The growing tattoo trend among many young Americans has led to a rash of new health concerns – literally. New research by the University of Rochester Medical Center has tied a growing number of skin rashes to tainted tattoo ink.
The study, published in the New England Journal of Medicine, documented 19 cases in Rochester – the largest ever reported – of tattoos infected with bacteria found in tap water. Researchers identified a premixed gray ink, typically used in portrait or photography tattoos, as the culprit.
Dr. Mary Gail Mercurio, a dermatologist who examined 18 of the 19 individuals infected, said the cases highlight a greater health risk than previously believed.
"I've seen people with tattoo-related issues over the years, but never this many: The volume of patients impacted makes this a real public health concern,” she said.
"Patients and doctors need to have a certain level of suspicion when they see a rash developing in a tattoo. Many of the patients I saw thought their skin was just irritated and the issue would go away during the healing process. In actuality, they had an infection that needed to be treated with an antibiotic; it wasn't going to go away easily on its own."
The outbreak, highlighted in the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report, was tracked to a single tattoo parlor and artist. Tests conducted at the Medical Center revealed that the bacteria, Mycobacterium chelonae, infected patients' skin and led to red, itchy bumps in their tattoos. Testing also showed a premixed gray ink, which the local artist had bought from a manufacturer in Arizona, contained the same bacteria and likely transmitted it to the skin.
The CDC issued a nationwide alert about the outbreak and the manufacturer voluntarily recalled the ink.
"This organism, M. chelonae, is found in some water supplies," said Dr. Robert F. Betts, an infectious disease expert at the Medical Center. "What probably happened is that the water used to dilute the ink introduced the bacteria into it and the trauma associated with getting the tattoo compromised the circulation to that area of the skin, allowing the organism to enter into the skin and grow."
Betts and Mercurio said tattoo-associated infections are probably common and that physicians should think about infectious causes if patients aren't responding to typical treatments for allergic reactions to a tattoo.