Studies find harmful bacteria in commercial tattoo inks and reveal risks vs. rewards with permanent makeup

08 Jul 2024 --- FDA researchers in the US say they are the first to investigate and find anaerobic and aerobic bacteria in commercial tattoo and permanent makeup inks, while another paper outlines key considerations for permanent makeup.

“Unopened and sealed tattoo inks can harbor anaerobic bacteria, known to thrive in low-oxygen environments like the dermal layer of the skin, alongside aerobic bacteria,” says Dr. Seong-Jae Kim, a microbiologist with the Division of Microbiology, National Center for Toxicological Research at the FDA.

“It suggests that contaminated tattoo inks could be a source of infection from both types of bacteria. The results emphasize the importance of monitoring these products for aerobic and anaerobic bacteria, including possibly pathogenic microorganisms.”

The study in Applied and Environmental Microbiology tested 75 tattoo inks from 14 manufacturers and found anaerobic aerobic bacteria in approximately 35% of the products. 

“Among the 34 bacterial isolates, 19 were identified as possibly pathogenic bacterial strains. Two species, namely Cutibacterium acnes (four strains) and Staphylococcus epidermidis (two strains), were isolated under anaerobic conditions. Two possibly pathogenic bacterial strains, Staphylococcus saprophyticus and C. acnes, were isolated from the same ink samples,” details the study.

Kim notes: “There was no clear link between a product label claiming sterility and the actual absence of bacterial contamination.”

Ensuring tattoo ink safety
Kim believes growing popularity of tattooing coincides with an increase in related complications, including infections, “inflammatory reactions, allergic hypersensitivity and toxic responses.”

“In light of our study results, we emphasize the importance of continuously monitoring these products to ensure the microbial safety of tattoo inks,” he adds.

The research team at the American Society for Microbiology promises to develop more efficient microbial detection methods for tattoo inks and deepen the understanding of microbial contamination to prevent ink tainting.

Researchers found aerobic and anaerobic bacteria in commercial tattoo inks, posing potential infection risks.Permanent makeup risks and rewards
A study in the Journal of the American Academy of Dermatology provides insights into permanent makeup and potential risks amid popular procedures for enhancing facial features and concealing medical conditions.

The study notes that permanent makeup, applied to facial areas differently than traditional tattoos, is increasingly used for procedures like eyebrow coloring and lip and eyeliner. 

Permanent makeup can hide alopecia, birthmarks and surgical scars and is used for nipple-areola reconstruction post-breast surgery.

“We often think about permanent makeup being used to enhance a person’s lips or eyebrows,” says Walter Liszewski, MD, FAAD, assistant professor of dermatology and preventative medicine at Northwestern Feinberg School of Medicine and co-author of the study. 

“However, for people with conditions like vitiligo or alopecia, permanent makeup can be transformative. It can be used as a tool to restore confidence and empower these patients to find a sense of renewed self-assurance with cosmetic results that current medications can’t deliver.” 

Additionally, permanent makeup is beneficial for individuals with conditions that hinder conventional makeup application, such as arthritis or tremors. However, Dr. Liszewski advises, “It is important to consult with a board-certified dermatologist to discuss the types of results you wish to achieve and whether there may be potential complications due to skin allergens.”

Permanent makeup offers non-pharmaceutical options for boosting confidence in patients with vitiligo and alopecia.Seek professional advice
Although there are many advantages, it is crucial to choose a certified expert to reduce risks and establish reasonable expectations. Dr. Liszewski emphasized that certain dermatologists provide permanent makeup services and can also suggest reputable artists.

Common complications include unrealistic expectations, poor ink application and dissatisfaction with the outcome. 

Furthermore, the COVID-19 pandemic is noted to result in an increase in infectious and allergic reactions, which can be attributed to increased demand. Other potential problems include bacterial and fungal infections, blood-borne illnesses and allergic reactions to tattoo ink. Cosmetic procedures like fillers or botulinum toxin injections may also distort permanent makeup.

Research warns during the tattooing process, diseases such as HIV and hepatitis C can be transmitted, especially in non-sterile environments. Eyeliner tattoos can cause burning and swelling during an MRI scan. To address these risks, proper hygiene and aftercare are vital. 

Dr. Liszewski observed that the lack of uniform training or regulatory guidelines for permanent makeup artists in the US complicates the selection process. Regulations vary widely, with some states requiring extensive training and others none.

Due to regulatory inconsistencies, the American Academy of Dermatology advises considering factors when choosing a permanent makeup professional:

• Adequate training in sanitation, sterilization, skin anatomy, common infections, universal precautions, medical waste disposal and wound care.
• Recording pigment details and reporting adverse reactions to health authorities.
• Regular inspections and operating permits for tattoo facilities.
• Use medical-grade gloves, proper instrument sterilization and adherence to Centers for Disease Control and Prevention guidelines.
• Providing skin care instructions and advice on recognizing complications.
• Compliance with Occupational Safety and Health Administration regulations related to blood-borne pathogens.

Dr. Liszewski advises those getting permanent makeup to wash their hands before touching healing tattoos, use fragrance-free products and contact their artist and a dermatologist if infection symptoms appear.

By Venya Patel