My mother is a nurse and my sister is a doctor, and for these reasons alone, there is no shortage of "clippings" and forwarded links to medical news on tattoos. For Christmas, I was given the gift of mass hysteria as an envelope filled with articles cried out that tattoos lead to AIDS & cancer. Of course, we all agreed that, with little science behind these articles, it's best not be a part of the fear mongering (yet) and see how things develop. [They promised to help me find better research that follow up such claims.]

One medical article my mom gave me that was way less sexy but important and practical is the cover feature in the latest Psoriasis Advance magazine entitled "To Tattoo or Not To Tattoo," which weighs the risks of skin trauma for people with psoriasis wanting a tattoo.

First off, what is psoriasis? The Psoriasis Advance website defines it as:

A chronic, autoimmune disease that appears on the skin. It occurs when the immune system sends out faulty signals that speed up the growth cycle of skin cells. Psoriasis is not contagious.
 
There are five types of psoriasis. The most common form, plaque psoriasis, appears as raised, red patches covered with a silvery white buildup of dead skin cells. Psoriasis can occur on any part of the body and is associated with other serious health conditions, such as diabetes, heart disease and depression.

Psoriasis is the most common autoimmune disease in the U.S. As many as 7.5 million Americans have psoriasis.

So how does this skin disease react when there are needles injecting pigment into it?

The answer is not clear cut and reactions differ with each person. The article discusses the experiences of those with the disease who took the risk and got tattooed. Some did not have any reaction or had minor flare-ups with only certain tattoos, while others had their tattoos obliterated by psoriasis. You can see a gallery and read all the deep meanings behind their tattoos here.

The opinions of the dermatologists interviewed differed as well. Here's what Dr. Kenneth Wasserman, a dermatologist in South Philadelphia, Pa., was quoted as saying:

'One of the issues, any time the skin is traumatized, is psoriasis can occur in that area,' says Wasserman, referring to what's known as the Koebner phenomenon. 'And tattoos are trauma. In order to get a tattoo, needles have to be put in and there's trauma that happens to the skin. It's likely to bring up psoriasis in those areas.'

But Dr. Jeff Crowley, a Bakersfield, Calif., dermatologist and clinical researcher, offers another viewpoint:

'In the many hundreds of patients I have treated with psoriasis and tattoos, I have noted no relationship between the tattoo 'trauma' and psoriasis,' says Crowley, a member of the National Psoriasis Foundation Medical Board. 'Some patients do develop lesions over portions of their tattoos, but this may just be the normal course of their psoriasis.'

Tattooists themselves have their own approaches when dealing with clients who have the disease. Some refuse to do any work, and some may even be prohibited by law. According to the article, "In Louisiana, for example, state law prohibits operators from tattooing on individuals 'with psoriasis or eczema present in the treatment area.'" Other tattooists take it on a case by case basis, like Briana Sargent of BUJU Tattoo in San Diego who says, "If a patient has an area with obvious psoriasis scales and redness, I would not tattoo that area." But she will tattoo non-affected areas and also offers touch-ups should there be any issue with healing. 

Another big concern is how a medication taken to treat psoriasis will affect the tattoo. For example, retinoids increase scarring in patients and topical steroid treatments can thin the skin.

Overall, the take-away from the article is to have a conversation with your dermatologist before heading to an experienced tattooist, then start small and proceed with caution. 

Read the full article here.