Tattoos have become increasingly popular in the U.S., especially among younger generations. Now, new research indicates that getting ink may come with more risks than many realize.
“We have done a really large study on everyone who got lymphoma in Sweden during a 10 year period and investigated whether they had tattoos or not,” explained Christel Nielson, an occupational and environmental medicine professor at Lund University in Sweden, author of research published this month in the eClinicalMedicine journal. “And we found that those who had tattoos actually had a 21% higher risk of developing earlier lymphoma.”
Nielson joined KCBS Radio to discuss the study findings. According to the publication, results based on nearly 12,000 patients suggest that tattooed individuals have an increased risk of developing lymphoma.
“We think it could be chemicals in the ink, but it could also be the ink particles… because we know that they don’t stay put in the skin,” Nielson explained. “They’re actually moved away by the immune system to the lymph nodes, and they get deposited there. So, we wanted to put the last… bits to the puzzle and understand how that would affect health in the long run.”
In the U.S., 32% of adults have tattoos, and 22% have more than one as of last summer, according to the Pew Research Center. That includes 38% of women with at least one tattoo and 27% of men who have at least one.
Rates are even higher for adults under 50. Around 41% of adults under age 30 have one and 46% of adults ages 30 to 49 have one. Among women ages 18 to 29, 56% have a tattoo and 53% of women ages 30 to 49 have one.
Black Americans are more likely to have tattoos than Hispanic, Asian or white Americans.
Tattoo ink is injected into the dermis layer of the skin, the lower of the skin’s two top layers. This layer contains blood vessels, nerve endings, hair follicles, and sweat glands. On top of it, the epidermis is regularly shedding, per Columbia University’s “Go Ask Alice!” column.
That’s why tattoo ink is injected into the dermis. There, after needles pierce the skin and leave ink behind, the immune system’s reaction helps it stay in place.
“Macrophages, one type of immune cell, eat up cellular debris and foreign material to protect the body from infection. Whenever someone suffers a wound, these fighter cells come rushing in to get rid of dead cells and any foreign invaders,” explained the column. “In the case of tattoos, the macrophages see the ink as foreign. These cells eat up the ink and actually keep it within their cellular membranes which results in the pigment staying put. When the lifespan of the macrophage is complete, it dies and releases the ink back into the skin, only to have it picked up again by another macrophage.”
Nielson said that tattoos might trigger low-grade inflammation as the immune system constantly fights them.
“We don’t know that today, but that’s a hypothesis that we will continue to work on,” she told KCBS Radio.
According to the study, tattoo ink often contains carcinogenic chemicals. This March, Audacy also reported a study published in the journal Analytical Chemistry that found 90% of tattoo inks from nine manufacturers in the U.S. “had major discrepancies with the labeled contents, such as different pigments than the ones listed or unlisted additives.”
More than half of the inks contained unlisted polyethylene glycol, which can cause organ damage through repeated exposure and 15 contained propylene glycol, a potential allergen, the study showed. An antibiotic commonly used to treat urinary tract infections and 2-phenoxyethanol, which poses potential health risks to nursing infants, were also found in the inks.
“Historically, tattoo inks have been underregulated in the U.S. market,” and have only been subject to regulation by the U.S. Food and Drug Administration since 2022, Audacy noted.
Though the Analytical Chemistry study found that red pigments are more likely to cause an allergic reaction, the Swedish study did not find any link between color and lymphoma risk.
There are many different kinds of lymphoma, cancer that begins lymph system cells. In the U.S., Hodgkin lymphoma and non-Hodgkin lymphoma are tracked by the American Cancer Society.
Non-Hodgkin lymphoma is one of the most common cancers in the country and accounts for approximately 4% of all cancers, per the society. This year alone, an estimated that 80,620 people diagnosed with NHL and 20,140 people are expected to die from it. Hodgkin lymphoma is a rarer diagnosis with an 8,570 new cases and 910 deaths annually.
Nielson said the recent study focused on younger patients with lymphoma in Sweden.
Results of the study suggested an increased risk of B-cell lymphomas, particularly diffuse large B-cell lymphoma and follicular lymphoma linked to tattoos. Still, Nielson said more research into the link is needed.
“I think we need to know a whole lot more,” she said. “I mean, this is basically the first large study on a long-term health effect that has ever been done. So, I would say that the research field is completely open. But given how many people in modern society who are tattooed today, I think it’s really important that we get going with the work.”
As for people who already have tattoos, Nielson said they shouldn’t try to get rid of them.
“We saw the laser therapy for tattoo removal make the situation even worse,” said the study author.