So, you finally got inked. You chose a design, picked out a parlor, and "sat" like a champ. (That’s tattoo artist-speak for grinning and bearing it through hours of pain.) Then you spent a few weeks diligently washing and moisturizing it while it healed. Now, save for moments you catch a glimpse of the design in the mirror, you usually forget the whole thing happened. What’s done is done, right?
Not always. In fact, skin irritation or a full-blown condition can develop months, years, even decades after the initial tattooing process. "Tattoos breach the protective layer of the skin, increasing your risk of skin complications," says David Lortscher, a dermatologist based in San Diego and San Francisco and co-founder of Curology. If you start to see redness, bumps, or even burns on or around a long-healed tattoo, one of these issues could be the culprit, and you should see your physician or dermatologist as soon as possible.
Your tattoo is infected.
You’ve heard horror stories of peoples’ ink getting infected and warping the appearance of the design. But while this typically occurs during the initial healing process, an infection is still possible even months later, according to the American Academy of Dermatology. Some signs to look out for: pain or redness that gets worse rather than better; a rash with itchy, red bumps; open sores; pus; and a fever with chills.
You've developed an allergy to the ink.
"Though it's rare, a reaction called a pseudolymphomatous reaction can occur in response to red ink," says plastic surgeon David L. Cangello of Cangello Plastic Surgery in New York City. Essentially, this is a delayed hypersensitivity to the ink.
"The exact etiology is unknown, but it's thought that the red ink acts as an antigen, or something that stimulates an immune response from the body," says Cangello. "Cells called lymphocytes infiltrate the skin in the area of the antigen — or red pigment in this case — and cause an inflammatory reaction." Likely, the response has been developing for some time but took months or years to appear on the surface of the skin.
You're predisposed to a skin condition.
Shockingly, tattoos can cause skin conditions such as eczema and psoriasis and even vitiligo to crop up for the first time. "This centers around something called the Koebner phenomenon," says Dhaval Bhanusali, a dermatologist in New York City. "Particularly with psoriasis and vitiligo, the idea is that any epidermal disruption can trigger disease, including a tattoo. Eczema is probably more reflective of an allergic reaction."
Ink can also cause someone who’s already aware of their condition to have a flare-up, says Cangello.
You were in the sun.
You've probably heard sunscreen is extra important if you have tattoos, since the sun’s UV rays can cause ink to fade. But have you ever gotten a particularly nasty sunburn on or around a tat with yellow ink? It’s actually a form of an allergic reaction. Blame the pigment’s traces of cadmium sulfide, which can cause swelling and redness around the tattoo site when exposed to the sun, says Lortscher.
"One study also found that tattoos with red, blue, or black ink caused sun-related complaints such as swelling, redness, an itchy rash, blisters, and hives. These symptoms can appear within minutes or hours of the sun hitting your tattoo."
You had an MRI.
Tattoo ink can contain metallic pigments including iron, barium, zinc, copper, molybdenum, and titanium. "The metallic tattoo pigment acts as an antenna for the radiofrequency pulse the MRI magnet sends out, generating heat," says Lortscher. "The larger the tattoo and the stronger the magnet, the higher the risk of burning."
Romil Patel, a radiologist in Orlando, says his team generally always asks patients if they have tattoos prior to performing an MRI — but make sure to speak up if your doctor doesn't.
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Originally Appeared on Allure