In recent decades, tattoos have evolved from a subculture to a widespread form of self-expression. However, alongside their growing popularity, concerns have also arisen regarding their long-term safety. A recent study, published in BMC Public Health, led by researcher Signe Bedsted Clemmensen and her team at the University of Southern Denmark, analyzed a potential link between tattoo ink exposure and the development of certain types of cancer.
The study utilized the Danish Twin Tattoo Cohort, a cohort of Danish twins, to investigate whether tattoo ink is related to a higher risk of skin cancer and lymphoma. The research was conducted using two main study designs: a cohort study and a case-control study in twins. The cohort study analyzed 2,367 randomly selected twins to assess the relationship between tattoo exposure and cancer incidence. The case-control study included 316 pairs of twins born between 1960 and 1996, where one twin had been diagnosed with cancer. This design allowed researchers to control for shared genetic and environmental factors.
Cancer diagnoses were obtained from the Danish Cancer Registry, while tattoo ink exposure was determined through surveys conducted in 2021. To enhance the accuracy of the analysis, researchers applied Cox regression models with adjusted covariates and time-to-event analysis techniques.
The results indicated an increased risk of skin cancer and lymphoma among tattooed individuals, particularly those with larger tattoos. In the case of skin cancer (excluding basal cell carcinoma), tattooed individuals had a 62% higher risk (HR: 1.62, 95% CI: 1.08–2.41). For lymphoma, a 2.73-fold increased risk was found in individuals with large tattoos (HR: 2.73, 95% CI: 1.33–5.60). Moreover, the risk was more significant for tattoos larger than the palm of a hand (HR: 2.37 for skin cancer and HR: 2.73 for lymphoma). In the cohort study, the risk of skin cancer was 3.91 times higher in tattooed individuals (HR: 3.91, 95% CI: 1.42–10.8), while basal cell carcinoma showed a 2.83-fold increased risk (HR: 2.83, 95% CI: 1.30–6.16).
Researchers propose the “ink deposit hypothesis”, which suggests that tattoo ink particles may interact with surrounding tissues and cause chronic inflammation. This persistent inflammation could create an environment that favors abnormal cell proliferation and, eventually, cancer development. Studies have shown that tattoo ink does not remain solely in the skin; pigments can migrate to lymph nodes and other organs. Toxic compounds in ink, such as polycyclic aromatic hydrocarbons (PAHs) and aromatic amines, some of which are known carcinogens, have also been documented.
The presence of these compounds in tissues may trigger a chronic inflammatory response, leading to cellular damage and an increased likelihood of genetic mutations. Over time, chronic inflammation can result in abnormal cell proliferation, facilitating the development of skin cancer and lymphoma. Previous studies have detected tattoo ink particles in the liver, kidneys, and lymphatic system, suggesting that ink does not remain confined to the tattoo site. This mechanism is similar to what has been observed in breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), where chronic inflammation caused by a foreign body appears to be the cancer trigger.
Figure 1. Illustration depicting the journey of tattoo ink in the body, from dermal deposition to systemic circulation, immune response, chronic inflammation, and potential cancer risk.
While the study suggests a link between tattoos and cancer risk, the authors emphasize that further research is needed to confirm these findings and better understand the underlying mechanisms. Some limitations include the lack of data on sun exposure, a key risk factor for skin cancer, and the exclusion of other potential confounding factors, such as lifestyle habits related to smoking or diet. Additionally, assessing a causal relationship is challenging due to the long latency period of cancer.
The researchers propose additional studies to examine the effects of different ink colors, the impact of tattoo size, and the potential risks associated with laser tattoo removal.
This study raises important questions about the long-term safety of tattoos and underscores the need for stricter regulations on ink composition. Given that tattoos are becoming increasingly common among young people, raising awareness of potential health risks is essential. The researchers also suggest that public information campaigns could help educate the population about the possible dangers and encourage further research into the impact of tattoo ink on the human body.
While tattoos remain a form of art and personal expression, this study highlights the importance of making informed decisions and continuing to investigate the potential adverse effects of tattoo ink on human health.
Main Reference:
Clemmensen, S.B., Mengel-From, J., Kaprio, J. et al. Tattoo ink exposure is associated with lymphoma and skin cancers – a Danish study of twins. BMC Public Health 25, 170 (2025). https://doi.org/10.1186/s12889-025-21413-3
Other References:
Sagoe, D., Pallesen, S., & Andreassen, C. S. (2017). Prevalence and correlates of tattooing in Norway: A large-scale cross-sectional study. Scandinavian journal of psychology, 58(6), 562–570. https://doi.org/10.1111/sjop.12399
Nielsen, C., Andréasson, K., Olsson, H., Engfeldt, M., & Jöud, A. (2023). Cohort profile: The Swedish Tattoo and Body Modifications Cohort (TABOO). BMJ open, 13(5), e069664. https://doi.org/10.1136/bmjopen-2022-069664
Paprottka, F. J., Krezdorn, N., Narwan, M., Turk, M., Sorg, H., Noah, E. M., & Hebebrand, D. (2018). Trendy Tattoos-Maybe a Serious Health Risk?. Aesthetic plastic surgery, 42(1), 310–321. https://doi.org/10.1007/s00266-017-1002-0
