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Allergic Reaction to Pigments and Metals

Body Art from the Allergist's Point of View

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Book cover Dermatologic Complications with Body Art

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Core Messages

  • › Complications after piercing are frequent. About every sixth person who has received a new piercing will suffer from health disturbances on the site of the piercing. Nickel allergy is still the most common cause of contact allergy in Europe and the predominant reason for allergic reactions to piercings.

  • › Tattoo colors consist of (inorganic) pigments and (mostly organic) dyes, or both. Allergic reactions have been observed in the form of Type I, III, and IV reactions, according to Coombs and Gell classification. The most problematic colors are red and black. Tattoo reactions are not infrequent, occurring at an estimated incidence of over 150/100,000 new tattoos.

  • › Steroids, laser therapy, and excision are the backbone of treatment for allergic reactions to tattoos and permanent make-up. Laser treatment itself may evoke additional reactions. No person with atopic history or immunologic disorders should acquire a tattoo, nor should children and adolescents.

  • › Temporary tattoos, presented as “henna” paint-on motives, often contain illegally high amounts of paraphenylenediamine (PPD). Allergic reactions to PPD are not rare and frequently cause persisting pigmentation disorders; transferable picture tattoos must be rated alike. Health education for parents of especially younger children is urgently needed. › Tattoo stickers cause little problems with respect to allergy, but can irritate the skin due to occlusion.

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Authors and Affiliations

  1. Department of Dermatology and Environmental Dermatology, Medical University of Graz, Auenbruggerplatz, Graz, 8, 8010, Austria

    Werner Aberer & Ulf-Maria Render

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  1. Werner Aberer
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  2. Johan E. Snauwaert
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  3. Ulf-Maria Render
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Editors and Affiliations

  1. Department of Dermatology AZ Sint-Jan, Ruddershove 10, Brugge, 8000, Belgium

    Christa De Cuyper

  2. Pontificia Universidad Católica de Chile, Department of Dermatology Clinica Las Condes, Lo Fontecilla, Santiago, 441, Chile

    Maria Luisa Pérez-Cotapos S

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Aberer, W., Snauwaert, J.E., Render, UM. (2009). Allergic Reaction to Pigments and Metals. In: Cuyper, C.D., Pérez-Cotapos S, M.L. (eds) Dermatologic Complications with Body Art. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-03292-9_6

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