Dear Doctors: My son, who has never been ill, was diagnosed with lupus. This comes after he got numerous tattoos. I've learned some of the inks that are used contain heavy metals, and I read that these may trigger lupus symptoms. Could his illness be linked to his tattoos?
Dear Reader: For readers who are not familiar, lupus is a chronic autoimmune disease. It arises from a malfunction in the body's natural defense systems. The defense systems attack a person's own tissues. This results in damaging inflammation. Over time, this can lead to a wide range of symptoms. Fatigue; headache; fever; rash; stiff, swollen or painful joints; dry eyes; sensitivity to sunlight; and hair loss can all be symptoms of lupus. The disease takes several forms. The most common form is systemic lupus.
The exact causes of lupus are not yet known. Environment, genetics and hormonal factors are believed to play a role. Because the immune system is responsive, it can be tempting to link the onset of symptoms with a recent environmental trigger. However, lupus develops gradually, over the course of months or even years. The start of lupus symptoms at the same time as another life event, such as an illness, surgery or even a tattoo, is not necessarily cause and effect.
That said, there is growing interest in the possible health risks of tattoo ink. Many inks come from pigments like those used in textile dyes, printer toner and automobile paint. A tattoo needle deposits these pigments into the dermis, which is the second layer of skin. At 50 to 150 jabs per second, even a one-inch tattoo can involve piercing the skin thousands of times. The body responds as with any other puncture wound. Bleeding, inflammation and escalated immune response can occur. The immune system reacts to the ink as well.
A fully healed tattoo may look like a finished product. However, the body's interaction with it will never stop. The immune system clocks the pigment particles as foreign materials and sends specialized white blood cells, known as macrophages, to dismantle and remove them. The result is continuous, low-level inflammation. Some ink gets carried to the lymph nodes. Surgeons have reported finding lymph nodes of tattooed patients stained black with ink.
The long-term health effects of tattoo inks are not yet fully understood. The pigments are not closely regulated, so ingredients vary widely. Recent studies have found trace amounts of heavy metals, known to activate immune responses. Some contain nanoparticles, which can get through cell membranes and circulate through the blood. Tattoo inks also include chemical carriers to evenly distribute the dyes and preservatives to prevent microbial contamination.
Our human brains are built to connect the dots. Finding the core logic in a sequence of events lets us prepare and defend against danger or recognize and repeat behaviors that bring benefit. But while tattoos have been shown to contribute to immune activity, at this time there is no evidence that the inks have a link to lupus.
(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
