A Polish man suffered total loss of hair and sweating after getting a tattoo, according to a new study that calls for better regulation of body ink composition.
The 36-year-old man got a red flower tattoo on his right forearm in 2020 and, around four months later, developed intense itching, severe skin peeling, and a bumpy rash at the site.
He soon had inflamed skin covering more than 90 per cent of his body and complete hair loss on his scalp and torso. He also stopped sweating entirely due to a condition called anhidrosis.
Unable to sweat, he could no longer exercise safely, work in heat or tolerate warm rooms.
“The Caucasian male developed erythroderma, alopecia, anhidrosis and vitiligo as complications of a red ink tattoo, marking a rare and previously unreported case of such extensive reactions,” according to the study published in Clinics and Practice.
“Four months after getting the tattoo, the patient began to develop itchy eczematous changes, which progressed to erythroderma over several months, along with alopecia universalis and anhidrosis.”
Skin patch tests confirmed an aggravated immune response likely triggered by components of the red tattoo ink.
After months of ineffective treatment with steroidal drugs to suppress immunity, doctors surgically removed the inflamed tattoo fragments.
But even this didn’t improve the patient’s clinical conditions much, and he developed vitiligo.
“Only after the complete removal of the red tattoo ink from the same series that caused the sensitisation and use of immunosuppressive and immunomodulatory drugs...was hair growth restored and the progression of vitiligo halted, but with no effect on anhidrosis,” the study noted.
“This case highlights the challenges in managing systemic reactions to tattoo ink and the importance of thorough evaluation and treatment strategies.”
Tattoos have grown in popularity in recent years, serving as symbols of identity, expression and artistry.
About one in four young people in the US and Europe is estimated to have at least one tattoo.
But concerns are growing about complications caused by tattoos, ranging from mild skin irritations to more severe allergic reactions.
There are also concerns about the constituents of modern tattoo inks and their potential harmful effects, including the development of skin cancer.
Research suggests that the number of adverse reactions a person may develop from their tattoo depends, among other factors, on the colour of the dye, which, in turn, is linked to its composition.
“Most commonly, they concern red ink,” the study noted. “Chronic allergic reactions to tattoos can occur months or even years after getting the tattoo.”
Authorities in many counties have flagged the need for regulations governing tattoo ink composition.
For instance, before regulations were enforced in the EU in 2022, red ink commonly contained toxic compounds such as mercury, cadmium, and arsenic.
“The patient, in the clinical case we are describing, got a tattoo in 2020, two years before these regulations were introduced,” the researchers said in the new study.
However, dermatologists are still unclear about the link between red ink hypersensitivity and the complete loss of sweating seen in the Polish man.
They suspect some of the tattoo’s pigment components may be antigens against the sweat gland, leading to a heightened immune reaction against it.
“Previous studies have demonstrated impaired sweating in tattooed skin, suggesting functional alteration of eccrine structures,” researchers said.
“These data support the concept that tattoo-related immune activation may extend beyond the local site, contributing to systemic dysfunction.”
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