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'Itchy, Scaly' Tattoo Ink Allergies More Common Than Thought

Image: Mohammed Abass, 28, draws a tattoo of a skull on Saad Saif's leg, 25, in Baghdad, Iraq

Mohammed Abass, 28, draws a tattoo of a skull on Saad Saif's leg, 25, in Baghdad, Iraq in 2011. Hadi Mizban / AP file

A surprising number of people who get tattooed say they develop severe itching and swelling lasting for months or even years, a new survey suggests.

After interviewing 300 randomly selected people with tattoos in New York City's Central Park, researchers found that 4 percent had experienced a short duration rash right after getting "inked," while an additional 6 percent reported skin problems that lasted longer than four months, according to the study published Wednesday in Contact Dermatitis.

"I've taken care of patients who have had problems with their tattoos and was curious about how common this was," said the study coauthor Dr. Marie Leger a dermatologist and assistant professor at the New York University. "I was surprised at the results.

The reactions can be quite striking, Leger said. "The colored portion can sometimes raise up as much as a centimeter above the skin and can affect the texture of the skin and the way the tattoo looks," she explained.

Leger suspects that allergies could be at the root of many of the rashes. Nearly two-thirds of the people with long-lasting rashes reported having allergies, as compared to just one-third in the group that had no reactions to the inking.

For the new study, Leger and colleagues staked out two spots in Central Park, asking passersby if they would be interested in being in the study. People who were over 18, had tattoos done in the U.S., and could respond in English were eligible to participate.

The 149 men and 151 women selected were asked for details about their tattoos and any skin conditions that appeared after the inking that didn't appear to be part of the normal healing process. People with reactions to their tattoos reported skin irritations that were "itchy, scaly, raised, and/or filled with edema."

Red ink appeared to be linked with rashes more often than other colors.

That wasn't a surprise to Mike Martin, president of the Alliance of Professional Tattooists.

"I don't have any statistics or percentages of people who break out with a rash and can speak from my personal experience only," Martin said. "The prevalence of a rash appearing is uncommon although not unheard of throughout the tattoo industry. Some folks' bodies do not like red pigments."

The rashes usually appear during the healing stage, though they can appear after the tattoo looks like it's healed, Martin said.

"I have heard of the rash appearing 12 months after the tattoo has been healed," he added. "It is usually in the site where red pigments were tattooed into the skin. The rash persists until all of the red ink has been pushed from the skin. Occasionally, I have seen this happen to some blues, purples and greens that were tattooed on someone overseas."

That could be a lot of skin rashes. A 2012 Harris Interactive Poll found that at least one in five of all adults in the U.S. has at least one tattoo.

Still, Martin said he thought that 10 percent was high, based on his 35 years of experience.

Leger and her colleagues found that the rashes sometimes appeared months or even years after the initial inking. Some people said that their rashes seemed to become worse when exposed to the sun.

Though Dr. Amy Crawford-Faucher isn't surprised to hear that one in 10 people with tattoos will develop some kind of skin problem, she suspects that many people aren't aware.

"It's an unreported, unseen problem," said Crawford-Faucher, a clinical assistant professor in the department of family medicine at the University of Pittsburgh Medical Center who is unaffiliated with the new study. "It's information that people should know about."

She's not sure why people don't come to the doctor more when they've got problems with their tattoos. But she's observed, "there's a lot of stoicism around tattoos. Even people who don't put up with a lot of discomfort when it comes to other things put up with a lot of side effects from tattoos because they think that's normal."

People unfortunately often don't seek medical attention when they have tattoo-related skin problems, Leger said. Prescription steroid treatments can help with the rashes.

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Leger said she can't say whether the results would generalize to anywhere in the nation. But studies in Europe found similar results, she said.

If you're planning on a tattoo, Leger advises:

  • Stay out of the sun
  • Consider avoiding red ink
  • Take really good care of the tattoo (keep it clean and follow instructions on care)
  • Pick a tattoo parlor with a good reputation.

Linda Carroll is a regular contributor to NBCNews.com and TODAY.com. She is co-author of "The Concussion Crisis: Anatomy of a Silent Epidemic" and the recently published "Duel for the Crown: Affirmed, Alydar, and Racing's Greatest Rivalry"