Tattoos And How They Affect Your Health

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A friend recently shared an article that I found extremely exciting, because it provides evidence and language for something I’ve known to be true and struggled to describe for a long time.  “Inside the Interstitium, the Human Body’s Hidden Pathways”, was published in the New York Times on May 11, 2026.  This article describes the findings of a research group led by Neil Theise, a professor of pathology at New York University, that suggest that our skin is directly connected to fascia by a fluid-filled network of connective tissue called the interstitium.  The interstitium facilitates the movement of nutrients and waste products between blood vessels and cells throughout your entire body, maintains fluid balance within tissues, supports and cushions organs and organ systems, and absorbs shock.  The fluid within the interstitium is called interstitial fluid.  

Everything is interconnected.

The confirmation of the presence of a fluid-filled network connecting parts of the body previously thought to be disconnected reinforces a core tenet of my approach to skin care: everything is interconnected.  The microbes in your gut and lungs and on your skin and genitals influence your health as you influence theirs.  Your metabolism influences inflammation and inflammation influences your metabolism.  Your gut communicates with your skin and your skin communicates with your gut.  If you’ve studied cells and how they grow together to form tissues, organs, organ systems, and organisms you realize it couldn’t be any other way.

My observations of cell and tissue biology informed my approach to skin care.

Before I moved to Davis to earn my PhD, I worked for a startup biotech company researching and developing ways to grow human cells on magnetic alginate beads in 3 dimensions, instead of on clear plastic dishes in 2 dimensions, conditions that more closely resemble those in an organism.  Growing cell cultures in conditions that more closely resemble that of an organism allows for more accurate data collection, saving time and money.  Throughout my career, as I’ve studied how cells and organisms use nutrients to grow together to form tissues and tumors and then metastasize and travel elsewhere in the body to form a new tumor, it became evident to me that a fluid-filled network other than the lymphatic or cardiovascular system had to exist in the human body.  

Although there was no definitive scientific evidence for the existence of this network when I was designing my approach to skin care and formulating the skincare products I make and sell through my business, Bexi’s Bespoke Revitalisation, I operated under the assumption that it had to exist.

Tattoos led to the visualization of the interstitium.

One of the interesting parts of the studies that Theise and his research team conducted was that they used tattoo ink to visualize the interstitium.  As I read through the studies leading up to their Nature publication, I learned a lot about how the permanent tattoo process and tattoo ink composition affect health.  

Given the popularity of tattoos, I thought I’d share what I’d learned, so you could make informed decisions about whether or not to get a permanent tattoo.  And if you know someone who’s thinking of getting one, share this article with them so that they, too, can make an informed decision.

Permanent tattoos are intended to last a lifetime.  

They’re created by using needles to inject ink into the middle layer of the skin, the dermis, which contains the interstitium.  During the tattooing process the ink and microbes introduced through the needle come into close contact with interstitial fluid, lymph, and blood, and move throughout your body. 

What are tattoo inks made of? 

Tattoo inks are made up of pigments dispersed in a liquid.  Pigments are insoluble, colored particles of various sizes and can be as small as micro and nanoparticles.  The liquid these particles are suspended in is usually a mix of solvents (primarily water) and additives.  

How long a tattoo persists in the dermis is determined by pigment particle size.

Large pigment particles remain suspended in the extracellular matrix of the dermis layer or are ingested by white blood cells called macrophages and stored in their vacuoles.  When the macrophage dies, the pigment is released and recaptured by the new generation of macrophages.  Tattoo pigments can go through consecutive cycles of capture-release-recapture without any fading or elimination of the tattoo.  The removal of permanent tattoos typically requires professional laser treatment, although exposure to sunlight can cause tattoos to fade as the sunlight breaks down the pigments in tattoo ink.

 Smaller pigment particles are broken down by macrophages and eliminated through the lymphatic system.  However, pigment particles can clog lymph nodes, leading to swelling.  Nanoparticles can pass through membranes, be transported in the blood, and enter tissue cells where they cause oxidative stress, inflammation, and programmed cell death (apoptosis).  Therefore, tattoo inks are 100% bioavailable and not limited to staying only in your skin.

To date, no risk assessments have been conducted to ensure the safety of tattoo inks.

Pigments are considered safe because they are inert and insoluble, but there is little data on tattoo ink composition, which varies a lot between ink brands.  

More importantly, the pigments used in tattoo inks are not manufactured only to be injected into your body.  Instead, pigments are manufactured for use in a variety of industries e.g., paint, plastics, textiles, and cosmetics.  Therefore, manufacturing standards are less stringent than they ought to be for something being injected into your body.  

Tattoo inks contain substances that are harmful to your health.

All pigments are impure and may include allergenic metals like chromium and nickel, toxic metals like cadmium and lead, carcinogens like formaldehyde and primary aromatic amines, mutagens like polycyclic aromatic hydrocarbons, and chemical preservatives like parabens and isothiazolinones. 

Tattoos stimulate your immune system.

Each time the needle penetrates your skin, it makes a wound that activates the inflammatory process, causes histamine release, and recruits immune cells to repair your skin and clear the tattoo ink.  

This wounding increases the risk of microbial infections, such as a bacterial infection.  Signs of a bacterial infection are local discomfort, redness, swelling, pus, and fever.

You also may have an allergic reaction to the components of tattoo ink.  Signs of an allergic reaction include intense itching and swelling of the tattooed skin and surrounding area, sneezing, and a runny nose and eyes.  Your allergic reaction may not be immediate, it can take weeks, months, or years.  

Red tattoo inks cause 80% of inflammatory reactions.  Blue and green inks also cause a high number of inflammatory reactions, but not as high as red ink.  Black inks can produce non-allergic inflammation.

The inks in your tattoo may sensitize you to inks in other items you put on or in your body. 

Because the pigments in tattoo inks are not specifically made for injection into your skin, but are also used in cosmetics and to color clothes and plastics, you may find yourself allergic to your eye makeup or to specific items of clothing.  

Are tattoos safe for someone with autoimmune disease? 

It depends on your definition of safety, your risk tolerance, your health, and how much joy tattoos provide you.

People living with chronic inflammation and/or autoimmune diseases, especially ones that affect the skin and connective tissue, such as psoriasis, lupus, vitiligo, and Sjogren’s disease, have a higher chance of having an allergic response to tattoo inks, increasing their chronic inflammation, destabilizing their immune system further, and/or triggering a flare of their disease.  

Think it through before you get a tattoo.  

A version of this blog post is published in my local newspaper, The Davis Enterprise.

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