Tattoos and permanent make-up are not without risk

According to a survey by a main German polling institute, almost one in ten Germans have a tattoo. The number of people who have areas of skin on their faces coloured with permanent make-up, as a substitute for daily make-up, is also on the increase. BfR points out, as a precautionary measure, that people with tattoos may in some cases be exposing themselves to a health risk which, at present, can only be assessed to a limited degree by scientists.

During tattooing and the application of permanent make-up, coloured pigments are injected by means of pinpricks into the middle skin layer (dermis). From there they can reach deeper skin layers from where they can spread through the body via the bloodstream and also be converted.

According to German dermatologists the most frequent adverse reactions to tattoos are severe skin reactions and infection. In most cases, allergic reactions are caused by the substance para phenylene diamine (PPD). It is used to darken henna; during the application of black henna tattoos it can reach or penetrate the skin. PPD can trigger dermatosis with serious consequences. Once people have become sensitive to PPD, they may show lifelong allergic reactions to the substance or to dyes with a similar chemical structure. Metal-containing ingredients in the dye mixes may also trigger allergies.

Other sources of risks are impurities in dye mixes and some azodyes which can be cleaved into carcinogenic aromatic amines. Azodyes of this kind also constitute a risk when tattoos are removed using laser technology. They may also be cleaved by laser rays into carcinogenic amines which are distributed throughout the body in the bloodstream. Other possible consequences of tattoo removal are scars, pigment disorders of the skin and infection.

BfR explicitly draws the attention of consumers and, more particularly, the parents of teenagers and children to the risks associated with tattoos and permanent make-up. Unlike the dyes used in cosmetics for application to the skin like blusher, eye shadow or eyeliner, the dyes used in tattoos and permanent make-up have not undergone any tests with regard to their health impact. At present, nothing is known about the long-term effect of these foreign substances in the body either although they remain there for a lifetime.

Whereas cosmetics that are applied to the skin are subject to regulation through the German Food and Commodities Act, the European Cosmetics Directive and the German Cosmetics Ordinance, tattoo dyes are not currently governed by any comparable provisions. There are no statutory provisions concerning the purity, quality or safety testing of tattoo dyes. Tattoos and permanent make-up, like non-permanent make-up, serve to decorate the body and, by extension, cosmetic purposes. Since, however, the dyes are injected into the skin during tattooing, they are not classified as cosmetics within the intendment of the valid statutory definition.

BfR, therefore, recommends that until there is a statutory regulation only those dyes should be used which comply with the requirements of the European Cosmetics Directive and the German Cosmetics Ordinance and which have been tested and approved for use in cosmetics. However, this is no guarantee that no adverse reactions will occur. BfR calls on doctors to notify any health disorders to BfR which may have been caused by tattoo dyes.

Further information on this subject can be accessed on our homepage on, under “Cosmetics“.

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