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Fels, P.; Lachenmeier, D.W.; Hindelang, P.; Walch, S.G.; Gutsche, B. Contaminants in Tattoo Inks. Encyclopedia. Available online: https://encyclopedia.pub/entry/50449 (accessed on 16 June 2024).
Fels P, Lachenmeier DW, Hindelang P, Walch SG, Gutsche B. Contaminants in Tattoo Inks. Encyclopedia. Available at: https://encyclopedia.pub/entry/50449. Accessed June 16, 2024.
Fels, Patricia, Dirk W. Lachenmeier, Pascal Hindelang, Stephan G. Walch, Birgit Gutsche. "Contaminants in Tattoo Inks" Encyclopedia, https://encyclopedia.pub/entry/50449 (accessed June 16, 2024).
Fels, P., Lachenmeier, D.W., Hindelang, P., Walch, S.G., & Gutsche, B. (2023, October 18). Contaminants in Tattoo Inks. In Encyclopedia. https://encyclopedia.pub/entry/50449
Fels, Patricia, et al. "Contaminants in Tattoo Inks." Encyclopedia. Web. 18 October, 2023.
Contaminants in Tattoo Inks
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This entry is adapted from the peer-reviewed paper 10.3390/cosmetics10050141

Tattooing has been an enduring form of body art since ancient times, but it carries inherent health risks, primarily due to the complex composition of tattoo inks. These inks consist of complex mixtures of various ingredients, including pigments, solvents, impurities and contaminants. 

contaminants impurities tattoos

1. Introduction

Tattooing is an art form that is almost as old as mankind [1]. In 2017, 24% of people in Germany reported having at least one tattoo. Another 21% are thinking about getting a tattoo [2]. Younger people (25–35 years old) are particularly interested in tattoos. Almost half of them have at least one tattoo [3]. It is clear that the importance of high-quality tattoo ink is growing.
Although newer and more advanced tattoo inks have been on the market for decades, resolutions on tattoo inks and their ingredients were only introduced in the European Union (EU) in 2003 [4] and then revised in 2008 [5]. These resolutions only covered a small number of chemicals, elements, pigments, etc., that were restricted in their concentration or banned from tattoo inks due to carcinogenic, mutagenic, reprotoxic or sensitizing properties (e.g., 4-chloroaniline, 3,3′-dimethylbenzidine, o-toluidine). Both resolutions were non-binding but were a suggestion for the implementation of legislation on tattoos and permanent makeup. However, only eight EU Member States (the Netherlands, Germany, Belgium, France, Norway, Spain, Slovenia and Sweden) and two European Free Trade Association (EFTA) countries (Switzerland and Liechtenstein) implemented national legislation on tattoo and permanent makeup products in line with the recommendations of the EU resolutions by 2015 [6][7][8]. On the other hand, six other EU Member States (Italy, Malta, Romania, Czechia, Finland and Slovakia) used these resolutions to regulate tattoo practices (safety, health and hygiene requirements) but did not implement them into national legislation. Three EU Member States (Austria, Denmark and Latvia) notified draft national legislation in 2013 (Austria, Denmark) and 2014 (Latvia). However, these drafts were put on hold by the EU Commission because they conflicted with Registration, Evaluation, Authorization and Restriction of Chemicals (REACH) provisions [6][7][8]. All other EU Member States did not have specific regulations on tattooing [8].
In many of the countries that have implemented the resolutions, risk management measures have been taken because several tattoo ink manufacturers were obviously not complying with these requirements; e.g., most of the products were imported into the EU, and the directives did not apply in their country of origin. To increase the safety of tattoo inks and to unify the regulations for tattoo inks within the EU, tattoo inks and pigments were regulated under REACH in 2022 [9]. This led to restrictions and bans on commonly used pigments and ingredients for tattoo inks such as Pigment Blue 15 and Pigment Green 7 [10].
The ban on certain ingredients and pigments in tattoo inks has been controversial within the tattoo community. Although professionals and scientists have been advocating for a unified regulation for decades, many consumers are attracted to colorful tattoo inks that are not REACH-compliant and can no longer be used [11]. It is also unknown whether the documented adverse effects after tattooing, such as allergic reactions, granulomas, lichenoid reactions or rashes [6][12][13][14], are due to the pigments themselves, to other ingredients in the tattoo ink mixtures, such as solvents, or to contaminants and impurities of either the pigments or other ingredients.

2. Contaminants in Tattoo Inks

There are several quantifiable contaminants that occur in tattoo inks in a wide range of concentrations. Aromatic amines and PAHs are common contaminants. PAHs are particularly prevalent in black and gray tattoo inks, while aromatic amines make up the majority of contaminants in all other tattoo ink colors.
Black tattoo inks show the widest concentration ranges. PAH concentrations range from a few µg/kg to more than 100 mg/kg. Possible explanations for these observations may be that the concentration ranges shown here were compiled from about a decade of published papers. The measurements themselves may also explain this finding, as different laboratories use different extraction and quantification methods to detect and determine the amount of PAHs in tattoo inks. Finally, differences in the production of black tattoo inks between manufacturers and the fact that there are two main ways to produce carbon black [15][16], which is the main pigment for black tattoo inks [17], offer an explanation for the highly variable concentrations. Due to the differences in production, there are a number of different carbon black products with different properties and varying levels of PAHs [18]. Due to the pre-REACH regulations on tattoo inks, which only limited the amount of total PAHs in tattoo inks, any type of carbon black could be used for black tattoo inks [19], which could explain the wide range of PAH levels in different studies.
Another possibly confounding factor is that carbon black adsorbs most of the contaminants. The analytically detected PAHs are probably only a small fraction of the total [19]. It is also unknown what happens to the adsorptively bound PAHs in carbon black after tattooing [20]. Since about 98% of the tattoo pigment particles disappear over the years [21], it is questionable whether the PAHs remain bound to the carbon black particles or whether part of the PAH content enters the skin and poses a risk to human health.
The size of tattoos, and therefore the amount of tattoo ink injected into human skin, can vary widely. A survey conducted in Germany, Austria and Switzerland in the years 2007–2008 examined the size of the most recent tattoo among consumers [22]. The average size was about 400 cm2. Combined with a pigment concentration of about 2.53 mg/cm2 (range: 0.6–9.4 mg/cm2) in a tattoo solution of about 25% (v/v) [23], the total PAH sum in a 400 cm2 tattoo can be up to 813 µg. For benzo[a]pyrene, the concentration would be in the range of 0.2–21 µg. The most problematic toxic effects are chronic, non-reversible effects such as mutagenicity and carcinogenicity of PAHs and especially benzo[a]pyrene. Acute effects are rare and only seen at high concentrations of PAHs (up to several mg per kg body weight), which is not realistic for PAH exposure from tattooing [24]. There is a paucity of epidemiological research on the association between the lifestyle factor of tattooing and cancer. Only one study of skin cancer reported that the risk was low because there are only about 50 case reports of skin cancer associated with tattooing in the past 40 years, while millions of people are tattooed [25]. No evidence was available for other cancer sites associated with PAH exposure, such as the lung, and it remains doubtful that epidemiologic studies are sensitive enough to detect an increased cancer risk from tattooing (single exposure) when common lifestyle risk factors, such as tobacco smoke (which also contains PAHs) or UV light exposure, increase risk at the same cancer sites as contaminants in tattoo inks, and with daily lifelong exposure. An experimental study showed that black tattoo ink with a benzo[a]pyrene content of more than 1 mg/kg, which is above the concentration limit laid down in REACH Regulation (EU) No. 2020/2081, did not induce skin cancer in hairless mice, but actually protected against UVR-induced skin cancer [26].
Gray and black tattoo inks in particular have a wide range of PAH concentrations. As many PAHs are classified by the IARC as category 1, 2A or 2B carcinogens [27], the concentration limit for these substances is 0.5 mg/kg and the concentration limit for benzo[a]pyrene is 0.005 mg/kg according to REACH Regulation 2020/2081 Annex 13. Most of these contaminants have concentrations above 0.5 mg/kg. As a result, most black inks containing these levels of PAHs are in violation of REACH and cannot be sold in the European Union. The amount of benzo[a]pyrene is of particular concern, as the concentration can be as high as 5 mg/kg, which is 1000 times higher than the limit in the above-mentioned REACH Regulation 2020/2081.
Most of the PAAs detected are listed in Annex II of Regulation (EC) No. 1223/2009 [28] as prohibited substances for use in cosmetic products, as the ingredients of tattoo inks, in particular pigments, may either degrade to or contain residual PAAs that are classified as carcinogenic or mutagenic [10]. These substances, which are restricted for use in cosmetic products that are applied to the skin, are also restricted for products that penetrate the skin, such as tattoos and permanent makeup [29]. A cross-reference has been introduced between REACH Regulation (EU) No. 2020/2081 and Cosmetics Regulation (EC) No. 1223/2009, which allows lists of substances banned in Regulation (EC) No. 1223/2009 to be collectively restricted in Regulation (EU) No. 2020/2081 for tattoo inks [29]. This means that most of these substances could only be present in concentrations below 0.5 mg/kg to be acceptable in tattoo inks under REACH Regulation (EU) No. 2020/2081. An exception is made for substances that are listed in Annex 13 of REACH Regulation (EU) No. 2020/2081. The concentration limit of Annex 13 of REACH Regulation (EU) No. 2020/2081 applies to all compounds in tattoo inks listed in Annex 13, regardless of other regulations. However, almost all of them have concentrations higher than 0.5 mg/kg and 5 mg/kg, which are the most used concentration limits in REACH Regulation (EU) No. 2020/2081. This means that most of them violate this regulation if they are present in tattoo inks. Almost every measurement showed at least one PAA contaminant. This could be because most of the pigments in the color spectrum are azo pigments, so it is expected that at least some of the contaminants in these colors will be aromatic amines or PAAs, as this chemical structure is part of the basic structure of azo pigments.
PAAs can be found in almost all tattoo inks, but the concentration and the specific PAAs vary between the different colors of the tattoo inks. The carcinogenicity of PAAs for oral and dermal exposure has been established for decades [30]. The carcinogenicity of PAA via intradermal exposure has not been studied as extensively as other exposure routes [31]. However, there is some evidence that PAAs are also carcinogenic when inserted under the skin [32], which would be the exposure route of PAAs through tattoos.
Inorganic contaminants such as cobalt, cadmium, chromium, mercury, nickel and lead have specific concentration limits for their occurrence in tattoo inks. Only the concentrations of mercury are within these limits, as all measured samples have a mercury content below 0.5 mg/kg. This is an acceptable level of contamination in tattoo inks under REACH Regulation (EU) No. 2020/2081. Cadmium, cobalt, chromium, nickel and lead do not always meet the concentration limits set by REACH Regulation (EU) No. 2020/2081. In particular, the highest measured concentrations of lead, nickel and chromium are well above the set criteria. This means that tattoo inks containing these levels of inorganic contaminants could not be sold in the European Union after the implementation of REACH Regulation (EU) 2020/2081 on 4 January 2022.
Nickel has a concentration limit of 5.0 mg/kg set by Annex 13 of REACH Regulation (EU) 2020/2081. The measured concentrations of nickel in different tattoo inks range from 0.038–11.70 mg/kg, with three of the measured inks having a nickel concentration above 5 mg/kg. This means that almost all of the measured inks are below the concentration limit and therefore REACH-compliant. For a 400 cm2 tattoo with a nickel content of 11.70 mg/kg, the nickel content for the whole tattoo would be 47 µg or 0.12 µg/cm2. In a study comparing two types of patch tests on people with a nickel allergy, people began to react to nickel at a concentration of 0.5 µg/cm2 [33]. This concentration is four times higher than the scenario of the maximum measured nickel content in tattoo inks. Since publications on intradermal testing for nickel allergy are quite rare, patch testing could be an indication of how much nickel should be tolerated in tattoo inks [34]. Another consideration for the concentration limit should be the type of nickel in the tattoo. Most nickel in tattoos is an impurity from iron oxide pigments and is not soluble [34][35]. Therefore, it is not known whether allergic reactions are caused only by soluble nickel or also by insoluble nickel [35]. Tattoo inks with a nickel concentration above the established concentration limit of 5.0 mg/kg in tattoo inks may not cause allergic reactions to nickel. However, to protect people with nickel allergies, the concentration limit should be strictly adhered to.
Adverse effects associated with chromium include contact dermatitis and skin irritation [36]. In particular, chromium(VI) is recognized as one of the most common sensitizers in humans, causing most of the observed adverse effects associated with chromium [36][37]. Studies have shown that there may be an elicitation threshold for chromium(VI), which would be the lowest concentration that elicits a positive response. This threshold would be 2 ppm or 0.02 µg/cm2 [38][39]. With a maximum concentration of 4.1 mg/kg in tattoo ink (0.04 µg/cm2 in a 400 cm2 tattoo), this product could cause an allergic reaction. With a concentration limit of 0.5 mg/kg, the concentration in a 400 cm2 tattoo would be 0.005 µg/cm2, which would be below the triggering threshold. Considering that this threshold was measured with a patch test and not intradermally, the concentration limit set by REACH Regulation (EU) No. 2020/2081 should be followed.
Cobalt is known to cause allergic reactions such as contact dermatitis [40]. There have been limited studies investigating the elicitation threshold of cobalt, such as the study of Fischer et al. [41]. One study determined the elicitation threshold of cobalt using patch testing [41]. This study found the elicitation threshold to be 30.8–259 ppm or 0.07–2.0 µg/cm2 [41]. The highest measured concentration of cobalt in tattoo inks was 6.4 mg/kg, so the concentration of a 400 cm2 tattoo would be approximately 0.07 µg/cm2. This concentration reaches the determined lower elicitation threshold determined by Fischer et al. [41]. However, taking into account the different exposure between patch testing (dermal) and tattooing (intradermal), the concentration limit of 0.5 mg/kg in tattoo inks set by REACH Regulation (EU) No. 2020/2081 should be respected.
Cadmium has been shown to be carcinogenic when injected subcutaneously into rats at a concentration of 30 µmol/kg [42][43] and is also classified as a Group 1 carcinogen by the IARC [44]. Therefore, the concentration of cadmium in tattoo inks should be as low as possible to minimize the risk of cadmium carcinogenicity.
The main adverse effects of lead are reproductive and neurotoxic effects [45]. Therefore, the concentration of lead should be as low as possible and comply with the concentration limit set by REACH.
REACH Regulation (EU) 2020/2081 does not specify a concentration limit for manganese, strontium and vanadium.

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Subjects: Toxicology
Contributors MDPI registered users' name will be linked to their SciProfiles pages. To register with us, please refer to https://encyclopedia.pub/register :
Patricia Fels
,
Dirk W. Lachenmeier
,
Pascal Hindelang
,
Stephan G. Walch
,
Birgit Gutsche
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Update Date: 19 Oct 2023
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