Permanent tattoos have become increasingly common, with 21 percent of adults in the U.S. reporting having at least one tattoo.
On rare occasions, outbreaks of nontuberculous mycobacterial (NTM) skin infections have been reported after tattooing.
In January 2012, public health officials in New York received reports of these skin infections in 14 New York residents who received tattoos late last year. All infections were associated with use of the same nationally distributed, pre-diluted gray ink.
The Centers for Disease Control (CDC) disseminated a public health alert to identify additional tattoo-associated skin infections. Previously, identified cases were reported in Washington, Iowa, and Colorado.
Public health investigations by CDC, state and local health departments, and the Food and Drug Administration (FDA) found contamination in tattoo inks used in two of five identified clusters. All infected persons were exposed to one of four different brands of ink.
Contamination of inks can occur during the manufacturing process as a result of using contaminated ingredients or poor manufacturing practices, or when inks are diluted with non-sterile water by tattoo artists.
No specific FDA regulatory requirement explicitly provides that tattoo inks must be sterile. However, the CDC recommends that ink manufacturers ensure ink is sterile and that tattoo artists avoid contamination of ink through dilution with non-sterile water. Consumers also should be aware of the health risks associated with getting an intradermal tattoo.