Tattoo-associated skin reactions: a Danish population-based survey in 5,914 tattooed individuals.

Background In Europe, Australia and the US, the estimated overall prevalence of tattooing is around 10-20%. Tattoo ink often comprises harmful chemicals and epidemiological studies on adverse effects of tattoos are lacking. Objectives We aimed to estimate the prevalence of tattoo-associated skin reactions in the general Danish population and describe individuals with tattoo-associated skin reactions by socio-demographic factors and tattoo characteristics. Methods The study was based on respondents aged 16 years or older from a population-based 2021 survey entitled "How are you?" conducted in the Central Denmark Region (n = 33,925). Logistic regression was used to characterise individuals with tattoo-associated skin reactions by socio-demographic factors (gender, age, educational level and ethnic background). Also, the relationship between size, age and colour of the tattoo and tattoo-associated skin reactions was studied. Model 1 was adjusted for all socio-demographic variables (gender, age, educational level and ethnic background); model 2, for all socio-demographic variables and tattoo characteristics (size, age and colour). Results In total, 21.1% reported that they had at least one tattoo, 10.2% hereof reported that they had experienced tattoo-associated skin reactions (itching, pain, inflammation and swelling) beyond the first three weeks after the tattoo was made. Lower age (16-44 years) (adjusted odds ratio (AOR) ≥ 1.75), larger tattoos (AOR ≥ 1.61) and having had tattoos for more than ten years (AOR = 2.92, 95% confidence interval (CI) 1.45-5.88) increased the odds of tattoo-associated skin reactions. In general, tattooed individuals with colours other than black had higher odds of tattoo-associated skin reactions. Conclusion Among participants with at least one tattoo, 10.2% had experienced tattoo-associated skin reactions beyond the first three weeks after their tattoo was made. This finding highlights the need for safer tattoo inks to prevent the adverse health problems experienced by many individuals with tattoos.