Could Tattoos Increase Risk of Malignant Lymphoma?

The popularity of tattoos has increased dramatically over the last few decades. In fact, approximately 30% of U.S. adults and 20% of European adults have tattoos today.

Christel Nielsen, associate professor at Lund University, noted there has been a global rise in the incidence of malignant lymphoma that remains largely unexplained. In response, she gathered a research team to investigate if tattoo exposure increases the risk of malignant lymphoma.

The team's results were published in a study on June 2024 in the journal eClinicalMedicine. The study sought to establish the relationship between tattoo ink exposure and malignant lymphoma and lymphoma subtype risk.

“The ink is transported away from the skin by the immune system, as the body tries to remove the ink particles that it perceives as something foreign that should not be there,” Nielsen said. “It has been shown that this process effectively translocates tattoo pigment to the lymph nodes, and that the ink particles are permanently stored there. We wanted to connect the dots and understand how our health is affected by the permanent storage of potentially toxic chemicals within the immune system.”

Through a population-based case–control study leveraging Swedish National Authority Registers, the researchers discovered that the time interval between getting the first tattoo and lymphoma diagnosis affects the risk levels.

“This could imply that the chemicals may act both as tumor initiators and tumor promotors, but this is speculation at this point and an interesting topic for further research to explore,” Nielsen said.

To account for other potential causes, the Lund University team adjusted the statistical models for potential confounding by educational attainment, household disposable income, smoking status and marital status. These variables were considered proxies of socioeconomic position and general lifestyle, Nielsen explained.

The study also found a significant risk increase for lymphoma among individuals who underwent laser tattoo removal, though the numbers were very small.

“However, the results are quite plausible because laser therapy for tattoo removal works by fractioning the ink particles into smaller molecules that can be excreted by the body,” she said. “The chemicals that are generated, for instance aromatic amines, are more reactive and toxic than the original pigments. The ink doesn’t vanish into the air, it has to pass through the body on its way out, which implies systemic exposure.”

While she admits that more research is needed to come up with any true conclusions, Nielsen noted the study did show that such research should be prioritized.

“What we can say at this point is that for people with tattoos, it is good to be aware that tattoos might have adverse health effects and you should seek medical care if you experience any symptoms that you think may be tattoo related,” she said. “I am convinced that we will continue to get tattoos, and that it is a societal responsibility to make sure that it can be done as safely as possible.”