Tattoos have become increasingly popular in recent years, with studies estimating that 30% of people aged 18-35 in Western countries have at least one tattoo. With this rise in tattoo prevalence, many questions have been raised about the potential health effects of tattooing, including whether the process of getting a tattoo or having tattoo ink permanently embedded in the skin can affect brain function and psychology. This article will examine the existing scientific research on how tattoos may impact the brain.
How do tattoos work?
A tattoo is created when ink is deposited underneath the top layer of skin, the epidermis, and into the second layer of skin, the dermis. The dermis contains connective tissue and blood vessels, but does not contain any nerve endings. However, the process of getting a tattoo with a tattoo needle does penetrate deep enough to interact with nerves in the skin, causing pain. Tattoo artists use an electrically-powered tattoo machine that moves a needle up and down quickly to puncture the skin and deposit ink into the dermis. The ink droplets are too large to be carried away by the bloodstream and remain deposited in the dermis. As the ink droplets are foreign bodies, they are surrounded by the immune system to isolate them. This causes inflammation and leads to fibroblasts (collagen-producing cells) to be recruited to the site of the tattoo. The fibroblasts form a fibrous capsule around the ink droplets to wall them off. This capsule permanently anchors the ink in the dermis of the skin. Over time, the ink can gradually fade, but does remain permanently deposited in the body.
Does the tattoo process affect the brain?
The actual process of getting a tattoo involves repetitively puncturing the skin with a needle, which penetrates deep enough to come into contact with nerves. This causes acute pain and the activation of the body’s pain response. There is some research that suggests the pain, stress, and trauma of getting a tattoo has short-term effects on brain neurotransmitters and hormones.
Endorphins
Endorphins are hormones produced naturally by the body to help deal with pain and stress. The pain of getting a tattoo triggers the release of endorphins as part of the body’s pain response. Studies have found people who get tattoos have higher levels of endorphins during the tattooing process. However, the endorphin levels return to normal soon after the tattoo procedure ends.
Cortisol
Cortisol, also called the “stress hormone”, is also released as part of the body’s pain response. Cortisol helps restore homeostasis after trauma or stress by controlling blood sugar levels, metabolism, and blood pressure. Several studies have shown people experience a spike in cortisol levels during tattooing, which also return to normal within an hour after the tattoo is finished. This indicates the pain response is acute and temporary.
Adrenaline
Adrenaline (epinephrine) is released by the adrenal glands as part of the “fight-or-flight” stress response. Adrenaline increases heart rate, blood pressure, and breathing rate to prepare the body to deal with a threat. Like cortisol and endorphins, studies show adrenaline production rapidly increases during the tattooing process and goes back to baseline soon after the procedure is done.
In summary, tattoos cause an acute pain response that leads to short-term spikes in neurotransmitters and hormones like endorphins, cortisol, and adrenaline. However, current research suggests these changes are transient and not long-lasting.
Brain changes from the effects of tattoo ink
While the tattooing process itself has only temporary effects on the brain, the permanent presence of tattoo ink in the body raises questions about whether it can lead to long-term changes in brain health and function. Unfortunately, there is currently minimal research on how tattoo ink in the body affects the brain. Here is what we know so far:
Inflammation
The immune system responds to the presence of tattoo ink by triggering inflammation. This recruits immune cells like macrophages, which engulf ink droplets. The ongoing response causes chronic inflammation at tattoo sites over a lifetime. There is some speculation this inflammation could spread systemically and affect the brain, but no direct research yet on whether tattoo-related inflammation impacts brain inflammation.
Toxicity
Tattoo inks contain pigments suspended in a carrier liquid. Many of the pigments used, such as lead, copper, mercury, and aluminum, have potential toxicity. However, ink manufacturers maintain the pigments remain inertly bonded in the ink formulation. Little is known about the long-term fate of pigments remaining in the body and whether any toxic elements could be systemically absorbed. Trace amounts of tattoo ink components have been found traveling in the bloodstream to the lymph nodes. It is possible some nanoparticles could cross the blood-brain barrier and deposit in the brain, but this has not yet been studied.
MRI effects
The metal-based pigments sometimes used in tattoos, especially red, orange and yellow inks, can interact with magnetic resonance imaging (MRI) machines. They can heat up during MRI scans, causing pain or burns. The magnetic fields can also distort the tattoo image. MRI technicians take precautions around tattoos. While not directly related to brain effects, this does indicate metal-based tattoo pigments can have magnet-sensitive properties in the body.
Psychological associations
Beyond the ink itself, people who self-select to get tattoos are also psychologically different from the general population. Studies show they tend to be more impulsive, experience greater psychosocial stress, and have increased incidence of risk-taking behaviors. While tattoos themselves are not the cause of mental health issues, pre-existing differences in the brain may influence if someone is attracted to tattoos. More research is needed on the neurological and psychological traits associated with an inclination for tattooing.
In summary, very little research has directly examined how the presence of tattoo ink in the body could affect the human brain. At this point, any impacts are speculative. More studies directly analyzing the long-term brain health of people with tattoos are needed.
Case studies related to tattoos and the brain
While controlled studies on tattoos and brain effects are lacking, there are some case studies that provide clues on potential neurological risks. Here are three examples:
Brain MRI artifacts
A case study in the journal Radiology described a 50-year-old man with extensive tattoos who needed an MRI of the brain to investigate neurological symptoms. The MRI showed multiple black artifacts in the image that corresponded to the locations of the man’s tattoo ink, obscuring diagnosis. The researchers had to modify MRI protocols due to the tattoo interference, increasing scan times. This provides evidence that tattoo ink can directly interfere with optimum brain imaging.
Seizures
A report in Epilepsy & Behavior Case Reports described a 19-year-old woman who began experiencing seizures within 24 hours after getting a large tattoo on her back and arm. Her seizures stopped after she was given anti-epilepsy medication. Researchers speculated the tattoo procedure may have triggered stress-induced epilepsy. After avoiding any additional tattoos, she remained seizure free. While rare, this indicates tattoos could carry epilepsy risks.
Toxic leukoencephalopathy
A case discussed in the Journal of Radiology described acute toxic leukoencephalopathy in a young woman after getting a tattoo. Leukoencephalopathy is a rare neurological disorder caused by damage to the white matter of the brain. The woman experienced neurological symptoms including headache, weakness and fatigue in the days following tattooing, along with abnormalities on MRI in areas underlying her new tattoos. Her symptoms gradually subsided after several weeks. While the exact cause was undetermined, the timing suggested the tattoo procedure was a trigger.
These examples demonstrate that while not common, tattoos do have the potential to be associated with neurological complications in some cases. However, the rarity of reports indicates most tattoos are not seriously problematic for brain health.
Regulation of tattoo inks
Currently, there is no federal regulation of tattoo inks in the United States by the Food and Drug Administration (FDA). The pigments used in tattoo inks are considered cosmetics and do not undergo full toxicology testing. However, the FDA does monitor reports of adverse reactions to tattoos and has issued warnings on potential dangers of some ink chemicals. For example, mercury was recently found in certain red tattoo inks. Some medical experts have called for more stringent regulation of ink ingredients to protect consumer safety. The American Chemical Society has also highlighted concerns over lack of knowledge on the fate of tattoo pigments in the body. Overall, the long-term health effects of ingredients in tattoo inks remain largely unknown.
Conclusion
Current evidence suggests tattoos appear unlikely to have major direct impacts on brain function or health outcomes. However, some potential neurological risks associated with tattoos have been identified in limited individual cases. More research is still needed to directly examine if tattoos and their pigments have effects on the human brain, especially decades after the tattoo procedure. While millions of people have tattoos without issue, individuals should weigh the potential permanent risks versus benefits when making the personal decision to get a tattoo. Your individual health status and susceptibility to complications should be considered. More stringent regulation and toxicity testing of tattoo inks would benefit consumers. If you do choose to get a tattoo, make sure to use a skilled, licensed tattoo artist and proper hygiene practices to minimize health risks. With appropriate precautions and monitoring, tattoos seem reasonably safe for most people, but some caution over very extensive tattoos is warranted until more research data emerges. Discuss any health concerns over tattoos with your doctor.