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Thursday, 11 September, 2025
HomeDermatologyExperts unpack potential cancer risk of tattoo ink

Experts unpack potential cancer risk of tattoo ink

Recent studies have connected tattoos and cancers, including skin cancers, lymphoma and leukaemia, and although the research is early, and many unknowns remain – and the reason for the potential link – people should be aware of the risks, say experts.

Not enough definite evidence exists to say whether tattoos cause cancer, said Rachel McCarty, PhD, an epidemiologist at the International Agency for Research on Cancer (IARC), headquartered in Lyon, France, told WebMD, “and we’re not going to know the answer to that for years.”

“But still, people should be made aware of the potential risks,” said Signe Bedsted Clemmensen, PhD, an epidemiologist at the University of Southern Denmark.

Milena Foerster, PhD, also an epidemiologist at the IARC, said that old-time “stick-and-poke tattoos take a lot longer than tattoo machines, so the tattoo surface was a lot smaller”.

“Plus, with modern tattoo machines, there is more ink coming into the skin.”

Those older dyes were different, too. Traditionally, the skin was decorated with soot, charcoal, or pounded leaves. Modern inks are different.

“Coloured inks are often composed of the same components that would be in printer ink, car paint, things like that,” McCarty said.

These inks are cocktails of organic and inorganic compounds, including solvents, emulsifiers, binders, antifoam agents and preservatives. Some of these compounds, like polycyclic aromatic hydrocarbons, recently found in close to half of European inks, are known health hazards.

“That’s the main carcinogen in cigarette smoke,” said Foerster.

Then, there are heavy metals such as lead, chromium, or arsenic, found in 9% of European inks, and azo pigments (that’s the car paint stuff), some of which can release cancer-causing aromatic amines.

And although European inks may seem more harmful, that’s mainly because they were the most recently studied, not because they’re worse than inks found elsewhere, like the United States.

Rather, US inks may contain the same substances but are subject to less scrutiny.

Since 2022, the European Union has regulated substances in tattoo inks and permanent make-up. But in America, there are currently no regulations, McCarty said.

Tattoo inks are classified as cosmetics, and the FDA hasn’t approved any of them for injection into the skin. (Tattoo practices are generally regulated by local jurisdictions.)

With so many potentially toxic compounds in tattoo inks, epidemiologists are concerned about downstream health effects, cancer included.

Doctor’s hunch and cancer correlation

McCarty and her colleagues started looking into the cancer question after they got a call from Paul Shami, MD, a haematologist at the University of Utah Huntsman Cancer Institute.

Shami, who treats patients with leukaemia, felt he was seeing more cancer patients with tattoos.

Was there a connection, or was it just that more people in the general population were getting inked? The scientists analysed 820 cancer cases and matched them with 8 200 controls based on age, sex and ethnicity. The results, published in 2024, suggested that people with a tattoo may have an increased risk of certain types of non-Hodgkin’s lymphoma.

And those who’d had their tattoos since before age 20 had a higher risk of myeloid neoplasms (rare blood cancers).

Then came another study, from Sweden, showing that people with tattoos had a higher risk of lymphoma. A Danish study, published in 2025 and co-authored by Clemmensen, found that for tattoos larger than the palm of a hand, the risk of lymphoma was more than double that of people without tattoos.

As with any observational study, these can’t prove anything – they can only show a link, not the cause.

But scientists do have a theory: “It’s been well documented that the inks don’t remain fully in the skin,” McCarty said. “They get transported through the lymphatic system and accumulate in regional lymph nodes. That’s really one of the key parts of our hypothesis for why tattooing could potentially cause lymphomas.”

Research shows that the polycyclic aromatic hydrocarbons from black inks can be found in lymph nodes near the tattoo site, sometimes causing the lymph nodes to swell. This build-up could lead to chronic inflammation.

“The lymph nodes may try constantly to do something about this foreign substance, and it might induce a chronic immune reaction,” Clemmensen said. “This could lead to abnormal cell proliferation and, in time, an increased risk of cancer.”

Melanoma risk a mixed bag

Some studies suggest that getting inked could also raise the risk of skin cancers, such as melanoma.

In Clemmensen’s study, people with tattoos had over double the chance of getting skin cancer.

But in McCarty’s new study – published in August – such links did not show up. “Our findings do not suggest tattooing could increase your risk of melanoma,” she said. “If anything, we’re seeing a protective effect.”

That doesn’t mean tattoos are good for your health – but, rather, it could be that people who are more at risk of developing melanoma, such as those with many moles, are less likely to get a tattoo, McCarty said.

Or it could be about sun exposure. “When you get a tattoo, they tell you: put on sunscreen, because your tattoo will fade. And so maybe some of that extra sun protection is reducing melanoma risk,” she said. Indeed, a 2023 study showed that people with tattoos are more likely to protect themselves from the sun.

Tattoos might disguise cancer 

Getting a tattoo could also make it harder to diagnose cancer. A 2025 review of 43 malignant melanoma cases found that if a cancer starts on inked skin, the prognosis is worse, most likely due to delayed diagnosis.

“If you don’t have a tattoo, it’s much easier to notice changes,” Clemmensen said. For doctors, patterns and drawings on the body make it harder to analyse lesions with a dermatoscope, a hand-held device that takes a close look at the skin.

There’s a similar problem inside the body. Tattoo ink complicates biopsies of lymph nodes. A study of women with early cervical cancer found that 40% of those with tattoos had lymph nodes coloured with ink.

This pigmentation can potentially make it harder for doctors to analyse biopsies and check lymph nodes for cancer cells, said Giovanni Di Favero, MD, an oncologist at Asklepios Hospital in Hamburg, Germany, and the study’s lead author.

Removal can backfire

All this doesn’t mean you should rush to remove your tattoos. It turns out the laser light used for removal can cause certain pigments, including red and orange ones, to produce cancer-causing substances, research shows.

“If tattoos have the potential to cause cancer, removal could be even more harmful, because you’re breaking down the pigments,” McCarty said.

Foerster is even more direct: “I would not remove it,” she said.

Then what should you do if you're concerned about the cancer risk? “Keep tattoos safe from the sun,” McCarty said. When you expose a tattoo to UV light, “additional harmful components can form within the skin”.

A 2025 study showed that sunlight makes pigments leak toxic substances into the skin, such as DBCP, a pesticide.

If you’re not in a hurry, wait a while. Foerster, McCarty, and their colleagues are currently running several large prospective studies looking at whether people with tattoos may be more likely to develop cancer over time. This method could provide stronger evidence than previous studies that simply compared people with and without tattoos.

“We will have first quite reliable results, I hope, in three or four years,” Foerster said.

 

WebMD article – Cancer Link to Body Ink: What to Know About New Tattoo Data (Open access)

 

See more from MedicalBrief archives:

 

Tattoos may boost lymphatic cancer risk – Swedish study

 

EU seeks to restrict chemicals in tattoo inks over cancer fears

 

Tattooing may hold immune system risk

 

 

 

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