Final Thoughts on Tattoo Safety

Hi, I'm Rose Rimmler, filling in for Wendy Zuckerman, and this is Science Versus . Today we are talking about tattoos. Tattoos are more popular than ever, but lately they've been getting some flack. Online we're hearing that tattoos are toxic. What is a toxic guy tattoo? Upper chest, Roman numerals. That is always a toxic guyy. Everone knows one of those guys. No, not that kind of toxic. Like poisonous. But turns out tattoos are actually pretty unhealthy for us. You're constantly being poisoned by the toxins. If I were to go back in time with the knowledge I have now, I would not have the tattoos that I have. People are pointing to tattoo ink saying that it's full of stuff that you don't want in your body. Every single person who has a tattoo has metals leaching into the bloodstream, mercury, lead , nickel, and other harmful heavy metals that will slowly release in your body, adding to your toxic burden daily. And ultimately, they say that the consequences can be serious. A new study has found it could increase your risk of developing cancer. 21% chance of getting a malignant lymphoma with even small tattoos . And if this risk is real, it would affect a lot of people. According to surveys, in the US and Australia, a third of adults are tattooed. And globally, that number is one in five. So are these people making a terrible m istake? If you get a tattoo, are you poisoning yourself and upping your risk of cancer ? And finally, has science found any benefits to getting inked? Because when it comes to tattoos, there's a lot of upper chest Roman numerals. But then there's science. Science versus tattoos is coming up after the break. This episode of Science Versus is presented by Amazon Health AI. Guys, we gotta talk about your secret late night internet searches. You know the ones: bumpy leg rash, hair loss, itchy bum. Trying to figure out your body by endlessly searching for answers. We all do it, but does it always work? Well, you could try Amazon Health AI. It can connect your symptoms with your medical history to offer personalized care 24/7. So call off the search. Amazon Health AI is here. Healthcare just got less painful. This episode is brought to you by Adobe Firefly, the all-in-one creative studio with AI-powered image and video generation. Built for today's creative process. Firefly helps you generate, edit, and experiment fast, because the asks aren't getting smaller, and the timelines? Ooh, yeah, still tight. With all the best creative AI models in one place, Firefly brings your ideas to life. Learn more at Adobe.com/slash Firefly . Welcome back. We are here to talk about tattoos. I'm Rose Rimmler and I'm here with Science versus Editor and tattoo haver, Blad Terrell. Hi, Blad. Hares. Famed tattoo haver. I will say. So how many tattoos do you have? Where are they? Spill it. So the first one I got, I got with my good friend, like when I was 18. We got we both got flowers. It's just like I'm 18, I have a flower. My husband and I have one that's kind of like I love you in sign language, stylize. Uh I have a a stylized double helix on my ankle. Very nerdy, very on theme. And then my the other one is uh the Batman logo. Um but it is the it is the 1960s Batman. I've always kind of been curious about it. Why why Batman? So my initials are B-A-T. And so it's been like a running joke. Okay. Um that you're the Batman. Revealed on this podcast. Have you ever worried about your tattoos ? I mean, my mom worried that I wouldn't get jobs. Um but like health wise, I mean I guess oh only to the extent that I was like, okay, is that is this guy getting like a clean needle out of the package? But beyond that, no. Has never come up for me. Yeah. And I was pretty surprised myself when I saw this stuff pop up online about tattoos being toxic. Um I don't have any tattoos myself, but I know so many people who do. So I really want to know, is this true or is this just BS? Yeah, very curious to know what you found. So, you know, obviously tattoos have been around thousands of years, but interestingly , scientists have only recently begun to study how the tattoo ink like interacts with our biology. This is kind of on the newer side of things. Um, scientists like Santiago Gonzalez, he is a toxicologist and immunologist at the University of Lugano in Switzerland. Here's what happened. Santiago needed to label mice for an experiment they were doing about the immune system. The way they had been doing that was putting a tag on the mouse's ear, like tagging in their ears, which is very common. Yeah. bit heavy and the animals is a bit annoying for the animals. So instead of tagging their ears, the scientists in his lab decided they were gonna try tattooing the animals in order to like mark them. We basically have a tattoo machine which is exactly the same as the as the tattoo that machine that is used by by by all the tattoo artists and we just uh do it normally like is it like teeny teeny tiny? It's uh yeah it's it's it's very small so obviously you have to be very very careful. So they're chugging along, tattooing their mice, um, to do their next experiment, which all seemed to work fine. But then something unexpected happened. My students told me, you know, the lymph nodes of the animals are completely full with the ink of the tattoo. Oh. Gross. And just as a reminder, lymph nodes are structures in the body that are part of the immune system. They filter out lymph, which is a fluid that comes from the blood. So Santiago's team was looking at one of the lymph nodes in the mouse's leg near its foot, which is what had been tattooed. And they found that it got stained with the tattooing. It's not what they expected. And it kind of messed up that experiment. Right. That's not what they were studying. Right. It's not what they were studying. They're just using the tattoos to label the mice for another experiment. But after seeing this, they decided to do an experiment where they tattooed the mice and then watched where the ink went in a more controlled way. Okay. So we did all this again and then took photos of the lymph nodes two months later. So let me show you. Oh yeah, you can really see like though it's really you can really see the ink in there. Like it's it's bright, yeah. It's a few different colors of ink and you can see like in one mouse has a pretty bright blue lymph node, like bulbous little goofy thing. So how did that happen? Well, okay, so your body has these white blood cells. They're called macrophag es that go around gobbling up stuff that they think shouldn't be there. So this is typically like bacteria, broken bits of cells. Um when you get a tattoo, macrophages in your skin, they go around and they slurp up some of that ink. And it turns out that they're also bringing that ink to the lymph nodes. And scientists have also seen this in people. We've had case studies documenting it, like if someone with tattoos goes in to get their lymph node biopsied for whatever reason, pathologists will sometimes find ink in the lymph node. And Santiago's team also found this when they looked at lymph nodes from people , which led him to conclude when you are tattooing your skin, you are also tattooing your lymph nodes. Okay. So we have tattooed lymph nodes, but does that like does that automatically equal some kind of a problem? Well, it's possible. I mean if the lymph node is involved, that means the immune system is involved in some way. So Santiago's team also check levels of immune markers in the mice's bodies to see if they were elevated. That would suggest that they were stressed out, basically. Um, there's these are molecules that are part of the body's stress response to injuries or illness. And he did find that these molecules increased in both the lymph taken from the lymph node and in the mice's blood. But most of that activation went back to normal after a week or so from getting the tattoo, which makes sense. Like of course you'd have a temporary inflammatory response to a bunch of needles in your skin. But there was one exception: a molecule associated with chronic inflammation. It's actually called alarmin . Great. Yeah. What was the alarmment doing, Ruth? It was alarmed. It was raised, even two months post-tattooing, which Santiago argues should have been past the initial healing phase of the tattoo. Uh-huh. Okay . So how worried should we be about that? Well, you know, Santiago's study was kind of exploratory. It showed some hints of some immune system weirdness in mice. It wasn't looking at long-term issues in real people . So zooming out to other studies, we do start to see that this activation of the immune system might be a problem for some people . I read this case study, um, a guy from Poland. He had a full-blown immune reaction to his tattoo four months after he got it. He lost his hair, he developed vitiligo . What's that? That's like a skin, a change in the color of your skin. Okay. And he had to get the tattoo essentially cut out of his arm. Whoa There's another series of cases that was published recently in Australia about people who got this allergic reaction to their tattoo ink and it attacked their eyes. Oh my god. And some of them even had vision loss . Those examples are extreme and they're not that common. Um, but in general, we do see a lot of allergic reactions to tattoos. Just typically it's confined to the skin. Actually, you know what that makes me think of, Rose? Huh. So the other day I was sitting with my husband and he looked at me and he was like, Do your tattoos ever itch? And I was like, no , do your tattoos ever itch? And you know what else, Rose? He has some like immune system stuff going on a little bit. Another autoimmune system thing. So I kind of had this feeling that as you say this, I'm like, oh, I wonder if like suddenly there's this change and like the itchy, like Jack's tattoos are getting a little itchy. I wonder if it's related. Okay, interesting. Well, the best numbers I could find on how common this is, this like sort of skin reaction to tattoos, it comes from a survey of people with tattoos in Germany and it found that about nine percent of people reported persistent skin problems at least a month after they got their tattoo. Hmm. Okay. And so it sounds like he might be in that unlucky sliver of people. No. Um Lucky Lucky in love, unlucky in tattoos. Obviously. So this happens to a fraction of unlucky people, nine percent in that German study. But there are other reasons to be concerned about tattoo ink that's more universal for everyone who gets tattooed. Mm-hmm. One of those things is the fact that a lot of tattoo ink contains chemicals that we think are possibly carcinogenic. Hmm. And that includes black ink. And you know, black a lot of your tattoos are black, I noticed. I think they're yeah, most of them are black. Okay, great. What are you gonna tell me about black ink, Rose? Carcinogenic? Black ink is basically soot. Sorry. Great. So it's like yeah, like if I m if I were a chimney sweep instead of a podcaster. That's the is that what's going on here? Yes. Right. Um but this is what makes some people worried that tattoos might cause cancer. Mm. And we're gonna need some more science to figure that out. Mm. Okay. So we're gonna have to go to Sweden. I'm ready. All right. Snoring? Gasping during sleep, feeling fatigued? Ask your doctor about Zeppbound, Terzepatite, the first and only FDA-approved prescription medicine for moderate to severe obstructive sleep apnea, OSA, in adults with obesity. Zepbound is a prescription medicine used with a reduced calorie diet and increased physical activity to help adults with moderate to severe obstructive sleep apnea, OSA, and obesity to improve their OSA. Zetbound is approved as a 2.5, 5, 7.5, 10, 12.5, or 15 milligram injection. Zetbound contains terzepatide and should not be used with other terzepatide containing products or any GLP1 receptor agonist medicines, it is not known if Zetbound is safe and effective for use in children. Don't share needles or pens or reuse needles. Don't take if allergic to it, or if you or someone in your family had medullary thyroid cancer, or if you've had multiple endocrine neoplasia syndrome type 2, tell your doctor if you get a lump or swelling in your neck. Stop subbound and call your doctor if you have severe stomach pa in or a serious allergic reaction. Severe side effects may include inflamed pancreas or gallbladder problems. Tell your doctor if you experience vision changes before scheduled procedures with anesthesia. If you're nursing, pregnant, plan to be, or taking birth control pills. Taking zip bound with a sulfonyl urea or insulin may cause low blood sugar. Side effects include nausea, diarrhea, Talk to your doctor. Call one eight hundred five four five five nine seven nine or visit Zbound dot lily dot com . This episode is brought to you by Amazon Health AI. Hey there, it's me, Wendy. Before this podcast continues, I'll need you to fill out 37 forms about your listening history. Oh wait. Just kidding. That would be ridic ulous. Yet we do it every time we need healthcare. But new Amazon Health AI is different. It can connect your health history to offer personalized care. So that you can get help fast. Amazon Health AI. Healthcare just got less painful. Snoring? Gasping during sleep? Feeling fatigued? Ask your doctor about Zepbound. Terzepatite, the first and only FDA-approved prescription medicine for moderate to severe obstructive sleep apnea, OSA, in adults with obesity. Zetbound is a prescription medicine used with a reduced calorie diet and increased physical activity to help adults with moderate to severe obstructive sleep apnea and obesity to improve their OSA. Zebbound is approved as a 2.5, 5, 7.5, 10, 12.5, or 15 milligram injection. Zetbound contains terzepatide and should not be used with other terzepatide containing products or any GLP1 receptor agonist medicines. It is not known if Zetbound is safe and effective for use in children. Don't share needles or pens or reuse needles. Don't take if allergic to it, or if you or someone in your family had medullary thyroid cancer, or if you've had multiple endocrine neoplasia syndrome type 2, tell your doctor if you get a lump or swelling in your neck. Stop subbound and call your doctor if you have some Severe side effects may include inflamed pancreas or gallbladder problems. Tell your doctor if you experience vision changes before schedule procedures with anesthesia. If you're nursing, pregnant, plan-to-,be or tak ing birth control pills. Taking zip bound with a sulfonyl urea or insulin may cause low blood sugar. Side effects include nausea, diarrhea, and vomiting, which can cause dehydration and worsen kidney problems. Talk to your doctor, call 1-800-545-5979 or visit setbound.lilly.com . Every outfit starts with a choice. What am I wearing underneath? Something comfortable and let's be honest something that keeps everything looking smooth that's where vanity fair lingerie comes in their new smoothing wireless bra has four-way stretch fabric for all over smoothing soft lightly lined cups for a natural shape and no wire comfort that lasts all day. All over smooth, all day comfort, vanity fair lingerie. Find yours at Target today . Welcome back. Uh we're talking about tattoos today, and I'm here with Blythe Terrell. Hi Blythe. Hey Rose. So it turns out there are some reasons to be concerned about tattoos. Um we know that the ink doesn't just stay put static in our skin, it's actually interacting with our immune system, getting into our lymph nodes. We know that some of the ink might be bad for us, might be even carcinogenic. But we wanna know like what are the consequences? Right, besides just you feeling superior to me for nothing. Because you don't have tattoos that I do. We know that people without tattoos are better. Um but are they healthier? Um I spoke about this with Christelle Nielsen. She works at Lund University in Sweden. She is an epidemiologist who focuses on environmental toxins typically, stuff like forever chemicals. But a few years ago, she got curious about potential toxins in tattoos. And I might have one or two tattoos myself. So that triggered the interest. What do you have? I have a dragon on my arm and I was awesome. Mm-hmm. And I'm jung I was young in the nineties, so I might have a Chinese sign on my lower back. A Chinese character? On your lower back I'm not I'm just laughing because Yeah yeah. You laugh. It's the stereotype . But I don't have a tribal. I have to say that. What does the Chinese character mean? It's supposed to mean horse because I'm born in the year of the horse. Uh but but but I showed it to my daughter's friend who knows Chinese and she said I've never seen that sign before so I don't know what it means this is the classic tattoo horror story of the of the 90s. Yeah. So she's relatable is what I'm saying. Yes, she's very relatable. Um so she decided to learn Chinese. No, no, she didn't. She um decided to look into tattoos and health. I was ready to go with you on that journey. She zoomed in on cancer for the reasons we talked about before the potential carcinogenic ink. And also we know that chronic inflammation can lead to cancer. So she dove into that beautiful Scandinavian public health data that we love so much here at Science Versus in Sweden we have these very very in terms of research useful national registries where we all end up whether we like it or not. So it's it has full population coverage and especially for cancer. We have the national cancer registry. So if you get diagnosed with cancer in Sweden, any cancer, you will end up there. So she and her team decided to focus on two types of cancer that they could see plausibly being connected to tattoos. Um skin cancers, including melanoma. It's kind of obvious. But also lymphoma, that's cancer of the lymph system. Right. Because we know that the ink is in the lymph system. Right. So that makes sense. Okay. Right. Got it. And so they pulled the records of everyone in Sweden who had been diagnosed with those cancers between the ages of 20 and 60. And then they set out to find who among them had tattoos. So we contacted all of them. And I mean, lymphoma is a severe disease, so not everyone who were diagnosed ten years ago were still alive. Right. And in that case, we contacted their next of kin. I see. With the main point then of understanding whether the And they also gathered a group of um like matched people who did not have cancer, um, sort of like matched controls, and they sent out questionnaires to them as well. A lot of lifestyle stuff, but also like lots of questions about tattoos. Not just like, do you have a tattoo, but how many do you have? How big is it? When do you get it? Where'd you get it? All that kind of stuff. Um, people really got excited about this. They sent Christelle like all these emails and stuff. Like they wanted to tell her all about their tattoos. It's nice to get to know your participants in a way. And some still send me postcards. It really, it's really, really sweet. So the data started coming back. And Christelle was working closely with one of her co-authors. But this is during the pandemic. They weren't together that much. So one day, Christelle found herself just crunching the data alone. I was, you know, in my house, it was just me, and I had the data there, and I just I just needed to have a look. And then there were the preliminary results. And I just threw myself at the phone and told her that well we might actually have something here. Whoa . Yeah. So she found something when it came to cancer risk. So first lymphoma. We saw an increased risk of lymphoma among those with tattoos. Compared to those who did not have tattoos, their risk was 20% increased. They also found about a 30% increased risk of melanoma. Wow. That seems big. Is that big? Well, here's Christelle on that. So we're talking about relative risk increases. So the risk on an individual level is small. People shouldn't be freaking out. Because it's like it's that sort of situation where a 20% increase risk is serious, but the original risk might be very small. Yeah. So the new risk, even 20% higher, is still not like astronomical. Is that the idea? Exactly. So like in the US, according to the National Cancer Institute, the absolute risk of getting lymphoma is about 2.2%. So if we apply Christelle's finding to that, it suggests that a tattoo might make that risk go from 2.2 to 2.64%. And then for melanoma, it would be like starting at two point two percent, going to two point nine percent. Mm-hmm. Like sort of for the average person. Okay. I mean, right. So it's not the thing, obviously. Yeah. And so maybe if you're a person who's already like at increased risk or whatever, it's something maybe you want to factor that in. Exactly. And there are a couple other studies that have looked into this. Um, and not all of them find this link to cancer, but the strongest and biggest studies do find this link. Like a similar one that was done in Denmark. Well, but what about like is there any reason to think there might be some confounders? Like, do people who have tattoos had that had tend to have a different kind of lifestyle or like be slightly more likely to party or engage in other behaviors rows that like might contribute to cancer risk or that kind of stuff so the these studies do try to adjust for that as best they can. Um but yeah, it's probably not perfect. Um and there is some evidence that uh people who have tattoos might do some on the whole are more likely to do some risky behavior compared to people who don't have tattoos. So smoking is something that has come up in the literature. Um the thing is like these cancers are not particularly associated with smoking. Okay, so it sounds like you think there's something here. Yes. I do and I do. Partly because I think the studies Christelles' and the other study from Denmark are good studies. And also it seems like we have a mechanism that's plausible. It just it does make some sense. Should I get all my tattoos removed? Should I get 'cause you can, right? Like if you are ways to get tattoos removed. Yeah, you can get them removed with lasers. Um and y you might want to do that if you're freaked out about what I just said, or you know, you got a Chinese character on your lower back and you actually don't know what it means. And in fact, outside of this, studies do find that something like 20 to 25% of people regret at least one tattoo. Christelle says: the thing about that is: for as little as we know about the effect of tattoo ink on the body? We know even less about what happens when we shoot lasers at tattoos. So what people need to know is I mean don't laser tattoos and they evaporate into thin air. I mean, that's not what happ ens. They need to get through the body to get out in the other end, basically. The laser blasts the ink into smaller fragments that the immune system then can go and clean up, but you're still like getting your immune system to you know you're triggering an immune response. And you're also changing the molecules. Um, and some of those are worse than the original molecules in the ink. So for example, we know that a lot of the colors in tattoo inks are made with um nitrogen groups called az os and when azos are broken apart they can form compounds that we know are carcinogenic. So we might set off a cascade of exposure to something that we don't know what it is, but it might be worse than the original exposure . Might be. I mean there's a lot we don't know. We should be getting more information about tattoos generally over the next five or ten years. Christelle is gonna keep studying people. She's got this cohort, you know, she's gonna keep studying them. There's another project that's backed by the World Health Organization that's getting off the ground, following people with tattoos over a number of years. Okay. So we're gonna find out more about tattoos and health. I think that we as a society we will continue to get inked and then we need to make sure that it's safe to do it. Absolutely. And I think the what we do in the show, right, is like try to give you the information to like make that decision for yourself. You know, we're not cops. But even when I think about it, I'm like, I knowing all this, like, I don't know. You know, like maybe I still would have gotten my tattoos. Cause I like them. Uh-huh. You know what I mean? Like, I'm not sure if knowing this would have been quite enough for me to be like, never. Right. Well, yeah, I mean and the thing is like with with anything that we talk about, it's always like risk versus benefit, you know? Benefit looks cool. No, there are real benefits, Blythe. It's more than just looking cool. And I have one final guest to introduce you to, to tell us a little bit more about that. His name is Virin Swamy. He is a professor of social psychology at Anglia Ruskin University in the UK. Being tattooed or being able to get a tattoo is a small marker of agency. Says I am allowed to own my own body and do what I want with my body. Historically, essentially, tattoos were the preserve of what psychologists have called out groups. And outgroups we simply mean marginalized communities. So like in the West and in communities colonized by the West, tattooing has been associated with being in an outgroup, um like think of sailors in the 1700s, but it's mainstream in other parts of the world, like in Polynesia. Um and even though today in the West tattoos are not as stigmatized, researchers still find an echo of that motivation. So this is interesting. The demographic in the US that is most likely to get tattooed. Um, this is according to a Pew research survey from a few years ago. 68% of people who identify as queer women have at least one tattoo. Interesting. And that makes a lot of sense to Virin. It goes back to the idea of being part of an outgroup. I think any community that has a history of marginalization will try and reclaim the body in some way. It's also the same reason why some researchers have talked about how women who have been who have had a history of sexual or physical abuse tend to get tattooed again And we do have some evidence that getting tattooed can help people feel better about themselves. A few years ago, Viran went to a tattoo shop in London and he surveyed people before and after they got their first tattoo and also followed up with them a little bit later. He did stuff like he was assessing their self-esteem. He asked them, how do you feel about your body ? How do you feel about how you look? And it turns out that after they got their tattoo. People reported being happier with their bodies, appreciating their bodies more, feeling like they were more unique as a result of getting tattoos and feeling lower anxiety about their appearance. Another study found this too. This study actually had college students design a temporary tattoo that an artist painted on them. It lasted a couple weeks. Uh-huh. And they measured their like self- esteem and and how they felt um before and after that temporary tattoo. And it did also give them a boost. Oh, that's fun. And I think it's telling that most people don't regret their tattoos even years later. Remember that stat I told you earlier. It's like maybe 20% of people regret their tattoos. And that means 80% don't totally. I I'm among the 80% rose. Okay. I well I was gonna ask you, how are you feeling about tattoos after all that information and your husband's Well, yeah. I guess I should