June 8, 2017 – Most people know that dirty tattoo needles can transmit infections like Hepatitis C.

But it is less well known that the wound itself can get infected – something that led to severe consequences for one man who died from a tattoo infection after he went swimming in the Gulf of Mexico.

The man, identified as a Texas resident in a study in the British Medical Journal, had received the tattoo in his right leg and went swimming five days later.  He was admitted to the hospital three days later and tested positive for Vibrio vulnificus, a bacteria found in coastal waters.

The man also had chronic liver disease, which hampered his recovery. He died about two months later.

Nicholas Hendren, MD , the lead author of the study, says that while infections of new tattoos are not a common occurrence, they are not rare.

One recent study found that 3.2% of people who received tattoos reported at least one infected tattoo.

Hendren says the Texas man’s case was “definitely on the extreme side.” People are more likely to contract MRSA, methicillin- resistant staphylococcus aureus, among other more common bacteria, he says.

Hendren tells his patients that getting a tattoo is similar to getting stitches, and that you wouldn’t want to go swimming in a pond after getting stitches. He tells people to avoid swimming in lakes, rivers and ponds, saltwater and pools and to avoid excessive scrubbing until the tattoo has healed.

Hendren says a tattoo is healed when the scab falls. Most tattoos take on average about one to several weeks before healing, says Doris Day, MD, a New York City dermatologist.

State and local health departments regulate tattoo parlors. A 2015 study of tattoo regulations found that only seven states specifically required their public health department to approve instructions for tattoo aftercare. Seven state have no licensing at all, and the rest have varying requirements. Most leave aftercare instructions up to the tattoo artist.

Hendren recommends using a licensed tattoo parlor to get a tattoo, saying it helps reduce the chances of liver infection. The most common is hepatitis B, as well as other infections like hepatitis C and HIV.

Day says that aftercare is important while you are waiting for a tattoo to heal.

“Wash with soap and water,” says Day. “Apply a topical ointment and nonstick bandage during the day and leave uncovered at night”. Remove plastic wrap when you get home, allowing the area to breathe. Plastic wrap keeps in heat and moisture, allowing bacteria to grow.

Both doctors recommend getting medical help immediately if you see any of these signs:

  • For tattoos that are on your arms and legs, a red linear band or streak developing and extending from the area.
  • Worsening pain around the tattoo five to seven days later.
  • Discharge coming from the area.
  • Having a fever, which is a sign of infection.

Show Sources

BMJ. “Vibrio vulnificus septic shock due to a contaminated tattoo.”

Nicholas Hendren, MD, Internal medicine resident, Parkland Health & Hospital System and UT Southwestern Medical center

JAMA Dermatology. “The Need for Greater Regulation, Guidelines, and a Consensus Statement for Tattoo Aftercare.”

Doris Day, MD, New York City dermatologist, attending at Lenox Hill Hospital  

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