Pigments in cosmetic tattoos, permanent makeup may cause allergic contact dermatitis

Key takeaways:

• Researchers found 79 unique pigments in 974 permanent makeup inks in the U.S.
• Ten of these pigments were traced to reports of allergic contact dermatitis.

Both organic and inorganic pigments used in cosmetic tattoos, also known as permanent makeup, may cause allergic contact dermatitis, according to a study.

Permanent makeup is a type of tattoo that is applied to the eyelids, lips, eyebrows or any other part of the body to mimic the appearance of makeup.

“[Permanent makeup] tattoos are applied with needles similar to decorative tattoos,” Sarah Rigali, MS, MD, a predoctoral research fellow at Northwestern Medicine, and colleagues wrote. “However, [permanent makeup] tattoos are applied more superficially in the skin and designed to fade over time.”

According to the authors, the tattoo industry is migrating towards the use of more organic pigments rather than heavy metals. In this study, the authors investigated the listed contents of permanent makeup pigments in the U.S., whether they use organic pigments vs. heavy metals and their association with allergic contact dermatitis.

Using internet searches to identify permanent makeup inks sold in the U.S., the researchers compiled safety data sheets to catalog the pigments used in these inks. A search into reports of allergic contact dermatitis following permanent makeup application was also performed.

The researchers found a total of 974 permanent makeup inks containing 79 unique pigments that are sold and used in the U.S. Twenty of the 79 pigments were classified as inorganic metals, which included iron, chromium, manganese and molybdenum.

On the other hand, 59 of the pigments were organic, four of which were black pigments made from carbon. The most common remaining organic pigments were azo, quinacridone or anthraquinone dyes.

The researchers found 15 publications that discussed reports of contact dermatitis following the application of at least one of the 79 pigments identified in this study. More specifically, contact dermatitis incidences were traced to 10 of the 79 pigments: Black 11, Blue 15, Green 7 Blue 15, Orange 34, Red 101, Red 122, Red 181, Red 210, Yellow 42, Yellow 65 and Solvent Yellow 33.

According to a Dutch study referenced by the authors, 52.6% of tattoo complications are attributed to allergic reactions. Furthermore, in a separate study of permanent makeup complications reported by the FDA, 82% of patients were classified as having an “allergic or granulomatous” reaction.

While most of the pigments used are organic vs. inorganic, some of them are still metallic and are known to cause allergic contact dermatitis.

“Although tattoo complications and allergies are often associated with metal pigments — such as mercury, cobalt and cadmium — we did not identify these metals in any of the inks we assessed,” the authors explained. “However, we did find other metals, including aluminum and chromium, which are known to cause [allergic contact dermatitis].

“Ultimately, consumers and patch testing physicians would benefit from better labeling of tattoo inks and the development of protocols designed to specifically test for tattoo pigment allergies,” they concluded.