More than 45 million people in the United States have a tattoo and 36 percent of these adults are in their late 20's.
The idea of branding the body is booming, but now, there is growing demand for more, bigger, brighter colors.
These new shades are raising unanswered questions about safety and skin cancer.
What adds color to your printed paper is an assortment of dyes and pigments. Some of which, according the Food and Drug Administration, have similarities to tattoo ink.
The package tells you printer inks are toxic and they shouldn't touch your skin.
Researchers say it might be time to add the same types of ingredient labels to the inks we inject into our skin.
No one except the manufacturer can tell you what's actually in the ink, not the FDA and most often, not even the tattoo artist.
Seth Bowman has a colorful collection of tattoos on his body.
"You'd think they would buy good ink," Bowman says. "At least, I assume they do, so that would never enter my mind."
Published reports in Melanoma Research highlight studies by scientists that have researched a possible relationship between tattoos and melanomas which is a type of skin cancer.
"The majority of patients getting tattoos don't know the risks," says Coleman Altman, a dermatologist in Charlotte, NC.
Most dermatologists agree the most common health risk is getting infections from tattoo shops that aren't sterilizing needles.
The new unknown risk is the short and long-term impact on the body from what could be in the ink.
From a sample of 56 inks, scientists in Italy discovered lead, titanium, cadmium and other heavy metals some of which are classified as toxic by the US Department of Labor.
They also found the presence of chromium nickel and cobalt in concentrations above the safe allergic limit.
Dermatologists told us the amount injected is likely small enough to be harmless, but that may all depend on the design of the tattoo.
"A small tattoo--I'm not worried about, but when it's all their back, all their chest, all their arms--that's a significant amount of lead," Altman warns. "Lead is a toxic metal."
Lead is known to be hazardous to the nervous system and was found in samples of tattoo ink during a study at Northern Arizona University.
"These chemicals do the same dying whether its on a sheet of chemicals or on your skin," points out Gary Slaughter, a dermatologist in Charlotte.
The FDA does not regulate tattoo ink, but reports that some are industrial grade colors suitable for printer ink or car paint.
Dermatologists report that red ink causes the most allergic reactions and the heavy metals in some colors could be responsible.
The brighter the yellow, purple, red and hot pink, the more potent the pigment is according to dermatologists.
They advise if you are set on getting inked, it's best to go with black. While the risk to lead remains, it is the easiest to remove. Most dermatologists agree, black ink causes fewer skin reactions.
"Don't just start letting them do tattoos on you and you don't know what's in it," Slaughter warns.
Doctors also recommend selecting a tattoo shop with the same eye for detail you would use in selecting a design.
Disposable needles and sterile surfaces should be standard. Ask about permits from either the state or local level, and you have every right to inquire about the ink they will be using.
Jim Ericson is with the Mecklenburg County Health Department and he inspects tattoo artists who operate in Charlotte, NC.
"Tattoo artists are very concerned about their reputation and their work," Ericson says, "They take their craft seriously."
The reason why is because a tattoo artist's reputation is a walking business card on a person's body.
Although the long-term health effects induced by ink are still largely unknown, the doctors we spoke with recommend you take an added ounce of caution before a needle ever penetrates the surface of your skin. That way, your biggest regret might only be the design you chose, and not any health consequences that could come with it.
We approached some tattoo artists and inquired about the kind of ink they used.
While no one would allow us to interview them on camera, some told us they do wish there was regulation of the industry so their art isn't at the mercy of an ink manufacturer.
Dermatologists say if you do have a reaction to a tattoo, call the artist to report it. After you hang up the phone, you should immediately head to a doctor's office.
1. Forte G, Petrucci F, Cristaudo A, Bocca B, Sci Total Environ. 2009 Nov 15;407(23):5997-6002. Epub 2009 Sep 19. "Market survey on toxic metals contained in tattoo inks."
2. "Think Before You Ink." http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm048919.htm
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