• Peter Laux, Tewes Tralau, Jutta Tentschert, Annegret Blume, Sascha Al Dahouk, Wolfgang Bäumler, Eric Bernstein, Beatrice Bocca, Alessandro Alimonti, Helen Colebrook, Christa de Cuyper, Lars Dähne, Urs Hauri, Paul C Howard, Paul Janssen, Linda Katz, Bruce Klitzman, Nicolas Kluger, Lars Krutak, Thomas Platzek, Victoria Scott-Lang, Jørgen Serup, Wera Teubner, Ines Schreiver, Elena Wilkniß, and Andreas Luch.
• German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany.
• Lancet. 2016 Jan 23;387(10016):395-402.

AbstractLong perceived as a form of exotic self-expression in some social fringe groups, tattoos have left their maverick image behind and become mainstream, particularly for young people. Historically, tattoo-related health and safety regulations have focused on rules of hygiene and prevention of infections. Meanwhile, the increasing popularity of tattooing has led to the development of many new colours, allowing tattoos to be more spectacular than ever before. However, little is known about the toxicological risks of the ingredients used. For risk assessment, safe intradermal application of these pigments needs data for toxicity and biokinetics and increased knowledge about the removal of tattoos. Other concerns are the potential for phototoxicity, substance migration, and the possible metabolic conversion of tattoo ink ingredients into toxic substances. Similar considerations apply to cleavage products that are formed during laser-assisted tattoo removal. In this Review, we summarise the issues of concern, putting them into context, and provide perspectives for the assessment of the acute and chronic health effects associated with tattooing.Copyright © 2016 Elsevier Ltd. All rights reserved.

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