The Grapevine

Don't Get A Tattoo If Your Immune System Is In Bad Shape

If your immune system is suppressed or weakened, you may be at risk of tattoo-related complications. In a new report, doctors warned getting inked may be linked to severe muscle pain in such cases.

The paper titled “Unusual complication of a tattoo in an immunosuppressed patient” was published in the journal BMJ Case Reports on June 18.

From being exclusively associated with sailors and prison inmates, tattoos noticeably gained popularity in recent years to become normalized among everyday people. But they are not without health risks such as inflammations or infections, especially when performed by a non-professional.

Those with pre-existing health conditions (for example, someone with allergic reactions) may need to take further caution. In this category, long-term immunosuppressed patients are often young adults who may wish to consider tattooing, the authors stated.

“It is well recognized that immunosuppressed patients are at increased risk of infection including cutaneous mycobacterial infections,” the authors wrote, putting them at high risk of complications from the process.

Immunosuppression is a situation where the human immune system is weakened or suppressed. Intentionally, it may be performed with drugs for medical purposes such as helping an organ survive after transplantation. In non-deliberate instances, it is referred to as immunodeficiency and can occur as an unwanted effect caused by HIV, cancer, etc.

In the report, the authors detailed how a 31-year-old woman had been taking immunosuppressive drugs for years after receiving a lung transplant in 2009. She decided to get tattooed on her left thigh, something she did not consider a risk as she was safely tattooed once before her lung transplant.

The tattoo was done in 2015 and resulted in mild skin irritation, which is considered a normal after-effect. But nine days after the session, the woman developed chronic pain in her left hip, knee, and thigh which lasted for months. Eventually, she had to turn to painkillers due to the severity of the symptoms.

Ten months later, she underwent testing at a rheumatology clinic to find out the source of the unusual pain. A biopsy revealed she was suffering from muscle inflammation potentially linked to the tattoo process and the suppression of her immune system.

“There was a variety of colored ink used in this tattoo and this could be another factor in the reaction,” the authors added.

To solve the problem, the patient was given physiotherapy to help strengthen the thigh muscles. The symptoms showed improvement after one year and successfully disappeared after three years.

While they were unable to prove causation, the doctors believed the timing and location of the pain strongly implied there was only one possible cause.

“In this case, the tattoo application by an unregulated parlor, combined with the patient's immune suppression could have resulted in the adverse reaction,” they wrote.

Doctors were urged to explain the risks of tattoo complications to patients with immune system problems. And since body ink is often not discussed in a medical setting, they stated tattoo-induced muscle inflammation should be considered when a patient reports such symptoms.