You want a tattoo—but you have psoriasis. Is it safe? There are some special considerations and risks. However, with proper planning and precautions, it is possible.
Understanding the risks
The biggest risk in getting a tattoo when you have psoriasis is the Koebner phenomenon. This is when psoriasis plaques occur at the site of a trauma to the skin. About 25 percent of people with psoriasis experience this as a result of a cut, injection, insect bite, sunburn, or other trauma to the skin according to a report in CMAJ. For the majority of people with psoriasis, a tattoo will not be the cause of increased psoriasis plaques.
Another risk of getting a tattoo is the increased chance of infection. Some people with psoriasis take immunosuppressant medications, increasing the risk of infection because the immune system is weakened and unable to fight off bacteria and viruses. But even those who don’t take these medications are more prone to developing infections. A study published in 2011 found that the rise in the level of infections in those with psoriasis was independent of whether immunosuppressant medications were used.
An analysis published in the March 2016 issue of Dermatology and Therapy reviewed 18 studies and concluded that the red ink used in some tattoos can cause negative skin reactions. Allergic reactions to both black and red ink can also be triggered by sun exposure, according to a Danish study included in the analysis. (All of the research examined in the analysis focused on the general public, not specifically on people with psoriasis.)
It’s important to know your triggers. If you have experienced the Koebner phenomenon in the past, you have more of a chance of it occurring again. While some people decide it is worth the risk and treat the plaques immediately, others decide that the risk of developing psoriasis plaques on the area of the tattoo is not worth it and decide to forego a tattoo.
You should avoid getting a tattoo in the midst of a flare. This can aggravate your psoriasis and even if you haven’t experienced Koebner phenomenon in the past, this might increase the risk of it occurring. Some states have laws regarding getting a tattoo when you have a skin condition; for example, in Louisiana the law states that you can’t get a tattoo if there is evidence of psoriasis or eczema in the area of the tattoo.
Some medications might prevent you from getting a tattoo. Topical steroids thin the skin, which can lead to excessive bruising and tearing of the skin making getting a tattoo painful. Blood thinners could cause you to bleed more than normal and retinoids can cause excessive scarring. Before getting a tattoo, talk to your doctor about how your medications might interfere with the process.
Some people with psoriasis and other skin conditions opt to start small. This gives them the chance to see how their body reacts. For many people with psoriasis, getting a tattoo doesn’t cause any additional problems. The National Psoriasis Foundation has a tattoo gallery to give you ideas on what other people with psoriasis have chosen.
Choosing a tattoo shop
It’s important to prepare before getting a tattoo. Always make sure you are choosing a reputable tattoo parlor. Verify that the shop and all tattoo artists are properly licensed and have gone through any required training for your state and locality. Look around to make sure the shop looks clean. Some questions you can ask include:
- Do all artists wear gloves when giving a tattoo?
- Have tattoo artists completed a course in blood-borne pathogens?
- Are the inks poured into a container and used for only one person?
- Are fresh needles used for each individual?
- Are all instruments sterilized properly after each use?
After getting your tattoo
Discuss the proper care of a tattoo with the artist before you leave the shop. You should also receive a written sheet of instructions. Make sure to always follow instructions for caring for a tattoo and continue with the care until it is completely healed.
While your tattoo is healing, it will swell and be itchy. But if you notice redness, oozing or excessive swelling, contact your doctor immediately as these are possible signs of infection. If you notice plaques at the site of the tattoo, call your doctor for immediate treatment.Plaques caused by the Koebner phenomenon should be treated the same as any other psoriasis plaque.