The receipt of a tattoo is not without risk, especially if the patient has an underlying condition.
Contraindications to tattooing:
(1) chronic skin condition that could cause an adverse skin reaction in the tattooed area (psoriasis, lichen planus, atopic dermatitis), especially if there is a history of Koebner reaction
(2) pregnancy or breastfeeding (due to potential chemical harm to fetus or infant)
Relative contraindications:
(1) history of keloid formation
(2) history of sarcoidosis
(3) history of epidermolysis bullosa
(4) allergic reaction to a particular tattoo component
(5) vitiligo
Restrictions on placement:
(1) personal or family history of melanoma: avoid tattoo near pigmented lesions
(2) site of previous skin cancer excision
Conditions requiring medical clearance (bleeding, delayed healing, infection)
(1) anticoagulation therapy
(2) immunosuppression (including steroid therapy) or immunodeficiency
(3) significant systemic disease
(3a) congenital heart disease or rheumatic fever (risk of infective endocarditis)
(3b) diabetes mellitus
(3c) coagulopathy
(4) history of tattoo-related skin infections
(5) likelihood of undergoing MRI
