Skip to main content

Cosmetic and Medical Applications of Tattooing

  • Chapter
  • First Online:
Dermatologic Complications with Body Art

Abstract

Cosmetic tattoos, also known as permanent Make-Up (PMU), have become mainstream and part of fashion in recent decades. Medical complications including infections and allergy are rare but can occur. Dissatisfaction and regret resulting from a poor aesthetic outcome are reasons to seek medical advice. Removal techniques also have their risks of side effects. Medical alert tattoos are a growing phenomenon. Tattoo devices can also be used for medical indications such as scar corrections and intradermal application of pharmacologic substances.

All these procedures should be performed by trained professionals, with sterile materials and in hygienic conditions.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.00
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Scheinfeld N (2007) Tattoos and religion. Clin Dermatol 25:362–366

    Article  PubMed  Google Scholar 

  2. Sperry K (1991) Tattoos and tattooing. Part I: history and methodology. Am J Forensic Med Pathol 12:313–319

    Article  CAS  PubMed  Google Scholar 

  3. Kosut M (2015) Tattoos and body modification. In: Wright JD (ed) International encyclopedia of the social & behavioral sciences, vol 24, 2nd edn. Elsevier, Amsterdam, pp 32–38. https://doi.org/10.1016/B978-0-08-097086-8.64027-8

    Chapter  Google Scholar 

  4. Angres G (1984) Eyeliner implants: a new cosmetic procedure. Plast Reconstr Surg 73:833–836

    Article  CAS  PubMed  Google Scholar 

  5. van der Velden EM, den Dulk LD, Leenders H et al (1995) The decorated body of the man from Hauslabjoch. Preliminary results. In: Höpfel F, Platzer W, Spindler K (eds) Der Mann in Eis Band II. Springer, Berlin, pp 275–278

    Chapter  Google Scholar 

  6. Brown JB, Cannon B, Mc Dowell A (1946) Permanent pigment injection of capillary hemangiomata. Plast Reconstr Surg 1:106–107

    Article  CAS  Google Scholar 

  7. Wecker von L (1872) Das Tatowiren der Hornhaut. Arch Augenheilkunde 2:84–87

    Google Scholar 

  8. Ziegler SL (1922) Multicolor tattooing of the cornea. Trans Am Ophthalmol Soc 20:71–87

    PubMed  PubMed Central  CAS  Google Scholar 

  9. van der Velden EM, Sanderubun Kok JHC (1994) Dermatography as a modern treatment for coloring leucoma corneae. Cornea 13:349–353

    Article  Google Scholar 

  10. van der Velden EM, Drost BHIM (2000) Dermatography: 10 years of applications as adjuvant treatment after nipple and areola reconstruction. Am J Cosmet Surg 17:23–26

    Article  Google Scholar 

  11. Fahradi J, Maksvytyte GK, Schaefer DJ et al (2006) Reconstruction of the nipple-areola complex: an update. J Plast Reconstr Aesthet Surg 59:40–53

    Article  Google Scholar 

  12. van der Velden EM, Defrancq J, Ijselmuiden OE (2001) Review: dermatography: a review of 15 years of clinical applications in surgery. Int J Cosm Surgery Aesthetic Dermatol 3:151–159

    Article  Google Scholar 

  13. Drost BH, van de Langenberg R, Manusama OR et al (2017) Dermatography (medical tattooing) for scars and skin grafts in head and neck patients to improve appearance and quality of life. JAMA Facial Plast Surg 19(1):16–22

    Article  PubMed  Google Scholar 

  14. Vassileva S, Hristakieva E (2007) Medical applications of tattooing. Clin Dermatol 25:367–374

    Article  PubMed  Google Scholar 

  15. Boulart L, Mimoun M, Noel W et al (2017) Dealing with tattoos in plastic surgery. Complications and medical use. Ann Chir Plast Esthét 62:e23–e29

    Article  CAS  PubMed  Google Scholar 

  16. Lee HC, Eom JS, Kim EK et al (2017) Does the sequence of tattooing a nipple reconstruction affect nipple projection. Ann Plast Surg 79(5):430–432. https://doi.org/10.1097/SAP.0000000000001122

    Article  PubMed  CAS  Google Scholar 

  17. Spyropoulou GA, Fatah F (2009) Decorative tattooing for scar camouflage: patient innovation. J Plast Reconstr Aesthet Surg 62:e353–e355

    Article  CAS  PubMed  Google Scholar 

  18. Askin MP, Waye JD, Fiedler L et al (2002) Tattoo of colonic neoplasms in 113 patients with a new sterile carbon compound. Gastrointest Endosc 56:339–342

    Article  PubMed  Google Scholar 

  19. Sauntry JP, Knudtson KP (1958) A technique for marking the mucosa of the gastrointestinal tract after polypectomy. Cancer 11:607–610

    Article  CAS  PubMed  Google Scholar 

  20. Baluyot ST, Shumrick DA (1972) Pre-irradiation tattooing. Arch Otolaryngol 96:151–153

    Article  PubMed  Google Scholar 

  21. Washington C, Leaver D (1996) Principles and practice of radiation therapy: introduction to radiation therapy. Mosby, St. Louis

    Google Scholar 

  22. van der Velden EM, de Jong B, van der Walle HB (1993) Tattooing and its medical aspects. Int J Dermatol 32:381–384

    Article  PubMed  Google Scholar 

  23. Engel E, Vasold R, Santarelli F et al (2009) Tattooing of skin results in transportation and light-induced decomposition of tattoo pigments – a first quantification in vivo using a mouse model. Exp Dermatol. https://doi.org/10.1111/j.1600-0625.2009.00925.x

  24. Rosenkilde F (2015) Tattoo Machines, needles and utilities. In: Serup J, Kluger N, Bäumler W (eds) Tattooed skin and health. Current problems in dermatology, vol 48. Karger, Basel, pp 21–30

    Chapter  Google Scholar 

  25. Council of Europe (2008) CoE Res AP 2008 (1). Accessed 10 Aug 2017

    Google Scholar 

  26. Kluger N (2015) Epidemiology of tattoos in industrialized countries. In: Serup J, Kluger N, Bäumler W (eds) Tattooed skin and health. Current problems in dermatology, vol 48. Karger, Basel, pp 6–20

    Chapter  Google Scholar 

  27. Seité S, Deshayes P, Dréno B et al (2012) Interest of corrective makeup in the management of patients in dermatology. Clin Cosmet Investig Dermatol 5:123–128

    Article  PubMed  PubMed Central  Google Scholar 

  28. De Cuyper C (2008) Permanent makeup: indications and complications. Clin Dermatol 26:30–34

    Article  PubMed  Google Scholar 

  29. Kluger N, Koljonen V, Blatière V (2012) Les tatouages et la chirurgie dermatologique, plastique et viscérale. Ann Dermatol Venereol 139:369–374

    Article  CAS  PubMed  Google Scholar 

  30. De Cuyper C (2015) Complications of cosmetic tattoos. In: Serup J, Kluger N, Bäumler W (eds) Tattooed skin and health. Current problems in dermatology, vol 48. Karger, Basel, pp 61–70

    Chapter  Google Scholar 

  31. Singh A, Yadav S (2016) Microneedling: advances and widening horizons. Indian Dermatol Online J 7:244–254

    Article  PubMed  PubMed Central  Google Scholar 

  32. Asif M, Kanodia S, Singh K (2016) Combined autologous platelet-rich plasma with microneedling versus microneedling with distilled water in the treatment of atrophic acne scars: a concurrent split-face study. J Cosmet Dermatol 15:434–443

    Article  PubMed  Google Scholar 

  33. Xu Y, Renyan Ma R, Juliandri J et al (2017) Efficacy of functional microarray of microneedles combined with topical tranexamic acid for melasma. A randomized, self-controlled, split-face study. Medicine 96(19):e6897

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Algahmdi KM, Khurram H (2011) Successful treatment of periungual warts with diluted bleomycin using translesional multipuncture technique: a pilot prospective study. Dermatol Surg 37:486–492

    Article  CAS  Google Scholar 

  35. Arpey CJ (2011) Successful treatment of periungual warts with highly diluted bleomycin using a translesional multipuncture technique: a prospective pilot study. Dermatol Surg 37:493–494

    Article  CAS  PubMed  Google Scholar 

  36. Kruter L, Saggar V, Akhavan A et al (2015) Intralesional bleomycin for warts: patient satisfaction and treatment outcomes. J Cutan Med Surg 19(5):470–476

    Article  CAS  PubMed  Google Scholar 

  37. van der Velden EM, Jairath D, Kock JH et al (1984) Dermatografie als behandelings methode in verschillende medische disciplines. Ned Tijdschr Dermatol Venerol 4:11–214

    Google Scholar 

  38. van der Velden EM, Oostrom CAM, Roddi R et al (1995) Dermatography with penta-monogalloylglucose as a new treatment for removal of color pigments in the eyebrows. Am J Cosmet Surg 12:3–9

    Article  Google Scholar 

  39. Torezan L, Chaves SY, Niwa A et al (2013) A pilot split-face study comparing conventional methyl-aminolevulinate-photodynamic therapy (PDT) with microneedling-assisted PDT on actinically damaged skin. Dermatol Surg 39:1197–1201

    Article  CAS  PubMed  Google Scholar 

  40. Togsverd-Bo K, Haak CS, Thaysen-Petersen D et al (2012) Intensified photodynamic therapy of actinic keratoses with fractional CO2 laser: a randomized clinical trial. Br J Dermatol 166(6):1262–1269. https://doi.org/10.1111/j.1365-2133.2012.10893.x

    Article  PubMed  CAS  Google Scholar 

  41. Haak CS, Togsverd-Bo K, Thaysen-Petersen D et al (2015) Fractional laser-mediated photodynamic therapy of high-risk basal cell carcinomas—a randomized clinical trial. Br J Dermatol 172:215–222. https://doi.org/10.1111/bjd.13166

    Article  PubMed  CAS  Google Scholar 

  42. Lawn A, Bassi D (2008) An unusual resuscitation request. Resuscitation 78:5–6

    Article  PubMed  Google Scholar 

  43. Kluger N, Aldasouqi S (2013) A new purpose for tattoos: medical alert tattoos. Presse Med 42:134

    Article  PubMed  Google Scholar 

  44. Kluger N, Aldasouqi S (2013) The motivations and benefits of medical alert tattoos in patients with diabetes. Endocr Pract 19:373–376

    Article  PubMed  Google Scholar 

  45. Colberta SD, Brennan PA (2017) Tattoos: could they be used to advantage as a medical alert in oral and maxillofacial surgery? Br J Oral Maxillofac Surg 55:300–301

    Article  Google Scholar 

  46. Kluger N, De Cuyper C (2017) A practical guide about tattooing for patients with chronic skin disorders and other medical conditions. Am J Clin Dermatol. https://doi.org/10.1007/s40257-017-0326-5

  47. Kämäräinen A, Länkimäki S (2009) A tattooed consent for organ donation. Resuscitation 80:284–285

    Article  PubMed  Google Scholar 

  48. Mallon WK, Russel MA (1999) Clinical and forensic significance of tattoos? Top Emerg Med 21:21–29

    Google Scholar 

  49. Wenzel SM, Rittmann I, Landthaler M, Bäumler W (2013) Adverse reactions after tattooing: review of the literature and comparison to results of a survey. Dermatology 226:138–147

    Article  PubMed  Google Scholar 

  50. Laux P, Tralau T, Tentschert J et al (2016) A medical-toxicological view of tattooing. Lancet 387(10016):395–402

    Article  PubMed  Google Scholar 

  51. Serup W (2017) Atlas of illustrative tattoo complications. In: Serup J, Bäumler W (eds) Diagnosis and therapy of tattoo complications. Current problems in dermatology, vol 52. Karger, Basel, pp 139–230

    Chapter  Google Scholar 

  52. Ortiz AE, Alster TS (2012) Rising concern over cosmetic tattoos. Dermatol Surg 38:424–429

    Article  CAS  PubMed  Google Scholar 

  53. Straetemans M, Katz LM, Belson M (2007) Adverse reactions after permanent-makeup procedures. N Engl J Med 356:26

    Article  Google Scholar 

  54. Høgsberg T, Saunte DM, Froimodt-Møller N et al (2013) Microbial status and product labelling of 58 original tattoo inks. J Eur Acad Dermatol Venereol 27:73–80

    Article  PubMed  Google Scholar 

  55. Kennedy BS, Bedard B, Young M et al (2012) Outbreak of Mycobacterium chelonae infection associated with tattoo ink. N Engl J Med 367:1020–1024

    Article  CAS  PubMed  Google Scholar 

  56. Wollina U (2011) Nodular skin reactions in eyebrow permanent makeup: two case reports and an infection with Mycobacterium haemophilum. J Cosmet Dermatol 10:235–239

    Article  PubMed  Google Scholar 

  57. Guilieri S, Morisod B, Edney T et al (2011) Outbreak of Mycobacterium haemophilum infections after permanent makeup of the eyebrows. Clin Infect Dis 52:488–491

    Article  Google Scholar 

  58. Duke D, Urioste SS, Dover JS et al (1998) A reaction to a red lip cosmetic tattoo. J Am Acad Dermatol 39:488–490

    Article  CAS  PubMed  Google Scholar 

  59. Taafe A, Knight A, Marks R (1978) Lichenoid tattoo hypersensitivity. Br Med J 1(6113):616–618

    Article  Google Scholar 

  60. Turnbull K, Steinkruas V, Boer A (2008) Kontactallergie auf Permanent-Make up der Lippe. Kosmet Med 29:206–207

    Google Scholar 

  61. Jaeger C, Hartschuh W, Jappe U (2005) Sunlight-induced granulomatous reaction to permanent lip liner. Hautarzt 56:63–65

    Article  Google Scholar 

  62. Serup J, Hutton Carlsen K (2014) Patch test study of 90 patients with tattoo reactions: negative outcome of allergy patch tests to baseline batteries and culprit inks suggest allergen(s) are generated in the skin through haptenization. Contact Dermatitis 71:225–263

    Article  Google Scholar 

  63. Serup J (2017) From technique of tattooing biokinetics and toxicology of injected ink particles and chemicals. In: Serup J, Bäumler W (eds) Diagnosis and therapy of tattoo complications. Current problems in dermatology, vol 52. Karger, Basel, pp 1–17

    Chapter  Google Scholar 

  64. Wenzel SM, Welzel J, Hafner C et al (2010) Permanent make-up colorants may cause severe skin reactions. Contact Dermatitis 63:223–227

    Article  CAS  PubMed  Google Scholar 

  65. McFadden N, Lyberg T, Hensten-Pettersen A (1989) Aluminum-induced granulomas in a tattoo. J Am Acad Dermatol 20:903–908

    Article  CAS  PubMed  Google Scholar 

  66. Yang DS, Kim SC, Lee S et al (1989) Foreign body epithelioid granuloma after cosmetic eyebrow tattooing. Cutis 43:244–247

    PubMed  CAS  Google Scholar 

  67. Coors EA, Wessbecher R, Driesh VD (2004) Beastly nodules instead of beauty: pseudoepitheliomatous hyperplasia developing after application of permanent make-up. Br J Dermatol 150:1027

    Article  CAS  PubMed  Google Scholar 

  68. Yesudian PD, Azurdia RM (2004) Scar sarcoidosis following tattooing of the lips treated with mepacrine. Clin Exp Dermatol 29:552–553

    Article  CAS  PubMed  Google Scholar 

  69. Antonovich DD, Callen JP (2005) Development of sarcoidosis in cosmetic tattoos. Arch Dermatol 141:869–872

    Article  PubMed  Google Scholar 

  70. Baumgarter M, Feldmann R, Steiner A (2010) Sarcoidal granulomas in a cosmetic tattoo in association with pulmonary sarcoidosis. J Dtsch Dermatol Ges 9:900–902

    Google Scholar 

  71. Wollina U (2012) Severe adverse events related to tattooing: a retrospective analysis of 11 years. Indian J Dermatol 57(6):439–443

    Article  PubMed  PubMed Central  Google Scholar 

  72. Konuk O, Evereklioglu C, Handur A et al (2004) Protective eyeshield can prevent corneal trauma during micropigmentation for permanent eyeliner. J Eur Acad Dermatol 18:642–643

    Article  CAS  Google Scholar 

  73. Ratnapalan S, Greenberg M, Armstrong D (2004) Tattoos and MRI. AJR Am J Roentgenol 183:541

    Article  PubMed  Google Scholar 

  74. Tope WD, Shellock FG (2002) Magnetic resonance imaging and permanent cosmetics (tattoos): survey of complications and adverse events. J Magn Reson Imaging 15:180–184

    Article  PubMed  Google Scholar 

  75. Kluger N, Koljonen V (2012) Tattoos, inks, and cancer. Lancet Oncol 13:e161–e168

    Article  PubMed  Google Scholar 

  76. Ortiz A, Yamauchi PS (2009) Rapidly growing squamous cell carcinoma from permanent makeup tattoo. J Am Acad Dermatol 60:1073–1074

    Article  PubMed  Google Scholar 

  77. Lee IW, Ahn SK, Choi EH et al (2001) Complications of eyelash and eyebrow tattooing: reports of 2 cases of pigment fanning. Cutis 68:53–55

    PubMed  CAS  Google Scholar 

  78. Molinaro R (2017) Communication at the ESTP Congress Regensburg 2017 abstract 032

    Google Scholar 

  79. Chiang JK, Barsky S, Bronson DM (1999) Tretinoin in the removal of eyeliner tattoo. J Am Acad Dermatol 40:999–1001

    Article  CAS  PubMed  Google Scholar 

  80. Anderson RR, Geronimus R, Kilmer SL (1993) Cosmetic tattoo ink darkening. A complication of Q-switched and pulsed-laser treatment. Arch Dermatol 129(8):1010–1014

    Article  CAS  PubMed  Google Scholar 

  81. Chang SE, Kim KJ, Choi JH (2002) Areolar cosmetic tattoo ink darkening: a complication of alexandrite laser. Dermatol Surg 28(1):95–96

    PubMed  Google Scholar 

  82. Jimenez G, Weiss E, Spencer JM (2002) Multiple color changes following laser therapy of cosmetic tattoos. J Dermatol Surg 28(2):177–179

    Google Scholar 

  83. Mafong EA, Kauvar AN, Geronimus RG (2003) Surgical pearl: removal of cosmetic lip-liner tattoo with pulsed carbon dioxide laser. J Am Acad Dermatol 48:271–281

    Article  PubMed  Google Scholar 

  84. Fitzpatrick RE, Lupton JR (2000) Successful treatment of treatment resistant laser-induced pigment darkening of a cosmetic tattoo. Lasers Surg Med 27(4):358–361

    Article  CAS  PubMed  Google Scholar 

  85. Ibrahimi OA, Syed Z, Sakomoto FH et al (2011) Treatment of tattoo allergy with ablative fractional resurfacing: a novel paradigm for tattoo removal. J Am Acad Dermatol 66:111–114

    Google Scholar 

  86. Reddy KK, Brauer JA, Bernstein L et al (2013) Topical perfluorodecalin resolves immediate whitening reactions and allows rapid effective multiple pass treatment of tattoos. Lasers Surg Med 45(2):76–80

    Article  PubMed  Google Scholar 

  87. Bae YC, Alabdulrazzaq H, Brauer J et al (2016) Successful treatment of paradoxical darkening. Lasers Surg Med 48:471–473

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

  • Darline Vierstraete, the Color Studio, Waregem, Belgium

  • Joëlle Senden, Aalst, Belgium

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Christa De Cuyper M.D. .

Editor information

Editors and Affiliations

6.1 Electronic Supplementary Materials

Video 6.1

Microneedling of the surgical scar; procedure by Dr. Dubelloy; recording by Dr. De Cuyper (MP4 52193 kb)

Video 6.2

Nipple-areola-complex repigmentation with a rotary device; procedure by Dr. Dubelloy; recording by Dr. De Cuyper (MP4 193338 kb)

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Cuyper, C.D., Dubelloy, R. (2018). Cosmetic and Medical Applications of Tattooing. 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_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-77098-7_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-77097-0

  • Online ISBN: 978-3-319-77098-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics