Case Report Links Red Tattoo Ink and Skin CancerSeptember 24, 2014 — The journal PRS Global Open has published a case report of a man who developed skin cancer four months after receiving a tattoo with red ink.

The report does not prove a causal connection between tattoo ink and skin cancer and the reaction may be coincidental. Even so, the researchers believe squamous-cell carcinoma should be added to the list of tattoo-related inflammatory reactions.

The researchers warn that red tattoo ink is the most common cause of hypersensitivity reactions. In the past, red tattoo ink contained mercury sulfide, a carcinogenic pigment. Other inks contain metallic salts and organic dyes, which are scattered in many layers of skin. Over time, the pigment can shift into deeper layers of the skin.

The case report describes a 48 year-old white man who had no medical problems, was fairly young, and had no history of binge tanning or severe sunburn. Four months after getting a tattoo, he noticed skin changes in the red part of his tattoo and he was diagnosed with skin cancer (squamous-cell carcinoma). The organic ink was sold by Eternal Ink and “Dark Red” was used.

Treatment involved surgery to cut out the tumor. During follow-up, additional skin changes were observed in red areas of the tattoo. He underwent another surgery to remove abnormal skin. He underwent a skin graft, which removed healthy skin from his left arm and transplanted it to his leg.

What is the problem?

Pigments in tattoo ink are subject to premarket approval from the U.S. Food and Drug Administration (FDA), but the agency rarely screens tattoo inks. According to the agency:

“Although a number of color additives are approved for use in cosmetics, none is approved for injection into the skin … Many pigments used in tattoo inks are not approved for skin contact at all. Some are industrial grade colors that are suitable for printers’ ink or automobile paint.”

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