An estimated 15million people in the UK have a tattoo – double the number of 20 years ago.
Once the preserve of sailors, bikers and rock stars, body art has become so mainstream that it now adorns the skin of everyone from Princess Eugenie (who has a tiny circle behind her left ear) to Prime Minister Andy Burnham, who sports a bee tattoo on his inner right bicep.
Such is the demand for body ink, that tattoo parlours are flourishing and Britons are spending around £700million a year getting the illustrations of their choice.
But while the vast majority of those with tattoos experience few – if any – significant side-effects (infections, for example, occur in about one in 20 cases), there are concerns in some quarters that they can increase the risk of lymphoma, a type of blood cancer that affects more than 16,000 people a year in the UK.
The disease occurs when white blood cells, called lymphocytes, start to grow out of control in the bloodstream.
Normally, in a healthy body, lymphocytes – which are part of the immune system – help fight off infections. But they can turn cancerous due to factors such as a weakened immune system, or long-term exposure to chemicals such as pesticides or insecticides.
They then multiply uncontrollably and can travel via the bloodstream around the body, damaging vital organs: around 5,000 people a year in the UK die from lymphoma.
Concerns about a possible link with tattoos spiked in 2024, when a study published in The Lancet reported that adults who had even a single tattoo were 21 per cent more likely to develop the condition.
There are concerns tattoos could increase the risk of lymphoma, a type of blood cancer that affects more than 16,000 people a year in the UK
Scientists at Lund University in Sweden compared tattoo rates in roughly 1,400 patients diagnosed with various forms of lymphoma between 2007 and 2017 with healthy adults of the same age (20 to 60).
Those with body ink were more likely to have lymphoma and, crucially, just one or two tattoos carried the same cancer danger as several more.
Researchers were at pains to point out that while there was an association between tattoos and lymphoma, the study certainly did not prove they caused it.
However, at least one other study since then has produced similar results.
Scientists at the University of Southern Denmark, in Odense, tracked more than 2,500 people to compare lymphoma rates among those with and without tattoos.
The results, published in BMC Public Health in January last year, showed that for anyone with a tattoo larger than the palm of the hand, the risk of developing lymphoma more than doubled.
In a report on their findings the researchers said: ‘We are concerned that tattoo ink interacting with surrounding cells may have severe consequences [i.e. lymphoma].’
But how does injecting ink into the skin potentially trigger a cancer of the blood?
There are around 200 different chemicals and additives in tattoo ink – some of these are thought to be carcinogenic.
But one of the main theories is that the chemicals used in tattoo ink are recognised as foreign by the immune system, which despatches defender cells to try and destroy it.
This then leads to chronic inflammation that creates a favourable environment for cancer cells to form (though it’s unclear why this would lead to lymphoma specifically and not other cancers).
There have been cases where suspicious tissue initially thought to be a tumour turned out to be non-cancerous – and this may be because tattoo ink deposits can mimic the appearance of a tumour.
An estimated 15 million people in the UK have a tattoo, including Princess Eugenie and Prime Minister Andy Burnham who sports a bee tattoo on his inner right bicep (pictured)
Numerous studies have found that pigments used in ink can travel through the bloodstream to congregate in lymph nodes – the network of bean-shaped glands throughout the body that helps regulate the immune system’s response to foreign organisms.
These ink molecules then clump together to form a semi-solid mass which – viewed on an MRI scan – can look uncannily like a cancerous growth.
Several cases have been reported in recent years where patients with suspected breast cancer that has spread to the lymph nodes in the armpit have undergone surgery to remove tumour tissue – only for tests to show it’s instead a hard mass made up of ink molecules that have stuck together.
A study published earlier this month in the International Journal of Surgical Pathology looked at more than 1,000 samples of lymph node tissue removed during biopsies from women with suspected breast cancer.
Although the study didn’t count how many had tattoos, results showed more than 8 per cent of them had ink deposits in their lymph nodes.
Dr Jonathan Kentley, a consultant dermatologist at Chelsea and Westminster Hospital in London and spokesman for the British Skin Foundation, says it’s not unusual for some ink from tattoos to settle in lymph nodes.
But he adds there is no good evidence at the moment that it does any damage, even though some chemicals used in tattoo pigment are potentially carcinogenic.
‘The data are not strong enough to say tattoos cause lymphoma – it’s only an association at the moment.’
Indeed, a review by researchers at the University of Nottingham, published in eClinicalMedicine last year, crunched data from three separate studies involving almost 18,000 patients and found no increased risk of lymphoma in tattooed volunteers.
Meanwhile, despite some suggestions that tattoos could be a risk factor, research also suggests there is no good evidence of a link between tattoos and malignant melanoma – which kills around 2,600 people a year in the UK.
There has been a succession of conflicting studies down the years – some suggesting a heightened risk, others ruling it out.
But one of the most recent investigations, at the University of Amsterdam in the Netherlands, looked at melanoma rates in the country over a 20-year period and concluded that there was ‘no evidence supporting a causal relationship between tattoos and melanoma’.
But while the chemicals in ink may not initiate skin cancer growth, they can sometimes make it harder to track changes in suspicious moles – particularly where dark pigments have been used, says Dr Kentley.
‘We use a device called a dermatoscope (a type of magnifying device with a built-in light source) to examine suspicious lesions.
‘But it can be harder to monitor skin pigment patterns that might be of concern when there is dark ink present.’
He warns against getting a tattoo on areas of the body where there are any existing moles – and advises only using one of Britain’s 2,000 or so registered tattoo artists licensed by local authorities who are required to adhere to hygiene standards.
Meanwhile, other well-documented adverse reactions to body art ink range from photosensitivity (where tattooed skin becomes more sensitive to sunlight, causing itching, swelling and a stinging sensation) to allergic reactions – which result in similar symptoms and are most often triggered by certain metals used in red ink.
At least one in ten people who gets a tattoo experiences skin reactions that involve itching, pain, inflammation and swelling for at least three weeks after having it done, according to a study published in 2023 in the journal Dermatology by scientists at the University of Copenhagen, Denmark.
