What to Know About Tattoos if You Have Psoriasis

If you have psoriasis, there are things you should know before you head to the tattoo parlor.

First, if you’re interested in getting a tattoo because you think it will disguise your psoriasis — specifically, the thick, scaly, itchy patches called plaques formed by a buildup of extra skin cells — you may want to reconsider. Tattoos likely won’t conceal these patches, and could in fact lead to additional problems with psoriasis symptoms.

“It’s a good idea to ask your doctor if a tattoo could make your condition worse,” says Edward Prodanovic, MD, a dermatologist in St. Louis.

Can a Tattoo Cause a Psoriasis Flare?

Prodanovic: When somebody gets a tattoo, the artist inserts permanent ink into the skin with small punctures of a needle. The risk for people with psoriasis is what we refer to as the Koebner phenomenon, in which a plaque forms at the site of a skin irritation, in this case, the tattoo. It typically shows up in two to four weeks, but it can also occur months to years later.

Not everyone with psoriasis will have this reaction. But if you have ever had a cut or burn that led to a psoriasis flare, then you may react similarly to a tattoo. If psoriasis plaques do develop, see your dermatologist.

Are There Other Reasons a Tattoo Might Not Be Safe for Someone With Psoriasis?

Prodanovic: Complications are relatively rare, but an underlying skin disorder like psoriasis can raise the risk of an immunological response to the ink. It may also prolong the healing time after the procedure.

If you’re prone to skin allergies, consider getting patch tested before tattooing to see how your skin might react to the ink. Keep in mind that patch test results are not a guarantee of how your skin will react to a tattoo.

Are Henna Tattoos Safer if You Have Psoriasis?

Even though the process is less invasive than a traditional tattoo, there is still a risk of the Koebner phenomenon.

What Should a Person With Psoriasis Consider When Choosing a Tattoo Parlor or Artist?

Prodanovic: Go to a tattoo artist who is licensed and a tattoo parlor that is registered. Any ink they use should be specifically approved for tattoos and not have expired. It’s important that the tattoo studio use proper sanitization processes. People with psoriasis can be more susceptible to infections following any injury to the skin. The tattoo artist may not be familiar with your condition, so inform them about it and make them aware of the risks.

How Can I Treat a Psoriasis Flare After I Get a Tattoo?

Prodanovic: Psoriasis treatments generally fall into three categories, though different types of treatment are often used in combination:

• Topical creams and ointments that are applied to your skin
• Phototherapy, which is when your skin is exposed to certain types of ultraviolet light
• Systemic therapies, which include oral and injected medications that work throughout the entire body

If a psoriasis plaque develops within a tattoo, it's ideal to start with topical therapies, since they are usually effective. If you are unable to get into your doctor’s office, you could try an over-the-counter cortisone cream first. If you already have a prescribed topical medication for your psoriasis, then it's reasonable to apply it on your tattoo. It should not damage or lighten the tattoo if you only use it for a couple of weeks.

If you don’t see your psoriasis improving within a week or two, then schedule an appointment with your provider. If you develop psoriasis in several areas of your body after getting a tattoo, then it may be reasonable to consider systemic therapies or phototherapy.

The Takeaway

• Tattoos can potentially trigger a psoriasis flare, especially at the site of skin irritation from the tattoo needle. It’s important to see your dermatologist if new plaques develop post-tattoo.
• In people with psoriasis, there is a higher risk of allergic reactions or prolonged healing time due to the various chemicals in tattoo ink, so consulting a healthcare provider before getting a tattoo is advisable.
• Prioritize visiting a licensed tattoo artist and registered parlor that follows proper sanitation to minimize the risk of infection, as people with psoriasis may be more susceptible.
• If you experience a psoriasis flare post-tattoo, topical treatments are typically effective. However, seek professional medical advice if there’s no improvement within a couple of weeks.

Additional reporting by Monroe Hammond.