Pigments in permanent makeup inks include substances reported to cause allergic contact dermatitis (ACD), but the ability to identify these allergies in patients is limited.
METHODOLOGY:
The allergenic potential of pigments in traditional tattoos is well-documented, but there is less clarity regarding pigments used in cosmetic tattoos, or permanent makeup, and their association with ACD. Researchers conducted an internet search to identify 974 individual permanent makeup ink products sold in the United States, identifying 79 unique pigments in these products. They evaluated the safety data sheets of these products and performed a PubMed search to identify documented ACD cases related to these pigments.
TAKEAWAY:
Of the 79 pigments, 20 contained inorganic metals, including iron, aluminum, silicone, chromium, copper, titanium, molybdenum, and manganese.
Organic pigments were more common: 59 pigments were organic compounds, mostly azo, quinacridone, or anthraquinone dyes, including four black pigments made from carbon only.
A literature search identified 29 cases where patients developed ACD thought to be caused by at least one of the 79 pigments identified by the study authors, including 10 of the 79 pigments (12%).
In 18 of the 29 cases, patch testing to the suspected pigment had been performed; in three cases, ACD was suspected without confirmatory testing.
IN PRACTICE:
Permanent makeup is becoming more popular, and reports of ACD related to pigments in the inks are increasing. The authors noted that “traditional patch testing methods may not be useful in confirming the presence of a pigment allergy, even if one is suspected.” They added, “Consumers and patch testing physicians would benefit from better labeling of tattoo inks and the development of protocols designed to specifically test for tattoo pigment allergies.”
SOURCE:
The study was led by Sarah Rigali, MS, of Rosalind Franklin University, Chicago Medical School, and coauthors from the Department of Dermatology, Northwestern University, Chicago. It was published online on May 31, 2024, in the Journal of the American Academy of Dermatology.
LIMITATIONS:
The study is limited by incomplete safety data sheets, preventing the investigation of many brands of permanent makeup ink. Additionally, some pigments may not be fully disclosed in ingredient lists, and precise ink content measurements were not available.
