Self-reported side effects of tattooing: a cross-sectional study in the Swedish TABOO cohort
Rietz Liljedahl, Emelie LU
; Rustemeyer, Thomas
; Saxne Jöud, Anna
LU
and Nielsen, Christel
LU
(2026)
In BMJ Public Health
4.
- Abstract
- Introduction Tattooing is common in many populations, yet population-based data on side effects remain limited. We aimed to describe the occurrence of self-reported acute- and delayed-onset side effects following tattooing and investigate individual and tattoo-related determinants in a Swedish population.
Methods The Swedish Tattoo and Body Modifications Cohort includes 13 049 participants, of whom 2633 reported having at least one tattoo and constituted the study sample. In 2021, participants reported predefined acute (within 1 month) and delayed (after 1 month) side effects following tattooing using a structured questionnaire. Information on educational attainment and yearly disposable income was obtained through linkage to... (More) - Introduction Tattooing is common in many populations, yet population-based data on side effects remain limited. We aimed to describe the occurrence of self-reported acute- and delayed-onset side effects following tattooing and investigate individual and tattoo-related determinants in a Swedish population.
Methods The Swedish Tattoo and Body Modifications Cohort includes 13 049 participants, of whom 2633 reported having at least one tattoo and constituted the study sample. In 2021, participants reported predefined acute (within 1 month) and delayed (after 1 month) side effects following tattooing using a structured questionnaire. Information on educational attainment and yearly disposable income was obtained through linkage to national registers. Multivariable logistic regression was used to identify determinants of reporting any acute- and delayed-onset side effects.
Results Overall, 40% of participants reported at least one acute-onset side effect and 10% reported a delayed-onset side effect following tattooing. A larger tattooed body surface area (>5 hand palms), compared with <1 hand palm, was associated with higher odds of both acute- and delayed-onset side effects (OR 1.81, 95% CI 1.13 to 2.90 and OR 2.06, 95% CI 1.04 to 4.10, respectively). Use of coloured inks, compared with black ink only, was also associated with increased odds of side effects. Acute-onset side effects were associated with younger age, a low-melanin, highly photoreactive skin phenotype, cosmetic tattooing and more tattoo sessions, whereas delayed-onset side effects were most strongly associated with prior acute-onset reactions (OR 8.17, 95% CI 5.45 to 12.20, compared with no acute-onset side effects). Healthcare-seeking for delayed-onset side effects was uncommon.
Conclusions Acute- and delayed-onset side effects following tattooing were common and associated with individual characteristics and tattoo-related factors. Delayed-onset side effects were strongly associated with prior acute-onset reactions, while healthcare-seeking was uncommon. These findings indicate that a substantial proportion of tattoo-related side effects never reach the healthcare system, highlighting the importance of population-based studies for assessing their occurrence and determinants. (Less)
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https://lup.lub.lu.se/record/76f8fe10-08e5-4a34-a63a-e401fe1edeb1
- author
- Rietz Liljedahl, Emelie
LU
; Rustemeyer, Thomas
; Saxne Jöud, Anna
LU
and Nielsen, Christel
LU
- organization
- publishing date
- 2026
- type
- Contribution to journal
- publication status
- published
- subject
- in
- BMJ Public Health
- volume
- 4
- article number
- e005480
- publisher
- BMJ Publishing Group
- external identifiers
-
- pmid:42602909
- ISSN
- 2753-4294
- DOI
- 10.1136/bmjph-2026-005480
- language
- English
- LU publication?
- yes
- id
- 76f8fe10-08e5-4a34-a63a-e401fe1edeb1
- date added to LUP
- 2026-09-16 14:29:45
- date last changed
- 2026-09-17 03:12:47
@article{76f8fe10-08e5-4a34-a63a-e401fe1edeb1,
abstract = {{Introduction Tattooing is common in many populations, yet population-based data on side effects remain limited. We aimed to describe the occurrence of self-reported acute- and delayed-onset side effects following tattooing and investigate individual and tattoo-related determinants in a Swedish population.<br/><br/>Methods The Swedish Tattoo and Body Modifications Cohort includes 13 049 participants, of whom 2633 reported having at least one tattoo and constituted the study sample. In 2021, participants reported predefined acute (within 1 month) and delayed (after 1 month) side effects following tattooing using a structured questionnaire. Information on educational attainment and yearly disposable income was obtained through linkage to national registers. Multivariable logistic regression was used to identify determinants of reporting any acute- and delayed-onset side effects.<br/><br/>Results Overall, 40% of participants reported at least one acute-onset side effect and 10% reported a delayed-onset side effect following tattooing. A larger tattooed body surface area (>5 hand palms), compared with <1 hand palm, was associated with higher odds of both acute- and delayed-onset side effects (OR 1.81, 95% CI 1.13 to 2.90 and OR 2.06, 95% CI 1.04 to 4.10, respectively). Use of coloured inks, compared with black ink only, was also associated with increased odds of side effects. Acute-onset side effects were associated with younger age, a low-melanin, highly photoreactive skin phenotype, cosmetic tattooing and more tattoo sessions, whereas delayed-onset side effects were most strongly associated with prior acute-onset reactions (OR 8.17, 95% CI 5.45 to 12.20, compared with no acute-onset side effects). Healthcare-seeking for delayed-onset side effects was uncommon.<br/><br/>Conclusions Acute- and delayed-onset side effects following tattooing were common and associated with individual characteristics and tattoo-related factors. Delayed-onset side effects were strongly associated with prior acute-onset reactions, while healthcare-seeking was uncommon. These findings indicate that a substantial proportion of tattoo-related side effects never reach the healthcare system, highlighting the importance of population-based studies for assessing their occurrence and determinants.}},
author = {{Rietz Liljedahl, Emelie and Rustemeyer, Thomas and Saxne Jöud, Anna and Nielsen, Christel}},
issn = {{2753-4294}},
language = {{eng}},
publisher = {{BMJ Publishing Group}},
series = {{BMJ Public Health}},
title = {{Self-reported side effects of tattooing: a cross-sectional study in the Swedish TABOO cohort}},
url = {{http://dx.doi.org/10.1136/bmjph-2026-005480}},
doi = {{10.1136/bmjph-2026-005480}},
volume = {{4}},
year = {{2026}},
}