Tattoos are a permanent form of self-expression and can have very personal meanings, but transplant recipients should consider taking a pass on this and other forms of body art, say experts. That’s because getting a tattoo can increase your odds of developing an infection or other problems — a risk that is even higher in people with compromised immune systems, including those who have undergone organ transplantation.

In fact, there have been case reports of a range of complications from tattoos. These include localized infections and inflammatory skin reactions, acute bacterial infections (such as impetigo, folliculitis and cellulitis), and more rarely, bacterial endocarditis (infection of the inner lining of the heart) and transmission of infectious viral diseases including hepatitis B and C, HIV and Molluscum contagiosum. These risks can also apply to other types of body modification that break the skin, such as piercings.

“We don’t generally recommend that transplant recipients get a new tattoo,” says Kate Miller, CPNP, an infectious disease nurse practitioner in the Pediatric Transplant Center at Boston Children’s Hospital. “If this is something that you are considering, please contact your transplant team to discuss the risks associated with tattoos, to be able to make the best decision for you.”

Tips for staying safe

Even with those caveats in mind, some transplant recipients may still choose to get a tattoo. If you do choose to go ahead with this decision, Miller recommends taking the following steps to make the process as safe as possible.

Do your research. Use only a licensed tattoo artist and establishment. You can get more information from your local public health department as well as the Alliance of Professional Tattoo Artists.

 

Ask questions. Pay them a visit first to ensure that the establishment is clean. Don’t be afraid to ask questions, including whether the artist adheres to universal precautions provided by the U.S. Centers for Disease Control and Prevention.

Watch closely. The tattoo artist should wash their hands, wear disposable gloves and use new, sterile equipment and single-use ink and razors.

Choose wisely. Never get a tattoo in non-professional settings, such as a home, from a friend, as part of a cultural ritual or in a prison.

Practice aftercare. Your tattoo artist should give you clear instructions for caring for your tattoo, including cleaning the area with antibacterial soap, applying topical antibiotic ointment and avoiding contact with water until it has healed.

Reach out. Don’t hesitate to contact your nurse or other clinician if you notice signs of infection, such as redness, tenderness or swelling at the tattoo site, a rash, fever or drainage of fluids.