Saturday, June 20, 2015

Defacing the Temple: the Hazards of Tattoos

Bruce Charlton has repeatedly discussed the spiritual hazards inherent in (and/or signaled by) tattoos, as well as addressing at least somewhat the psychological pathology reflected in the phenomenon:

Fashion, therapy, enhancement, self-mutilation: the slippery slope
(here's one post; you can also search his blog for "tattoos" and/or "uglification" and find other thoughtful discussions on the topic)

 so I'm going to focus fairly narrowly on just the physical/medical/bodily hazards, in this post. 

I'm sure all Christians are aware that your physical body is the literal temple of the Holy Spirit, and as such should be treated with care and reverence; we should no more deface it than we should spraypaint graffitti on the walls of our sanctuary.  Except that analogy is very weak, because getting a tattoo is in reality more like ENGRAVING graffitti into the walls and then impregnating that engraving with toxic waste.  Yes, really. (See the following.)

(Note:  if you're allergic to medical jargon, you can scroll down to the ************'s for a Q & A basic summary and some recommendations.)

What follows is a post-graduate student's Anatomy & Physiology capstone project summary, shared with permission:

Lymphatic Effects of Tattoos

            A recent “fad” has swept Western culture, resulting in unprecedented numbers of tattoos on people of all ages and both sexes.  Previously, only very few people in the West had tattoos, most of them were armed servicemen, and most of them had only one or two.  Women with tattoos were so rare as to be considered side show attractions (as in the vaudeville song, “Lydia the Tattooed Lady”).  Men with tattoos that covered entire limbs (“sleeves”) or other large parts of their bodies were either carnival attractions themselves, or “Hell’s Angels” members.  Now, tattoos on women, and multiple tattoos on anyone, are increasingly common. 
            This is of concern, because tattoo inks are not regulated.  The FDA has not approved any tattoo pigments for injection under the skin (, and the inks are embedded in the skin so deeply that they do not “wear off.”  Tattoo inks include known carcinogens, including some polycyclic aromatic hydrocarbons (PAH’s), that are such potent carcinogens that they are routinely used in animal research to grow tumors (Israel, 2011).
Until recently, little was known about the toxicity of tattoo inks, how the body attempts to process them, or the long-term effects of these inks on various body systems.  “The introduction in the dermis of exogenous pigments and dyes. . . represents a unique in-vivo situation, where a large amount of metallic salts and organic dyes remain in the skin for the lifetime of the bearer. . . potential local and systemic carcinogenic effects. . . remain unclear” (Kluger and Koljonen, 2012).  Noting a couple of studies that showed tattoo inks being concentrated in lymph nodes, and being interested in doing a project to learn more about the lymphatic system, I became curious as to the answers to some of these questions.


HPLC-DAD technology:  High-Performance Liquid Chromatography with Diode-Array Detection; a device used to obtain spectrographic profiles of chemicals in a sample (Lehner, et al., 2014).

Haematoxylin:  a crystalline phenolic compound, C16H14O6, found in logwood and used chiefly as a biological stain ( 

Lymphadenopathy:  abnormal enlargement of the lymph nodes ( 

Non-caseating:  not exhibiting caseation; caseation = necrosis with conversion of damaged tissue into a soft cheesy substance (    

PAH:  Polycyclic Aromatic Hydrocarbons; known carcinogens present in tattoo inks, especially black tattoo inks (Lehner, et al., 2014).

Cellular/Histology Report

            Lehner, Santarelli, Vasold, Penning, Sidoroff, Konig, Landthaler, and Baumler (2014) found that black tattoo inks collected and concentrated in the regional lymph nodes of the area of a tattoo.  The corresponding lymph nodes of that region appeared deep black.  “Biopsies have shown that pigment-laden cells cluster around small vessels presumably in an attempt to eliminate tattoo pigment as in a normal foreign-body reaction through the lymphatic system” (Hogsberg, Loeschner, Lo, and Serup, 2011).  Studies in animals show that carbon black induces inflammation and increases the likelihood of mutations with long-term exposure (Hogsberg et al., 2011).  Histopathological analysis of lymph nodes from a heavily tattooed patient with swollen painful axillary lymph nodes showed “reactive follicular hyperplasia and sinus histiocytosis” (Kluger, Cohen-Valensi, and Nezri, 2001).  This means that the follicles (nodules) of the lymph nodes are swollen, because they are clogged with cells (histiocytes) that are trying unsuccessfully to deal with the foreign matter of the tattoo inks.  The doctors concluded that this lymphadenopathy (abnormal swelling of the lymph nodes) occurred in reaction to a build-up of tattoo inks in the nodes.  (See the appendix for pictures from Hogsberg et al., Figure 1; and Kluger et al., Figure 2.)

Organ/Systemic Report

This means that the lymphatic system is attempting to remove tattoo ink from the body as a foreign substance; however, the fact that the inks are concentrated in the nodes means that, while the system is able to remove some of the ink from the subdermal space where it was injected, it is apparently unable to successfully remove it from the lymph nodes.  Tattooing thus creates stress on the lymphatic system, because “90% of the [ink] goes into the lymph nodes and stays there” (Tattoos and Lymphedema, n.d.).  Nodes full of inorganic particles that cannot be phagocytized and eliminated may become less capable of removing bacteria and viruses from the body; thus compromising immune function.  Further, since these particles are known carcinogens, it is likely that harboring a concentration of these particles for the long term may eventually induce cancer in the affected nodes.  At least one researcher at Swinburne University’s Centre for Skin Sciences asserts that toxins from tattoo inks are building up in the spleen and kidneys, as well (Sales, 2013).

Organism Report 

            For the affected person, the buildup of tattoo inks in the lymphatic system can lead to either localized symptoms of pain, swelling, and discomfort, or to generalized symptoms of systemic illness throughout the body.  A case study in the British medical journal The Lancet (Kluger, Cohen-Valensi, and Nezri, 2001) reported on a 38-year-old man with painfully swollen axillary lymph nodes.  The patient had no notable relevant medical history to explain this symptom, and blood tests for many different possible causes ruled them out; however, it was noted that “the patient had many tattoos, dating back to 20 years, on his arms, chest, abdomen, and back” (Kluger, et al., 2001).  The patient was diagnosed with reactive lymphadenopathy as a result of his tattoos.  See the appendix (Figure 2) for pictures of the lymph node histology.
            Another Lancet case report (Guerra, Alderuccio, Sandhu, and Chaudhari, 2012) described another man, age 37, with “small, erythematous papules underlying a 12-year-old tattoo on his right leg,” as well as progressive muscle ache in both legs, pain and swelling of both ankles, fever, fatigue, and night sweats.  This patient was diagnosed with systemic sarcoidosis, which the report notes has been associated with tattoos since 1952, and treated with prednisone.  They explain that chronic low-grade exposure of the immune system to the antigens of the foreign material in the tattoo inks may lead to this systemic reaction.  See the appendix (Figure 3) for the presenting granulomatous tattoo reaction.

Future Projections

            Because so many people are getting tattoos now, and so many of them are getting multiple tattoos as well, it is certain that any health effects of tattoos will become abundantly clear in the next decade or two.  It seems likely that the build-up of carcinogenic substances in lymph nodes does not bode well for the probability of lymphatic cancer, and in the meantime stressed lymph nodes that are unable to clear their sinuses of the various inorganic metal salts and other foreign substances are likely to be less able to do their job of clearing organic health threats (unfriendly bacteria and viruses) from the body, thus decreasing the overall health and vitality of the “decorated” person.  We might thus see a widespread syndrome of depressed immune function related to tattoos, as well as a pattern of tattoo-related lymphatic cancers.

Works Cited

Guerra, J., Alderuccio, J., Sandhu, J., & Chaudhari, S. (2012). Granulomatous tattoo reaction in a young man. The Lancet, 284-284.
Høgsberg, T., Loeschner, K., Löf, D., & Serup, J. (2011). Tattoo inks in general usage contain nanoparticles. British Journal of Dermatology, 1210-1218.
Israel, B. (2011, September 5). Tattoo health risks - research raises concerns. Environmental Health News. Retrieved April 30, 2015.
Kluger, N., Cohen-Valensi, R., & Nezri, M. (2008). Black lymph nodes—and a colourful skin. The Lancet, 1214-1214.
Kluger, N., & Koljonen, V. (2012). Tattoos, inks, and cancer. The Lancet Oncology, 13(4), E161-E168.
Lehner, K., Santarelli, F., Vasold, R., Penning, R., Sidoroff, A., König, B., . . . Rodrigues-Lima, F. (2014). Black Tattoos Entail Substantial Uptake of Genotoxic Polycyclic Aromatic Hydrocarbons (PAH) in Human Skin and Regional Lymph Nodes. PLoS ONE, E92787-E92787.
Sales, L. (2013, November 4). Nanoparticles in tattoo ink. Retrieved April 30, 2015, from
Tattoos and Lymphedema. (n.d.). Retrieved April 30, 2015, from
Think Before You Ink:  Are tattoo inks safe?  U.S. Food and Drug Administration. (n.d.). Retrieved April 30, 2015, from


Figure 1. Specimen of black tattooed human skin (top)

and one of the corresponding regional lymph nodes (center), which was cut into two pieces.

Transmission electron microscopy shows the shape and size of black tattoo particles, which consist of Carbon Black nanoparticles (bottom).

(Hogsberg, Loeschner, Lo, and Serup, 2011)

Figure 2.  Enlarged lymph nodes related to a tattoo. 

(A) The excised lymph nodes.

(B) Section through a lymph node. Haematoxylin and eosin stain; ×200 magnification.

(Kluger, Cohen-Valensi, and Nezri, 2001)

Figure 3.  Granulomatous tattoo reaction.

(A) Lateral aspect of the left leg showing pink papules and plaques with overlying white scales within areas of tattoo ink.

(B) Haematoxylin and eosin-stained tissue section (×100) from the skin biopsy showing a confluent non-caseating granuloma in the dermis. A giant multinucleated cell can be seen in the centre of the granuloma. 

(Guerra, Alderuccio, Sandhu, and Chaudhari, 2012)


Q & A

What on earth does all that mean?

For those stalwart souls who've made it this far, but perhaps didn't follow all the medical jargon, here's the bottom line:  your body recognizes tattoo ink as a foreign substance in the body.  The lymphatic system, whose job it is to capture and dispose of such foreign invaders, does a hero's duty of surrounding the ink particles and capturing them, then bringing them to the lymph nodes to be "processed."  If the particles were the normal kinds of things encountered in nature (mostly bacteria, viruses, the occasional wood fragment from a tiny splinter, that kind of thing), then big white blood cells "eat" (phagocytize) them in the lymph nodes and then either digest them or die themselves and get cleared out of the system.  However, the metals and other chemicals commonly present in tattoo inks are not the kind of thing these cells are designed to deal with; so they just build up in the nodes.  This does two bad things:  1)  it clogs up the nodes, so that the system will now have increasing trouble doing its job with bacteria and viruses and other things it is supposed to be taking care of, and 2)  while it is sitting there, it is continuously exposing the cells of your lymphatic system to a number of known carcinogens (some so reliably carcinogenic that they are routinely used to cause cancer in laboratory animals).  

Help!  I've already joined the crowd and had my toxic graffiti engraved on my body.  Now what?

If you've already had tattooing, at this point it seems like "removal" is not a good option, unless your tattoo is small enough or only composed of fairly thin lines, such that you can actually have it excised (cut out).  Excision can actually remove the ink and prevent any more from being transferred into the lymph nodes.  Laser tattoo "removal" does not actually "remove" the ink; it just breaks up the clumps of ink into smaller particles so that your lymphatic system can clear them away from the skin more efficiently.  It appears that this would likely only result in more toxic particles building up in the lymph nodes, which is definitely not desirable.  

So what can we do?

1)  Don't get any more "ink" injected into your body than you already have.  If you are wise enough so far not to get any, as the anti-smoking PSA's say, don't start!

2)  Keep your lymphatic system in the best shape possible.  Help it to do the best it can, even if it is dealing with some stuff it isn't designed to deal with, by eating healthy real foods (mostly foods as found in nature, not processed foods or tortured meat); drinking lots of pure water (the general recommendation is "8, 8-ounce glasses" a day; a more specific one would be half your body weight in ounces of water every day);  getting some sunshine for natural Vitamin D (a well-established cancer-fighter); and MOVING.  Your lymphatic system, unlike the circulatory system, has no pump.  It relies exclusively on your bodily movements to keep things flowing through.  If you are basically sedentary, you are courting lymphatic trouble even without the extra stress of toxic waste build-up.  Your body is made to move all day long, so however much you are moving now, just move a bit MORE, every day.  This will improve not only your lymphatic function, but every facet of your life.

3)  Pray.  Your whole self needs that every day, too. 

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