Distribution of nickel and chromium containing particles from tattoo needle wear in humans and its possible impact on allergic reactions

Title	Distribution of nickel and chromium containing particles from tattoo needle wear in humans and its possible impact on allergic reactions
Authors	Ines Schreiver, Bernhard Hesse, Christian Seim, Hiram Castillo-Michel, Lars Anklamm, Julie Villanova, Nadine Dreiack, Adrien Lagrange, Randolph Penning, Christa De Cuyper, Remi Tucoulou, Wolfgang Bäumler, Marine Cotte and Andreas Luch
Magazine	Particle and Fibre Toxicology
Date	08/27/2019
DOI	10.1186/s12989-019-0317-1
Introduction	Allergic responses to tattoos represent a prevalent adverse effect associated with the permanent placement of pigments within the dermal layer of the skin. While pigment characteristics and distribution have received attention, the health implications of tattoo equipment for the extensive population with inked skin have not been a primary focus of either research or clinical assessment. Tattoo needles contain substantial quantities of sensitising elements, specifically nickel (Ni) and chromium (Cr), yet their contribution to metal accumulation in the skin has remained unexamined. This study details the accumulation of nano- and micrometre-sized particles from tattoo needle wear within human skin, noting their subsequent movement to lymph nodes. Tattoo needles typically incorporate nickel (6–8%) and chromium (15–20%), both known to cause high rates of sensitisation. Experiments using pig skin demonstrated a significant increase in needle wear when tattooing with titanium dioxide white pigment, which is suspected to be abrasive, compared to carbon black pigment. Furthermore, scanning electron microscopy of tattoo needles showed considerable wear after use with titanium dioxide-containing ink. Examination of a skin biopsy from a nickel-sensitised patient experiencing a type IV allergic reaction to a tattoo revealed both wear particles and iron pigments contaminated with nickel. Previously, nickel contamination of iron pigments was considered the primary cause of nickel-driven tattoo allergies. However, our findings clearly indicate an additional source of nickel entry into both skin and lymph nodes, originating from tattoo needle wear. The impact of this additional entry on tattoo allergy formation and systemic sensitisation warrants further evaluation.
Quote	Ines Schreiver, Bernhard Hesse and Christian Seim et al. Distribution of nickel and chromium containing particles from tattoo needle wear in humans and its possible impact on allergic reactions. Particle and Fibre Toxicology. 2019. Vol. 16. DOI: 10.1186/s12989-019-0317-1
Element	Nickel (Ni) , Chromium (Cr) , Titanium (Ti) , Carbon (C)
Industry	Medical Devices , Pharmaceuticals & Cosmetics , Research & Laboratory