Are Tattoos Safe for People with Psoriasis?

A person with psoriasis can get tattoos, but the best bet is to stick to places where they don’t usually get flare-ups.

Note that in some states, laws may prohibit artists from giving a tattoo to anyone with an active psoriasis flare. Tattoo artists may also refuse to tattoo while an active flare is occurring.

Location

Plaque psoriasis can occur almost anywhere on the body, so it may be challenging to choose a location.

It isn’t possible to get a tattoo in areas where there are scale-like patches or plaques. Getting a tattoo where skin changes often is unpredictable and may ultimately be disappointing because the tattoo may be hard to see.

Infection and allergy

If precautions are not taken, any tattoo can become infected, which can be especially harmful to people with psoriasis. If the tattooing equipment is not properly cleaned, germs can get into the skin and lead to infection.

Your tattoo might be infected if there is a persistent red, bumpy rash on the skin around the tattoo.

While not unique to people with psoriasis, an allergic reaction can also result from the use of tattoo dyes and inks. This reaction can range from mild to serious, depending on the individual.

According to a 2019 study, tattoos created with red ink are more likely to cause an allergic reaction than tattoos created with other inks.

See your doctor if you experience a tattoo infection or allergic reaction.

Possibility of refusal

If you have psoriasis and are looking to get a tattoo, it is possible some artists might ask you only come in when your symptoms have subsided. Others may refuse to tattoo you, regardless of whether you’re having a flare-up.

Some states have laws about whether someone with active psoriasis can be tattooed. See below for more information.

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.

It’s estimated that 11% to 75% 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 to appear.

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.

Still, according to various studies, there isn’t enough scientific evidence to inextricably link tattoos with psoriasis.

Anyone thinking about getting a tattoo should be aware of the basic 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

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.

Follow healing instructions precisely. Contact your dermatologist right away if you experience new or worsening lesions or signs of infection such as:

• redness
• swelling
• burning that lasts beyond the typical healing period

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.

An older 2013 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% of tattoos created with blue ink
• 37% of tattoos created with red ink
• 21% of tattoos created with black ink
• 20% 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. There were 25 blue tattoos, while 45 tattoos were red and 133 were black.

Another 2012 Danish study looked at tattoos in young people. Study participants reported minor symptoms (such as itching and inflammation) in:

• 14% of black tattoos
• 10% of red tattoos
• only 4% of tattoos that weren’t created with black, red, or gray ink

Of those reactions, 58% were attributed to sun exposure. Sun-related skin reactions were reported in 8% of black tattoos, 6% of red tattoos, and 3% of 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 your tattoo has 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 colors of 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 of 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, regardless of 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.