Tattoos and Psoriasis

Overview

Many people choose to get a tattoo to express something about themselves or showcase a form of body art. Aside from these factors, there isn’t much to consider about the procedure.

However, the story is different for people with psoriasis as they need to take into account additional factors.

For instance, psoriasis will limit the choices on where to get the tattoo and how challenging it’s going to be.

Additionally, psoriatic patients are susceptible to developing a reaction known as the Koebner phenomenon*, during which psoriasis gets worse.

Note that psoriasis is highly variable, and each patient responds differently to the triggers; therefore, your doctor may find it challenging to foresee tattoo-induced complications.

 

In this article, we will cover the potential factors that a person with psoriasis should consider before deciding to get a tattoo.

 

What to consider before getting a tattoo?

The most important factors (for people with psoriasis) to keep in mind before getting a tattoo include:

 

The location of the tattoo

 

As you may know, psoriasis presents with several scale-like patches and plaques that affect the skin differently from one person to another.

Despite the high predilection of these lesions to the folds of the body (e.g., joints), psoriasis can affect any part of your skin.

For this reason, try to get the tattoo in an area of the skin that’s not usually affected by psoriasis and other skin conditions. Unfortunately, the mere fact of getting a tattoo can trigger a local flareup, with varying incidences.

Note that experts advise against getting the tattoo in an area that undergoes a rapid skin cell turnover, which occurs in psoriasis. The reason is simple; the plaques that form in the epidermis make it difficult to visualize the tattoo.

 

Infection and allergy

 

Similar to other invasive procedures, getting a tattoo can precipitate infectious or allergic processes.

This usually happens when the needle penetrates the deeper layers of the skin, introducing bacteria and other germs.

If high standards of hygiene are taken before getting the tattoo, the risk of infections drops sharply. However, the process still involves injecting a chemical dye to the skin, which could potentially trigger an allergic reaction.

 

In rare cases, these reactions are extremely severe, requiring the removal of the tattoo.

 

Possibility of refusal

 

Some tattoo artists have strict policies about giving a tattoo to a person with an active inflammatory skin condition. In fact, a group of artists refuses to tattoo individuals even if their skin condition is dormant (i.e., not active).

With that being said, you may need to wait for a couple of weeks/months before your psoriasis clears out to allow the tattoo artist to do his/her job.

Moreover, some states in the U.S. prohibit tattooing people with psoriasis and eczema. These include Louisiana, Oregon, and South Carolina.

 

What is the Koebner phenomenon?

 

As mentioned above, the Koebner phenomenon refers to the triggering of psoriatic changes after undergoing an injury to a healthy part of the skin.

The triggers of this phenomenon vary, as they can result from simple scratches, trauma, or tattoos.

The typical presentation occurs when a person with psoriasis chooses an area that’s never been affected by this condition. However, once the tattoo gets done, that area experiences a psoriatic flareup.

According to a 2013 paper published in the Canadian Medical Association Journal (CMAJ)**, researchers states that up to 25% of people with psoriasis develop the Koebner phenomenon after being subject to a skin injury (e.g., tattoo).

In general, the flareup induced by the Koebner phenomenon remains local.

Unfortunately, researchers have yet to fully understand this phenomenon, which makes it extremely difficult to predict.

The treatment of the skin changes that occur because of the Koebner phenomenon is usually similar to how you’d treat other forms of psoriasis. However, all people with psoriasis should be aware of this risk before deciding to get a tattoo.

 

Safety measures and risks

 

While psoriasis increases the risk of some tattoo-induced flareups, people should also consider other potential risks, including:

 

Contamination

 

This mainly occurs if the tattoo artist doesn’t pay attention to the strict rules of sanitizing the tools and needles.

As a result, the risk of transmitting debilitating infectious diseases, such as HIV and hepatitis B/C, increases.

 

Infections

 

Bacterial infections often take place when there is a skin injury without proper care. The signs and symptoms of a skin infection include:

• Fever
• Chills
• Rubor (i.e., redness)
• Dolor (i.e., pain)
• Calor (i.e., warmth)
• Tumor (i.e., swelling)

Choose the right tattoo artist

As you’ve seen throughout the article, the skills, experience, and attention to hygiene policies are crucial elements to look for in a tattoo artist.

Therefore, try to get tattooed by a licensed artist, as he/she is more likely to be more professional. Additionally, make sure the ink is approved for tattoos and check the expiration date.

Do not be shy to ask the studio about their sanitization processes and how they disinfect their tools before reusing them.

Finally, inform the tattoo artist about your psoriasis even if it’s dormant at the time. This will help him/her be more careful during the procedure, which reduces the risk of tattoo-induced flareups and skin infections.

 

Takeaway message

 

Getting a tattoo while dealing with psoriasis can be tricky, especially in active areas of inflammation. However, and even when choosing an inflammation-free region, there is still a risk of developing the Koebner phenomenon, which leads to psoriatic flareups.

 

Here you can read more about how you can relive the symptoms of your psoriasis: https://itsitchy.com/how-you-can-strengthen-your-immune-system-to-relieve-your-psoriasis/

*https://www.dermnetnz.org/topics/the-koebner-phenomenon/

**https://www.cmaj.ca/content/185/7/585

Written by Zac Hyde M.D.