Tattoos and Psoriasis

Medically Reviewed by Stephanie S. Gardner, MD on March 25, 2022
5 min read

Tattoos are a popular form of self-expression. More than 1 in 10 people in Western countries have one. It’s important for anyone getting a tattoo to make sure they choose a place that’s clean and safe to have it done. You’ll want to think carefully and take precautions before doing something that will leave a permanent mark on your body.

If you have psoriasis and really want a tattoo, the first thing to know is that it’s not out of the question. Many people with psoriasis find that tattoos help them feel better about their bodies. But you will want to think even more carefully about whether the risks of tattooing are worth it to you and what you can do to try and avoid making your psoriasis worse.

When you get a tattoo, your tattoo artist will likely use a machine to pierce your skin over and over again. With every poke, they leave ink behind. Even for people without any skin condition, tattoos come with some risks for skin problems including:

When you have psoriasis, a problem in your immune system makes your skin grow too fast. This is what happens in plaque psoriasis, the most common type.

Many things can trigger a flare in your symptoms. One common trigger is injury to your skin. Even a cut, scrape, or bug bite can make your psoriasis worse. Because getting a tattoo involves repeated injury to your skin, it could trigger the red patches, spots, and discomfort that come with psoriasis.

Your tattoo artist will want to put the tattoo in a place where your skin is healthy and clear. In some states, they can’t tattoo skin with any sort of rash, lesion, or pimple. For example, in Oregon, tattooing is forbidden on people with open lesions or rashes of any kind. Check the rules for tattooing in your state to see if they say anything about skin conditions, including psoriasis.

Sometimes people with psoriasis symptoms in one place will get new spots after the skin is injured. These spots can happen in places that are unusual for you to have signs of psoriasis. There’s even a special name for this. It’s called the Koebner phenomenon, after the person who first described it in the 1800s.

Doctors also call this phenomenon in which plaques spread to new places after injury isomorphic psoriasis. It can happen after a tattoo. It happens in up to a third of people with psoriasis.

For example, there’s a case report of a 27-year-old man with scalp psoriasis who got many more scaly plaques 2 weeks after getting his first tattoos on his arms and back. The red spots showed up in places where the tattoos were. But they also showed up on other parts of his skin.

Even though this could happen to you, it doesn’t happen in most people. And it usually goes away in a couple of weeks. One study of 90 people with psoriasis found that more than half of them had tattoos. Almost 30% had a flare-up of their psoriasis after they got the tattoo. Those who had this happen were more likely to have had a flare related to skin injury before.

It wasn’t common to have a flare on another part of the body after getting a tattoo. But it did happen to 7% of people in the study. Even so, more than 80% of those who got a tattoo said it had given them a more positive body image.

Another study looked at more than 2,000 people with psoriasis, 20% of which had tattoos. More than 15% of the people surveyed didn’t have a tattoo but wanted one. Close to half of the people in that group said the reason they hadn’t gotten a tattoo yet was because of their psoriasis.

Of those who’d gotten a tattoo, few said that they’d had problems. Almost 7% said they’d had a complication including:

  • Swelling
  • Itching
  • Allergy
  • Plaques in places where they normally weren’t (Koebner phenomenon)

Nobody said that they’d had a severe complication from getting a tattoo. People whose psoriasis needed treatment at the time they got the tattoo were more likely to have some kind of problem afterward.

Tattoo shops differ in what they recommend after your tattoo. But you’ll want to keep your tattoo area clean. You’ll also want to use a moisturizer to keep the skin from drying out. Make sure you use a lotion or cream that’s good to use when you have psoriasis. Use it several times a day.

You’ll also want to avoid swimming and stay out of the sun. It should take about 2 weeks for the area to heal. It’s normal for your skin to scab over as it heals. Be careful not to pick or scratch it. You shouldn’t wear clothes that will stick to the tattooed area either. All of this would cause more injury to your skin and might trigger your psoriasis.

Even though the risks of a tattoo when you have psoriasis aren’t serious, doctors often discourage them. That’s because there is the chance you’ll make your psoriasis worse. If you’ve decided it’s worth it to you, ask your dermatologist if they can help you find ways to make any potential problems less likely.

Another way to lower your risks is to make sure you’re going to a tattoo studio and artist with lots of experience. It’s important for anyone -- and especially those with psoriasis or any other skin condition -- to make sure the tattoo shop they choose follows safety standards. Make sure the studio is clean and that all equipment they use is sterilized.

They should have an autoclave. This is a special oven that uses heat and pressure to sterilize equipment. They should not use needles more than once, and your artist should always wear gloves. Here are other good questions to ask to make sure you’ve chosen the right place to get your tattoo:

  • Are you comfortable giving me a tattoo given that I have psoriasis?
  • How should I take care of the tattoo after I get it?
  • How long have you been doing tattoos?
  • Can I see examples of your work?
  • Can I see how you prepare for giving a tattoo?

Make sure to talk to your tattoo artist before your scheduled appointment. Ask them about any concerns they have about your psoriasis. Ask them also if they have any ideas to help make sure it goes smoothly. Careful decisions about where to put your tattoo and learning how to care for your skin before and after will give you the best chance of success.

If you’ve gotten a tattoo and think that your psoriasis is getting worse, contact your dermatologist to see if you need to treat it differently.