Abstract 

A tattoo is a form of body modification used to express art. It is usually done by using needles filled with ink or pigments to draw pictures and designs. Tattooing, if not done in a clean and aseptic environment, can lead to infections, which can cause discomfort and pain. Immunocompromised individuals are those who have a weakened immune system due to specific treatments, diseases, or genetic conditions. They are more at risk of tattoo infections, which can range from mild skin infections to life-threatening infections like sepsis. It is advisable to consult a doctor before undergoing a tattoo procedure to learn about the associated risks and potential complications. 

Introduction 

Tattoo is a form of body art that is produced when pigments are permanently inserted into the skin to create pictures, words and designs.⁶ 

These pigments may be coloured or black, depending on choice and availability, but black is most often used.^{1, 2} 

Tattoos are typically created using needles, lancets, or modern machines to inject pigments into the skin at a high frequency and with rapid motion.⁵

Who are immunocompromised individuals? 

Immunocompromised individuals are persons with a weakened immune system. 

The immune system helps protect the body and fight off invaders (which can be diseases or infections).  

People with an immunocompromised system may not be able to fight off these invaders naturally. 

This happens most times due to certain diseases like diabetes, cancer, malnutrition, AIDS (Acquired Immunodeficiency Syndrome) and certain genetic disorders.¹¹ These individuals are also referred to as immunosuppressed.

What is a tattoo infection?

A tattoo infection is an infection caused by an immune reaction or microbial contamination to a tattoo procedure. 

This occurs when the pores in the skin are opened as the needles inject ink deeply into the skin. 

Various tattoo infections in immunocompromised individuals 

Infections from tattoos can be localised (contained within the affected part) or systemic (spread to other distant organs).⁴

These tattoo infections include microbial infections caused by bacteria, fungi and viruses, with bacterial infections being the most common.³

The following are examples of tattoo infections in immunocompromised individuals:

• Bacterial infections, which include Staphylococcus, nontuberculous mycobacteria(NTM), Streptococcus and Pseudomonas
• Fungal infections, which include Candida and other opportunistic fungi
• Viral infections, which include hepatitis viruses, human papillomavirus(HPV) and herpes simplex virus(HSV)

Causes and risk factors of tattoo infections in immunocompromised individuals

What causes tattoo infections in immunocompromised individuals? 

Infections after getting a tattoo can be caused by microorganisms entering the body through small openings created when the needles break the skin barrier. 

These microorganisms can be found living naturally on the body or in the form of opportunistic microbes. 

The opportunistic microbes may not be found on the body but can be gotten from unsterilized instruments and materials.⁴

Other causes of tattoo infections in immunocompromised individuals include:

• Having a weakened immune system with difficulty fighting off infections¹
• Immune reaction to certain inks or procedures
• Poor hygiene practices like reusing needles and using saliva as a needle lubricant⁵
• The type of ink or colouring agents used, some of which contain heavy metals²
• A tattoo artist using nonsterile water to dilute black ink²
• Using contaminated ink from poor manufacturing or handling⁵

What are the risk factors for tattoo infections in Immunocompromised individuals?

Some of the risk factors for tattoo infections in immunocompromised individuals include: 

• People with pre-existing health issues like diabetes, cancer and HIV¹¹
• Specific treatment or drug usage, like radiation therapy, anticancer drugs¹¹ and chemotherapy
• Improper treatment of wound cleaning after the tattoo procedure 
• Exposure to harmful microorganisms
• Organ transplant patients²

Symptoms of tattoo infections in immunocompromised individuals

What are the common symptoms of tattoo infections in immunocompromised individuals?

The most common symptoms of tattoo infections in immunocompromised individuals are:

• Redness and pain
• Swelling
• Formation of blisters and crusts
• Fever and chills

Proper examination and testing are needed for accurate microbial diagnosis and adequate care.

Treatment of tattoo infections in immunocompromised individuals

How can tattoo infections be treated in immunocompromised individuals?

Tattoo infections can be treated in Immunocompromised individuals by: 

• Applying ice for pain relief 
• Taking prescribed antibiotics and painkillers 
• Cleaning the affected area mildly 
• Staying hydrated 
• Reducing strenuous activities 
• In severe cases, a doctor might administer intravenous medications or carry out surgery on the affected area

It’s advisable to see a doctor as soon as any sign is noticed, as it helps treat infections at an early stage. 

Prevention of tattoo infections in immunocompromised individuals

How can tattoo infections be prevented?

Tattoo infections can be prevented in immunocompromised individuals by doing the following: 

• Speaking to a healthcare professional before carrying out the procedure
• Receiving tattoos from a licensed professional who follows aseptic techniques²
• Talking to the licensed professional about their health conditions²
• Using ointments and antibiotics to care for after a tattoo procedure 
• Observing and seeking medical help immediately if needed 

FAQs

Can tattoo infections be treated in immunocompromised individuals? 

Yes, tattoo infections can be treated in Immunocompromised individuals. 

After examinations and tests, a doctor prescribes the most suitable treatment plan for the specific infection. 

How do I know my tattoo is infected? 

You would most likely experience pain, discolouration, swelling around the area, and fever after a while. 

It’s advisable to see a doctor immediately if you notice any signs in or around the affected area. 

Can tattoo infections be prevented in immunocompromised individuals? 

Yes, tattoo infections can be prevented in Immunocompromised individuals by: 

• Seeing a doctor before getting the procedure 
• Meeting a licensed professional and telling them about your medical condition 
• Going to a clean tattoo parlour where they follow aseptic procedures 

Can a tattoo infection affect other parts of my body? 

A tattoo infection can spread to other parts of the body if not treated early and adequately. 

Summary 

Tattoos can become infected when microorganisms enter the pores of the skin during the procedure or due to irritation. 

There are various microbial tattoo infections, each with its specific treatment. 

Immunocompromised individuals are at a higher risk of contracting a tattoo infection, as their weakened immune system is unable to fight off infections. 

It’s advisable to consult a doctor before undergoing a tattoo procedure to learn about the associated risks.