tattoo gun with bottles of ink in different colors

Tattoos When You Have Psoriasis: What You Need to Know

By Jené Luciani Sena
Reviewed by Allison Truong, M.D.
April 13, 2022

Body art, otherwise known as tattooing, dates back thousands of years. And tattoos have evolved over time. Once just for sailors and bikers, tattoos are now so mainstream that even grandmas are getting inked.

Plus, tattooing has expanded beyond typical tatts to include permanent makeup (also known as cosmetic tattooing), which uses similar techniques and includes popular procedures like eyebrow microblading and lip tattooing to add pigment to a pout. Tattooing can also mean more than just body art. It can mean drawing nipples on people who’ve undergone mastectomies, for example.

If you have psoriasis, you might be wondering: Is tattooing safe? And if you do decide to get a tattoo, what should you know before you go?

What Are the Risks?

Remember: Tattooing involves needles puncturing and depositing ink into the layers of the skin. People with psoriasis can experience a reaction to skin injury called the Koebner phenomenon. This is when plaques form on the skin where the trauma has occurred.

So, yes, getting tattooed is an injury to the skin, and it can essentially trigger psoriasis to appear in the area where you get your tattoo. According to the journal CMAJ, around 25 percent of people with psoriasis experience the Koebner phenomenon after a skin injury such as a tattoo.

What If I Want to Get a Tattoo Anyway?

Debra Jaliman, M.D., a board-certified dermatologist practicing in New York City, says she tells psoriasis patients that it’s okay to get tattooed, as long as they aren’t doing it in a spot with an active flare-up. “Trauma to the skin, such as tattooing, will make that person’s psoriasis so much worse and cause an overactive immune response,” she says.

A study of more than 2,000 people with psoriasis published in the Journal of the European Academy of Dermatology and Venereology shows that the likelihood of complications from tattooing is generally low, except in those who required treatment at the time of tattooing. Complications may also include more than just Koebner phenomenon, such as swelling, itching, and allergic reactions.

Another study reported that up to 30 percent of people with psoriasis had a flare within weeks after tattooing, sometimes outside the areas of the tattoo. However, 82 percent stated that their tattoo had a positive effect on their body image. So, it may be worth it for some people to get their tattoos despite the risk of flares or potential side effects.

Even if you don’t have an active flare, carefully consider where on your body you’ll get inked. “There are definitely spots on the body more susceptible to psoriasis, and typically, people know where they tend to have flare-ups, so we would want to avoid those areas altogether,” says Jay Laviolette, owner of Pure Ink Fury, a tattoo shop in Schenectady, New York. “The elbows, wrists, and joints seem to be common areas, so we’d avoid those.”

If a person does get tattooed in a spot where they tend to flare up, Laviolette says it could make them more susceptible to infections, that the tattoo may not heal properly, and that you likely won’t like the way it looks in the end.

“We always tell customers to check with their doctor first,” Laviolette says. “Then, when they arrive, they are asked to fill out a consent form which asks for pertinent medical history. This would be a good time to explain their condition and any spots we maybe should avoid.”

Is After-Care Different for People with Psoriasis?

The healing process for a tattoo could take up to three weeks, and in some cases, up to three or four months. Skincare can help the process go more smoothly.

“We advise people to closely monitor the area for a few days to check for any signs of infection or any type of reaction,” says Laviolette. He gives clients an ointment to apply regularly and recommends they clean the area with antibiotic soap.

Jaliman recommends a few additional steps for healthy healing of the tattoo. “Avoid the sun, chlorine, and hot showers, and wear a sunscreen with at least 10-percent zinc oxide,” she says. “Don’t pick at any scabs.”

What About Permanent Makeup?

Permanent makeup has slightly different considerations than a tattoo, since cuts into the skin happen on the face—an area you might not want to risk getting new psoriasis plaques.

“People with psoriasis that have had microblading on their eyebrows reported that it triggered psoriasis on their face when they’d never had it there before,” says Genn Shaughnessy, a permanent makeup artist in Albany, New York. “In fact, when I prescreen new clients, I give them a sheet that states that if they are prone to any type of skin irritation near the area being treated, I would not advise them to have treatment.”

Shaughnessy adds that people with psoriasis might also not heal properly or have as long-lasting results with permanent makeup.

The decision to get a tattoo or permanent makeup is a personal one, and when you have a condition like psoriasis, it’s one you should make along with your doctor. Make sure you understand the risks and get guidance from a medical professional to decide whether the risks are worth it for you. Also, be sure you really want the tattoo, since some people have regrets after getting a tattoo, and tattoo removal carries the same risks.

Know that there are many treatments available for psoriasis, including for flares that result from tattooing or permanent makeup. Your doctors are there to help you achieve the quality of life that you want and deserve, even if that includes a tattoo.

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