Systematic review identifies allergic reactions and infections as major tattoo-related adverse effects, suggesting policy improvements for safety standards.
Purpose: This study aimed to systematically identify the types and major risk factors of adverse effects associated with tattoo procedures. Methods: A systematic literature search was conducted in major domestic and international databases, including KoreaMed, RISS, KISS, KMBASE, KoreaScience, MEDLINE, EMBASE, Cochrane, and APA PsycInfo, covering publications from January 2000 to June 2025. A total of 27 studies were included in the final analysis. Results: The most frequently reported adverse effects were allergic reactions (70.4%) and infections (63.0%), followed by tumor-related changes (33.3%), other dermatological abnormalities (14.8%), and immune-related complications (3.7%). The main causes identified included pigment composition (particularly red and gray pigments), tattooing techniques and depth, inadequate sterilization and hygiene of instruments and environments, and insufficient post-procedure care. Conclusions: Tattooing may pose potential health risks not only to the skin but also to systemic health. These findings highlight the urgent need for multifaceted policy improvements, including the standardization of safety evaluation and regulatory frameworks for pigments, structured training and licensing of tattooists, stricter hygiene standards, and the implementation of adverse event surveillance systems.
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Park et al. (2025) studied this question.
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