Abstract
Body art has become increasingly popular resulting in the rising occurrence of adverse reactions; some of them are related to the procedures; other side effects are caused by the chemical substances. Nickel allergy is the most common complication of body piercing. The composition of tattoo and permanent Make-Up inks is complex. Besides a variety of inorganic and organic colorants, they contain impurities resulting from the production process of the pigments and a wide range of auxiliary ingredients. In order to identify the harmful agents, it is essential to know the exact composition of the materials. There is still a lack of knowledge about the biokinetics and metabolism of these substances and their impact on human health. More in particular there is a lot of concern about the safety of the pigments because their degradation in the skin leads to the formation of hazardous decomposition products. Although much work has been done to improve ink quality and safety, more research and epidemiological surveys are required. There is still a need of uniform worldwide regulation on the procedures and materials.
This chapter will give an overview of materials used nowadays in the different forms of body art and new initiatives to reduce potential side effects.
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References
International Organization for Standardization. http://www.iso.org/iso/home.html. Accessed 12 Dec 2017
ASTM International, Standards Worldwide. http://www.astm.org/. Accessed 12 Dec 2017
https://echa.europa.eu/documents/10162/7851171d-53e9-455a-8bb8-7ca22e89ad87. Accessed 5 Nov 2017
https://en.wikipedia.org/wiki/Tygon_tubing. Accessed 12 Dec 2017
WHO Hand Hygiene. http://who.int.infection-prevention/en/. Accessed 8 Nov 2017
Gawkrodger DJ (1996) Nickel dermatitis: how much nickel is safe? Contact Dermatitis 35:267–271
Kaatz M (2001) A trend and its complications: piercing. Kosmetische Medizin 24:188–193
Lidén C, Norberg K (2005) Nickel on the Swedish market. Follow-up after implementation of the nickel directive. Contact Dermatitis 52:29–35
Garg S, Thyssen JP, Uter W et al (2013) Nickel allergy following European Union regulation in Denmark, Germany, Italy and the U.K. Br J Dermatol 169(4):854–858
Thyssen JP (2011) Nickel and cobalt allergy before and after nickel regulation – evaluation of a public health intervention. Contact Dermatitis 65(issue S1):1–68
Schnuch A, Schwitulla J (2013) Decrease in nickel allergy in women after the second EU nickel directive. Contact Dermatitis 69(4):253–256
Goldenberg A, Vassantachart J, Lin E et al (2015) Nickel allergy in US adults – a 53-year review of indexed cases. Dermatitis 26(5):216–223
www.nickelinstitute.org. Accessed 08 Nov 2017
Thyssen JP, Maibach HI (2008) Nickel release from earrings purchased in the United States: the San Francisco earring study. J Am Acad Dermatol 58(6):1000–1005
Purim KSM, Rosario BA, Rosario CS, Guimarães ATB (2014) Piercings in medical students and their effects on the skin. An Bras Dermatol 89(6):905–910
Thyssen JP, Skare L, Lundgren L et al (2010) Sensitivity and specificity of the nickel spot (dimethylglyoxime) test. Contact Dermatitis 62(5):279–288
Uter W, Schmid M, Schmidt O et al (2014) Cobalt release from earrings and piercing jewelry – analytical results of a German survey. Contact Dermatitis 70(6):369–375
Midander K, Julander A, Skare L et al (2013) The cobalt spot test–further insights into its performance and use. Contact Dermatitis 69(5):280–287
Bruze M, Hamada H, Dahlin J et al (2013) A positive cobalt spot test falsely indicating an occupational allergic contact dermatitis caused by cobalt. Contact Dermatitis 69(3):172–175
Characterisation of tattoo inks used in Australia. https://www.nicnas.gov.au/__data/assets/pdf_file/0006/42297/Tattoo-Ink-Report-23-August-2016.pdf
https://en.wikipedia.org/wiki/Federal_Food,_Drug,_and_Cosmetic_Act. Accessed 8 Nov 2017
EC, European Parliament and Council Regulation No 1907/2006 of 18 December 2006 concerning the Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH), establishing a European Chemicals Agency. OJ L 396, 30.12.2006: p. 1-849. http://eur-lex.europa.eu/legalcontent/
Katz L (2017) Communication at ECTP congress Regensburg 2017 abstract 07. www.ESTPesearch.org
EC, European Parliament and Council Regulation No 2001/95/EC on General Product Safety of 3 December 2001. OJ L 11, 15.1.2002,, 2001: p. 4-17. http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=celex%3A32001L0095
Papameletiou D, Schwela D, Zenie A et al (2003) Risks and health effects from tattoos, body piercing and related practices. In: Workshop on the technical/scientific and regulatory issues on the safety of tattoos, body piercing and related practices. European Commission, Ispra, pp 8–36
Res AP 2003 CoE Council of Europe, Resolution (2003)2 on tattoos and permanent make-up, pp 1–8. https://search.coe.int/cm/Pages/result_details.aspx?ObjectId=09000016805df8e
Res AP (2008)1. CoE Council of Europe, Resolution (2008)1 on requirements and criteria for the safety of tattoos and permanent make-up up (superseding Resolution ResAP (2003) 2 on tattoos and permanent make-up), 2008, pp 1–10. https://search.coe.int/cm/Pages/result_details.aspx?ObjectID=09000016805d3dc
Talberg HJ (2003) The question of positive or negative lists. In: Papameletiou D, Schwela D, Zenie A et al. Workshop on the technical/scientific and regulatory issues on the safety of tattoos, body piercing and related practices. European Commission, Ispra, pp 84–88
Cosmetics Directive 76/768/EEC has been replaced by the Regulation (EC) No.1223/2009 of the European Parliament and the Council of 30 November 2009 on cosmetic products
Directive 67/548/EEC is now superseded by the new regulation with CMR classification into categories 1A, 1B, and 2 (Regulation (EC) No. 1272/2008 of the European Parliament and of the Council of 16 December 2008 on classification, labelling and packaging of substances and mixtures amending and repealing Directives 67/548/EEC and 1999/45/EC, and amending Regulation (EC) No. 1907/2006)
Prior G (2015) Tattoo inks: legislation, pigments, metals and chemical analysis. Curr Probl Dermatol 48:152–157
Renzoni A et al (2015) Implementation of European Council Resolution Res AP (2008)1 in Italy. Curr Probl Dermatol 48:201–205
Piccinini P, et al. (2015) Safety of tattoos and permanent make-up. Compilation of information on legislative framework and analytical methods. JRC Report, EUR 27394 EN, pp 1–446. https://doi.org/10.2788/542617. http://bookshop.europa.eu/en/safety-of-tattoos-and-permanent-make-upcompilation-of-information-on-legislative-framework-and-analytical-methodspbLBNA27394/
Piccinini P et al (2015) Safety of tattoos and permanent make-up. State of play and trends in tattoo practices. JRC Report, EUR 27528 EN, 10.2788/924128, pp 1–193. http://bookshop.europa.eu/en/safety-of-tattoos-and-permanent-makeup-pbLBNA27528/
Piccinini P et al (2016) Safety of tattoos and permanent make-up – Adverse health effects and experience with the Council of Europe Resolution (2008)1, 2016: JRC Report, EUR 27672 EN. https://doi.org/10.2788/177900
Piccinini P et al (2016) Safety of tattoos and permanent make-up: final report JRC Report, EUR 27947 EN (2016). Available at: https://ec.europa.eu/jrc/en/publication/eur-scientific-and-technical-research-reports/safety-tattoos-and-permanent-make-final-report.
EDQMCoE (2017) Safer tattooing – Overview of current knowledge and challenges of toxicological assessment.pdf, https://www.edqm.eu/en/tattoos-and-permanent-make-up
Michel R (2015) Manufacturing of tattoo ink products today and in future: Europe. Curr Probl Dermatol 48:103–111
Prior G (2014) Tattoo inks: analysis, pigments, legislation. An introduction to tattoo inks, their analysis, pigments in use, their chemical classes, present legislation in Europe, problems arising from incomplete laws, quantification of pigments and metals in the skin. epubli GmbH, Berlin. ISBN 978-3-8442-8611-3
Serup J (2015) Seamless prevention of adverse events from tattooing: integrated strategy emphasising the customer-tattooist interaction. Curr Probl Dermatol 48:236–247
Worp J, Boonstra A, Coutinho RA et al (2006) Tattooing, permanent make-up and piercing in Amsterdam; guidelines, legislation and monitoring. Eur Surveill 11:1–6
Verdier C (2015) Surveillance of tattoo-related adverse events by the EU RAPEX system and by national monitoring. Curr Probl Dermatol 48:210–217
Miljøstyrelsen. Chemical Substances in Tattoo Ink 2012 [2017-07-26]. Available from: http://www2.mst.dk/udgiv/publications/2012/03/978-87-92779-87-8.pdf
Baumler W, Lundsgaard J, Talberg HJ, Vasold R (2003) Chemical composition of tattooing and permanent makeup products. In: Working paper of the TWG/JRC on the issue of tattooing and piercing, 2003, Joint Research Center (JRC), pp 1–75
Dirks M (2015) Making innovative tattoo ink products with improved safety: possible and impossible ingredients in practical usage. Curr Probl Dermatol 48:118–127
Høgsberg T, Loeschner K, Löf D et al (2011) Tattoo inks in general usage contain nanoparticles. Br J Dermatol 165:1210–1218
Høgsberg T, Jacobsen NR, Clausen PA et al (2013) Black tattoo inks induce reactive oxygen species production correlating with aggregation of pigment nanoparticles and product brand but not with the polycyclic aromatic hydrocarbon content. Exp Dermatol 22(7):464–469
Sepheri M, Hutton Carlsen K, Serup J (2016) Papulo-nodular reactions in black tattoos as markers of sarcoidosis: study of 92 tattoo reactions from a hospital material. Dermatology 232:679–686. https://doi.org/10.1159/000453315
Laux P, Tralau T, Tentschert J et al (2016) A medical-toxicological view of tattooing. Lancet 387:395–402
Beute TC et al (2008) In vitro spectral analysis of tattoo pigments. Dermatol Surg 34:508–515
Forte G et al (2009) Market survey on toxic metals contained in tattoo inks. Sci Total Environ 407:5997–6002
De Cuyper C, D’hollander D (2010) Materials used in body art. In: De Cuyper C, Perez-Cotapos ML (eds) Dermatologic complications with body art, tattoos, piercings and permanent make-up. Springer, Heidelberg, pp 13–28
Lehner K et al (2014) Black tattoos entail substantial uptake of genotoxicpolycyclic aromatic hydrocarbons (PAH) in human skin and regional lymph nodes. PLoS One 9(3):e92787
Schreiver I, Hesse B, Seim C (2017) Synchrotron-based ν-XRF mapping and μ-FTIR microscopy enable to look into the fate and effects of tattoo pigments in human skin. Nat Sci Rep 7:11395. https://doi.org/10.1038/s41598-017-11721-z
De Cuyper C, Lodewick E, Schreiver I et al (2017) Are metals involved in tattoo related hypersensitivity reactions? Case report. Contact Dermatitis 30:683–690
Schneider J (2016) Development of an experimental set-up for the in vitro determination of selected photodegradation products from irradiated tattoo pigments (German). Thesis, University of Basel, Basel
Regensburger J et al (2010) Tattoo inks contain polycyclic aromatic hydrocarbons that additionally generate deleterious singlet oxygen. Exp Dermatol 19(8):e275–e281
Petersen H, Lewe D (2015) Chemical purity and toxicology of pigments used in tattoo inks. Curr Probl Dermatol 48:136–141
Hauri U (2011) Inks for tattoos and PMU (permanent make-up)/organic pigments, preservatives and impurities such as primary aromatic amines and nitrosamines. Available from: www.kantonslabor.bs.ch/dam/jcr:ba246390-48da-406f-aa4e-9e1b24726a31/JB_Tattoo_PMU_2011_EN.pdf+&cd=2&hl=de&ct=clnk&gl=de
Engel E, Santarelli F, Vassold R et al (2008) Modern tattoos cause high concentrations of hazardous pigments in skin. Contact Dermatitis 58(4):228.33
Cui Y, Spann AP, Couch LH et al (2004) Photodecomposition of pigment Yellow 74, a pigment used in tattoo inks. Photochem Photobiol 80:175–184
Hauri U, Hohl C (2015) Photostability and breakdown products of pigments currently used in tattoo inks. Curr Probl Dermatol 48:164–169
Sabbioni G, Hauri U (2016) Carcinogenic tattoos. Epidemiol Biostat Public Health 13(4). https://doi.org/10.2427/12018
Engel E, Vasold R, Santarelli F, Maisch T, Gopee NV, Howard PC et al (2010) Tattooing of skin results in transportation and light-induced decomposition of tattoo pigments–a first quantification in vivo using a mouse model. Exp Dermatol 19(1):54–60
Jemec GB (2010) (2010) Comment on: Tattooing of skin results in transportation and light-induced decomposition of tattoo pigments. Exp Dermatol 19(1):61–62
Engel E, Spannberger A, Vasold R et al (2007) Photochemical cleavage of tattoo pigment by UV radiation or natural sunlight. J Dtsch Dermatol Ges 5:583–589
Gaugler S (2011) Analysis of bioactive compounds in tattoo inks before and after irradiation with sunlight using HPTLC and In Situ Detection with Vibrio fischeri, 2011. Thesis, University of Hohenheim, Stuttgart
Wezel K (2013) Untersuchung des Verhaltens von Tätowiertinten und Pigmenten unter Lichteinfluss, 2013. Thesis, University of Giessen
Anderson RR, Parish JA (1983) Selective photothermolysis; precise microsurgery by selective absorption of pulsed radiation. Science 220:524–527
Baeumler W (2003) Possible risks of tattoo removal using laser therapy. In: Papameletiou D, Schwela D, Zenie A et al (eds) Workshop on the technical/scientific and regulatory issues on the safety of tattoos, body piercing and related practices. European Commission, Ispra, pp 66–69
Bäumler W, Eibler ET, Hohenleutner U et al (2000) Q-switch laser and tattoo pigments: first results of the chemical and photophysical analysis of 41 compounds. Lasers Surg Med 26(1):13–21
Bäumler W (2009) Laser therapy of tattoos. Kosm Medizin 30:8–11
Vasold R, Naarmann N, Ulrich H et al (2004) Tattoo pigments are cleaved by laser light-the chemical analysis in vitro provide evidence for hazardous compounds. Photochem Photobiol 80(2):185–190
Anderson RR, Geronimus R, Kilmer SL et al (1993) Cosmetic tattoo ink darkening. A complication of Q-Switched and pulsed-laser treatment. Arch Dermatol 129:1010–1014
Ross EV, Yashar S, Michaud N et al (2001) Tattoo darkening and nonresponse after laser treatment: a possible role for titanium dioxide. Arch Dermatol 137:33–37
Timko AL, Miller CH, Johnson FB et al (2001) In vitro quantitative chemical analysis of tattoo pigments. Arch Dermatol 137:143–147
Kim JW, Lee JW, Won YH et al (2006) Titanium, a major constituent of blue ink, causes resistance to Nd-YAG (1064 nm) laser: results of animal experiments. Acta Derm Venereol 86:110–113
Armstrong ML, Roberts AE, Koch JR et al (2008) Motivation for contemporary tattoo removal: a shift in identity. Arch Dermatol 144:879–884
Wu C (2007) Disappearing ink: Tattoo technology for modern impermanence. Sci News 172:232–234
Klitzman B, Koger KE (2000) Tattoo inks. Option Technologies, Durham
Mathiowitz E et al (1981) Photochemical rupture of capsules. J Appl Polym Sci 26:809–822
Peyratout CS, Dähne L (2004) Tailor-made polyelectrolyte microcapsules: from multilayers to smart containers. Angew Chem Int Ed 43:3762–3783
Dähne L, Schneider J, Lewe D, Petersen H (2015) Tailored surface engineering of pigments by Layer-by-Layer coating. Curr Probl Dermatol 48:128–135
Bandodkar AJ, Jia W, Ramírez J, Wang J (2015) Biocompatible enzymatic roller pens for direct writing of biocatalytic materials: “do-it-yourself” electrochemical biosensors. Adv Healthcare Mater 8:1215–1225. https://doi.org/10.1002/adhm.201400808
Agnello M, Fontana M (2015) Survey on European studies of the chemical characterisation of tattoo ink products and the measurement of potentially harmful ingredients. Curr Probl Dermatol 48:142–151
Hauri (2014) Results from the National Market Surveillance Study of the Association of the Cantonal Chemists of Switzerland (VKCS) 2014, Main laboratory: Basel-City: inks for tattooing and permanent make-up/pigments, preservatives, aromatic amines, polyaromatic hydrocarbons and nitrosamines. http://www.kantonslabor.bs.ch/dam/jcr:d12e5456-c71d-4e59-8f29-4a7d8c38d15d/Tattoo_PMU_2014_EN(UK).pdf
Hohl C, Hauri U (2016) Chemical analysis: an indispensable means for uncovering severe cases of fraud with cosmetics and tattoo inks. Chimia (Aarau) 70(5):357–359
Aberer W, Snauwaert JE, Render U-M (2010) Allergic reaction to pigments and metals. In: De Cuyper C, Perez-Cotapos ML (eds) Dermatologic complications with body art, tattoos, piercings and permanent make-up. Springer, Heidelberg, pp 61–89
Serup J (2017) Distribution of tattoo pigments to lymph nodes and liver: studies in mice. ECTP congress Regensburg 2017 Abstract 016 at www.ESTPresearch.org
Sepehri M, Sejersen T, Qvortrup K, Lerche CM, Serup J (2017) Tattoo pigments are observed in the Kupffer cells of the liver indicating blood-borne distribution of tattoo ink. Dermatology 233(1):86–93. https://doi.org/10.1159/000468149. Epub 2017 May 10
Baumler W (2015) Absorption, distribution, metabolism and excretion of tattoo colorants and ingredients in mouse and man: the known and the unknown. Curr Probl Dermatol 48:176–184
Lehner K et al (2011) The decrease of pigment concentration in red tattooed skin years after tattooing. J Eur Acad Dermatol Venereol 25:1340–1345
Cui Y, Churchwell MI, Couch LH, Doerge DR, Howard PC (2005) Metabolism of pigment yellow 74 by rat and human microsomal proteins. Drug Metab Dispos 33(10):1459–1465
Platzek T et al (1999) Formation of a carcinogenic aromatic amine from an azo dye by human skin bacteria in vitro. Hum Exp Toxicol 18(9):552–559
Ortiz AE, Avram MM (2013) Redistribution of ink after laser tattoo removal. Dermatol Surg 38:1730–1731
Zelickson BD, Mehregan DA, Zarrin AA et al (1994) Clinical, histologic, and ultrastructural evaluation of tattoos treated with three laser systems. Lasers Surg Med 15:36–72
Hutton Carlsen K, Kocks M, Sepehri M, Serup J (2016) Allergic reactions in red tattoos: Raman spectroscopy for ‘fingerprint’ detection of chemical risk spectra in tattooed skin and culprit tattoo inks. Skin Res Technol 22(4):460–469
Gaudron S, Ferrier-Le Bouedec MC, Franck F, D’Incan M (2015) Azo pigments and quinacridones induce delayed hypersensitivity in red tattoos. Contact Dermatitis 72(2):97–105
Schreiver I, Hutzler C, Andree S, Laux P, Luch A (2016) Identification and hazard prediction of tattoo pigments by means of pyrolysis-gas chromatography/mass spectrometry. Arch Toxicol 90(7):1639–1650
Kluger N, Koljonen V (2012) Tattoos, inks, and cancer. Lancet Oncol 13(4):e161–e168
Paradisi A, Capizzi R, De Simonne C et al (2006) Malignant melanoma in a tattoo: case report and review of the literature. Melanoma Res 16:375–376
Blume A, Platzek T, Vieth B, Hutzler C, Luch A (2015) Towards the limiting of health risks associated with tattooing: whitelists for tattoo pigments and preservatives. Curr Probl Dermatol 48:185–189
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De Cuyper, C., D’hollander, D. (2018). Materials Used in Body Art. In: De Cuyper, C., Pérez-Cotapos S, M. (eds) Dermatologic Complications with Body Art. Springer, Cham. https://doi.org/10.1007/978-3-319-77098-7_2
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