Most people get a tattoo without having a second thought about their health. This isn’t necessarily the case for people with psoriasis.
If you have psoriasis, getting a tattoo is still possible. However, it’s important to understand the risks.
Tattoos break the skin and cause bleeding. This by itself makes anyone who gets a tattoo vulnerable to various complications, such as:
- skin infection, which can sometimes become severe
- disease from cross-contamination if tools and needles aren’t properly sanitized (these diseases can include HIV, hepatitis B or C, tuberculosis, and tetanus)
- an allergic reaction to the dyes used
To avoid some of these risks, take precautions such as:
- using a tattoo studio with a very good reputation
- making sure the studio is clean and uses proper sanitization processes
- being sure inks are used one time from individual cups, not from a multi-use bottle
- asking questions about the studio’s process as well as about the experience and training of the staff
Any skin trauma, such as a cut, insect bite, or sunburn, can cause psoriasis-type lesions to develop. This is known as the Koebner phenomenon.
Since tattoos cause skin trauma, getting one may cause these psoriasis-like lesions to appear on your skin around the tattoo.
About 25 percent of people with psoriasis will experience the Koebner phenomenon after a skin injury. It typically occurs within 10 to 20 days of injury, but it may take as little as 3 days or as long as 2 years.
Researchers once believed that the Koebner phenomenon only occurred in people with preexisting psoriasis or other types of skin conditions. However, the diagnostic criteria were expanded to include people with no previous skin conditions.
To help prevent a tattoo infection, be sure your tattoo artist is reputable. Check their references and confirm that their license is current. Talk about sanitation procedures, and make sure they wear gloves and only use needles removed from sealed packages.
While not unique to people with psoriasis, an allergic reaction can result from the use of tattoo dyes and inks. This reaction can range from mild to serious, depending on the individual.
According to a 2020 study, tattoos created with red ink are more likely to cause an allergic reaction than tattoos created with other inks.
Nonallergic skin reactions are also possible. For instance, many participants in two Danish studies reported skin reactions that appeared to be both nonallergic and immune-mediated. Immune-mediated reactions are caused by the immune system.
A 2014 Danish study of sunbathers found that sun-related skin reactions were most common, percentage-wise, in tattoos created with blue and red ink. Sun-related skin reactions, such as redness and itching, were reported in:
- 40 percent of tattoos created with blue ink
- 37 percent of tattoos created with red ink
- 21 percent of tattoos created with black ink
- 20 percent of tattoos created with yellow ink
However, the number of blue tattoos was relatively low in comparison to the number of red and black tattoos. Twenty-five tattoos were blue, while 45 tattoos were red and 133 were black.
A 2013 Danish study looked at tattoos in young people. Study participants reported minor symptoms (such as itching and inflammation) in:
- 14 percent of black tattoos
- 10 percent of red tattoos
- only 4 percent of tattoos that weren’t created with black, red, or gray ink
Fifty-eight percent of those skin reactions were attributed to sun exposure. Sun-related skin reactions were reported in 8 percent of black tattoos, 6 percent of red tattoos, and 3 percent of the other tattoos.
In the case of both Danish studies, many study participants mentioned that their tattoos were at least 3 months old. This means that their tattoos were likely to be fully healed before they experienced their symptoms.
State laws vary regarding tattooing people with psoriasis.
For example, tattoo artists in Oregon, Wisconsin, and Louisiana aren’t permitted to work on any area of the skin where there are lesions. Louisiana even has a clause that specifically mentions psoriasis.
South Carolina also prohibits tattooing on skin with any type of irregularity, such as a rash, sunburn, lesion, or pimple.
Finding out your state’s tattoo laws will be an important part of your preparation process.
It takes about 2 weeks for a tattoo’s top layer to heal. The tattoo will scab over, and then the scab will eventually fall off. During this time, your tattoo may itch, but avoid scratching it. Scratching it may slow the healing process.
Your tattoo artist should give you specific care instructions, but here are some basic guidelines:
- Remove the bandage after a couple of hours.
- Wash and dry your tattoo gently, but don’t scrub it.
- Apply ointment given to you by your tattoo artist.
- Don’t soak your tattoo in water until it’s healed. This includes soaking in a bathtub, hot tub, or swimming pool.
- After it’s healed, apply a good unscented moisturizer to your tattoo regularly.
If at any point after the initial healing process time your tattoo burns or becomes red, you should consult a medical professional. This may indicate that the tattoo is infected.
Once you have a tattoo, be sure to avoid exposing it to sunlight for very long. Sunlight will fade or damage your tattoo. Be sure to always cover it with sunscreen.
If you eventually decide that you would like to remove your tattoo, a dermatologist or plastic surgeon can do it.
However, the results aren’t guaranteed and the procedure may not get rid of the entire tattoo. This is why it’s important to really think through getting a tattoo.
It’s possible to alter your tattoo or cover it up instead of removing it. A coverup will usually be larger than the original tattoo, though. Your coverup will also be limited in color, as the inks will be blending with the color ink you already have.
An alteration or coverup can be done any time after your tattoo is fully healed, even years later.
While people with psoriasis may be at risk for aggravating their condition with tattoos, available data suggests this doesn’t occur very often.
If you have psoriasis, you should talk with your dermatologist about treatment options, whether or not you plan to get a tattoo.
If you do plan to get a tattoo, it’s also a good idea to talk about your psoriasis with your tattoo artist ahead of time, especially if lesions are present. They may choose to postpone the procedure or discuss placing the tattoo in a different location.