Allergic Contact Dermatitis in a Tattoo

The pigments used in tattoos include cobalt (blue), chrome (green), cadmium sulphide (yellow), cinnabar (red), and manganese (purple). Hypersensitivity reactions may occur to the pigment, especially cinnabar (mercuric sulphide). See tattoo for other diagnostic considerations.


The skin of the tattoo localized to one color is inflamed, indurated, and potentially scaly. In severe cases, the skin may ulcerate and become infected. Onset may be weeks to 17 years after tattoo placement.

Generalized allergic contact dermatitis is a rare adverse reaction of laser tattoo removal [Lasers Surg Med. 2015 Feb;47(2):180-2].


Topical, oral, and/or intralesional steroids may be tried initially. If they fail, destructive methods such as cryotherapy, electrosurgery, surgical excision, or laser (CO2 laser, Q-switched lasers) have been utilized with varying results.


Severe reaction to red tattoo. AllExperts

Additional Pictures

Classic allergic contact dermatitis reaction to the red pigment only. Courtesy of Michael O. Murphy, MD
Allergic contact dermatitis to red pigment of tattoo


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