctor may prescribe antibiotics to help treat the infection while also preventing its spread. Not only can infections lead to serious complications, but they can also lead to tattoo scarring.