Tattoos and permanent make-up

There are several types of tattoos and make-up available, including some that are permanent and others that are temporary. 

• Permanent tattoo: A needle inserts coloured ink into your skin. Permanent tattoos last a lifetime.
• Permanent makeup: This is a type of permanent tattoo. A needle inserts coloured ink into your skin to look like eyeliner, lip liner, eyebrows or other make-up.
• Henna: Plant dye called henna or mehndi is used to stain your skin. A henna tattoo lasts from 3 days up to a few weeks.
• Black henna: This type of tattoo may or may not contain henna and may contain hair dye or other dye to make it darker and longer lasting.
• Decal temporary tattoos: Some decal tattoos have a backing that is removed with water when applying the design directly to your skin. Others have a backing that sticks to your skin. Decal tattoos may last for a day or up to a week or more.

For the most part, getting a tattoo is safe, but tattoos can have health risks, some of which can be ongoing. Tattoo risks include:

• infections and serious illness from unclean tattoo tools, practices or products
• allergic reactions to the inks or stains, such as rashes
• other skin problems, like increased chance of sunburn
• swelling and burning of some permanent tattoos when you get an MRI test.

Any tattoo means that the surface of your skin has been broken (like having a small operation) and the broken skin needs to heal. After getting a tattoo, it’s normal to see some redness and swelling. Your skin will feel sore, and you may see clear fluid oozing from your new tattoo. As your skin heals, it can itch and flake. Scabs may form. All of this can be part of the normal healing process.

Signs of an infection

An infection can happen immediately after getting inked, or days or months later. If an infection develops, your skin reacts a bit differently. You may notice one or more of the following:

• redness becomes darker or spreads instead of lightening and diminishing
• pain continues or worsens instead of subsiding
• a rash of itchy, red and painful bumps within the tattoo
• fever, chills and shivering
• pus in the tattoo
• open sore(s) in the tattoo.

If you have any signs or symptoms of an infection, see your doctor right away. The sooner treatment is started, the less damage it can do to your health and your tattoo.

Read more about skin infections. 

Some people may get allergic reactions to the inks or stains, which cause skin problems such as rashes and swelling. You can develop an allergic reaction at any time. It can happen immediately or weeks or years later.   

• Red tattoo pigments cause the most reactions, particularly those made from mercury sulfide (cinnabar). Hypersensitivity reactions to pigments used to make black, blue, purple and green tattoos are much less common.
• Allergic reactions can also occur with henna tattoos. Henna itself should be safe, but the dye is often mixed with paraphenylenediamine (PPD), a chemical substance that is well known for causing allergic reactions in people sensitive to it. In this case, the dye is black in colour, so-called black henna.
• Some reactions may only happen when the tattoo is exposed to sunlight. This is most common with yellow tattoos created from cadmium sulfide but can also occur in red tattoos, as trace amounts of cadmium are added to brighten red tattoo pigment.

Read more about dermatitis.

Hepatitis is a viral infection that causes inflammation of your liver. The hepatitis B and C viruses are carried in blood and can only be passed to someone through blood-to-blood contact. This happens when the blood of an infected person enters the bloodstream of an uninfected person. The most common way this occurs is through sharing needles. If you are not careful about how and where you get your tattoo, you can become infected.

Take precautions to prevent hepatitis  

• Find a licensed, safe and clean place to get your tattoo. 
• The tattoo artist should wear gloves and use new needles and fresh ink for each customer.
• Make sure that all equipment being used has been sterilised. This is not the same as just cleaning the equipment with hot water or alcohol. Everything being used should be in its own separate package.
• Getting a tattoo from an unlicensed person who has used the same needles or ink on more than one person puts you at more risk for hepatitis B and C infection.

Read more about hepatitis C.

While rare, a few people have developed a burn on tattooed skin during an MRI scan. These are mostly mild, but a few serious burns have been reported. If you have a tattoo or permanent makeup, you can still get an MRI. Tell the technician who is giving you the MRI that you have tattooed skin or permanent make-up and ask them to stop the MRI if you feel burning or stinging in that area. Read more about MRI scan.

The operator who does your tattoo should give you after-care advice, preferably written. Follow their instructions carefully. While the tattoo heals, you are still at risk of infection, scarring or disfigurement. Tattoo care includes keeping it out of water (apart from gentle washing) and out of sunlight while it heals. It will take up to 2 weeks for your skin to heal. You can reduce the risk of infection by not touching the tattoo until it heals.

Brochures

Skin infections
Dermatitis
Hepatitis C | Pokenga huaketo
MRI scan

1. Tattoo-associated skin reactions(external link) DermNet NZ, 2019
2. Tattoos and permanent makeup(external link) Food & Drug Agency, US, 2015
3. Tattoos – 7 unexpected skin reactions and what to do about them(external link) American Academy of Dermatology, US, 2017
4. Tattoos and hepatitis C(external link) American Liver Foundation, US, 2018
5. Guidelines for tattoo and permanent makeup substances(external link) Environmental Protection Authority, NZ, 2012