tattoo rumor...anyone heard of this before?

Question

i heard a rumor that if you have a tattoo, you can't get an MRI done if you ever need one. is this true? supposedly its because there's some metal in the ink?? i've never heard of that before. are there some inks with metal and some without?

thanks guys! and if it was on mythbusters, i believe it. i love that show!

Answer 1

Yes, you can get an MRI done if you have had a tattoo. Yes, there are lots of different materials in tattoo ink.

BUT:

It is NOT a MYTH that there can be complications with tattoos and MRI. It can cause problems with images, and it HAS, in RARE instances caused burns. The MRI Technologist will tell you that if they are imaging the area over the tattoo, you wil need to let them know if it begins to feel warm. They will give you an emergency squeeze ball that you can use if you have trouble.

It would be very RARE for it to cause heating of the tattoo, but it is possible to get burned. See below: These are the guidelines:

Tattoos, Permanent Cosmetics, and Eye Makeup
Traditional (i.e., decorative) and cosmetic tattoo procedures have been performed for thousands of years. In the United States, cosmetic tattooing or permanent cosmetics are used to reshape, recolor, recreate, or modify eye shadow, eyeliner, eyebrows, lips, beauty marks, and cheek blush. Additionally, permanent cosmetics are often used aesthetically to enhance nipple-areola reconstruction.

Magnetic resonance (MR) imaging is a frequently used imaging modality, particularly for evaluating the brain, head and neck, and other anatomic regions where cosmetic tattoos are typically applied. Unfortunately, there is much confusion regarding the overall MR safety aspects of permanent cosmetics. For example, based on a few reports symptoms localized to the tattooed area during MR imaging, many radiologists have refused to perform MR procedures on individuals with permanent cosmetics, particularly tattooed eyeliner. This undue concern for possible adverse events prevents patients with cosmetic tattoos from access to an extremely important diagnostic imaging technique.

While it is well-known that permanent cosmetics and tattoos may cause MR imaging artifacts and that both cosmetic and decorative tattoos may cause relatively minor, short-term cutaneous reactions, the frequency and severity of soft tissue reactions or other related problems associated with MR imaging and cosmetic tattoos is unknown. Therefore, a study conducted by Tope and Shellock determined the frequency and severity of adverse events associated with MR imaging in a population of subjects with permanent cosmetics.

A questionnaire was distributed to clients of cosmetic tattoo technicians. This survey asked study subjects for demographic data, information about their tattoos, and for their experiences during MR imaging procedures. Results from 1,032 surveys were tabulated. One hundred thirty-five (13.1%) study subjects underwent MR imaging after having permanent cosmetics applied. Of these, only two individuals (1.5%) experienced problems associated with MR imaging. One subject reported a sensation of 'slight tingling' and the other subject reported a sensation of 'burning', both transient in nature.

Based on these findings and information in the peer-reviewed literature, it appears that MR imaging may be performed in patients with permanent cosmetics without any serious soft tissue reactions or adverse events. Therefore, the presence of permanent cosmetics should not prevent a patient from undergoing MR imaging. Furthermore, when one considers the many millions of clinical MR procedures that have been conducted in patients over the past 17 years and that only a very small percentage of these individuals have had minor, short-term problems related to the presence of permanent cosmetics, it is apparent that this MR safety concern has an extremely low rate of occurrence and relatively insignificant consequences.

In a letter to the editor that described a second-degree burn that occurred on the skin of the deltoid from a decorative tattoo, the authors suggested that "the heating could have come either from oscillations of the gradients or, more likely from the RF-induced electrical currents". However, the exact mechanism(s) responsible for complications or adverse events in the various cases that have occurred related to decorative tattoos is unknown.

Before undergoing an MR procedure, the patient should be asked if he or she has ever had any type of permanent coloring technique (i.e., tattooing) applied to any part of the body. This includes cosmetic applications such as eyeliner, lip-liner, lip coloring, as well as decorative designs.

This question is necessary because of the associated imaging artifacts and, more importantly, because a small number of patients (fewer than 10 documented cases) have experienced transient skin irritation, cutaneous swelling, or heating sensations at the site of the permanent colorings in association with MR procedures (review of Medical Device Reports, 1985 to 1999).

Interestingly, decorative tattoos tend to cause worse problems (including first- and second-degree burns) for patients undergoing MR imaging compared to those that have been reported for cosmetic tattoos. For example, Kreidstein et al. reported that a patient experienced a sudden burning pain at the site of a decorative tattoo while undergoing MR imaging of the lumbar spine using a 1.5-Tesla MR system. Swelling and erythema was resolved within 12 hours, without evidence of permanent sequelae. The tattoo pigment used in this case was ferromagnetic, which possibly explains the symptoms experienced by the patient. Surprisingly, in order to permit completion of the MR examination, an excision of the tattooed skin with primary closure of the site was performed.

The authors of this report stated, Theoretically, the application of a pressure dressing of the tattoo may prevent any tissue distortion due to ferromagnetic pull. However, this simple, relatively benign procedure was not attempted for this patient. They also indicated that, In some cases, removal of the tattoo may be the most practical means of allowing MRI.

Kanal and Shellock commented on this report in a letter to the editor, suggesting that the response to this situation was rather aggressive. Clearly the trauma, expense, and morbidity associated with excision of a tattoo far exceed those that may be associated with ferromagnetic tattoo interactions. A firmly applied pressure bandage may be used if there is any concern related to "movement" of the ferromagnetic particles in the tattoo pigment. Additionally, direct application of a cold compress to the site of a tattoo would possibly mitigate any heating sensation that may occur in association with MR imaging.

ARTIFACTS
Imaging artifacts associated with permanent cosmetics and certain types of eye makeup have been reported. These artifacts are predominantly associated with the presence of pigments that use iron oxide or other type of metal and occur in the immediate area of the applied pigment or material. As such, tattoo- and makeup-related MR imaging artifacts should not prevent a diagnostically adequate MR imaging procedure from being performed, especially in consideration that careful selection of imaging parameters may easily minimize artifacts related to metallic materials.

The only possible exception to this is if the anatomy of interest is in the exact same position of where the tattoo was applied using an iron oxide-based pigment. For example, Weiss et al. reported that heavy metal particles used in the pigment base of mascara and eyeliner tattoos, have a paramagnetic effect that causes alteration of the local magnetic field in adjacent tissues. These changes in normal signal may result in distortion of the globes. In some cases, the distortion may mimic actual ocular disease such as a ciliary body melanoma or cyst.

GUIDELINES AND RECOMMENDATIONS
In consideration of the available literature and experience pertaining to MR procedures and patients with permanent cosmetics and tattoos, the following guidelines and recommendations are provided:

(1) The screening form used for patients should include a question pertaining to the presence of permanent cosmetics or decorative tattoos.

(2) Before undergoing an MR procedure, the patient should be asked if he or she has a permanent coloring technique (i.e., tattooing) applied to any part of the body. This includes cosmetic applications such as eyeliner, lip-liner, lip coloring, as well as decorative designs.

(3) The patient should be informed of the relatively minor risk associated with the site of the tattoo.

(4) The patient should be advised to immediately inform the MRI technologist regarding any unusual sensation felt at the site of the tattoo in association with the MR procedure.

(5) The patient should be closely monitored using visual and auditory means throughout the entire operation of the MR system to ensure safety.

(6) As a precautionary measure, a cold compress (e.g., wet washcloth) may be applied to the tattoo site during the MR procedure.

United States FDA and Statement on Tattoos
In addition to the above, information and recommendations have been provided for patients by the U. S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, Office of Cosmetics and Colors Fact Sheet, as follows: "the risks of avoiding an MRI when your doctor has recommended one are likely to be much greater than the risks of complications from an interaction between the MRI and tattoo or permanent makeup. Instead of avoiding an MRI, individuals who have tattoos or permanent makeup should inform the radiologist or technician of this fact in order to take appropriate precautions, avoid complications, and assure the best results."

SUMMARY AND CONCLUSIONS
Because of the relatively remote possibility of having an incident occur in a patient with a permanent cosmetic or tattoo and due to the relatively minor, short-term complication or adverse event that may develop (i.e., transient cutaneous redness and swelling), the patient should be permitted to undergo an procedure without reservation. Any problem of performing an MR procedure in a patient that has a permanent cosmetic or tattoo should not prevent the examination, since the important diagnostic information that is provided by this diagnostic modality is typically critical to the care and management of the patient.


REFERENCES

Becker H. The use of intradermal tattoo to enhance the final result of nipple-areola reconstruction. Plast Reconstr Surg 1986;77:673.

Carr JJ. Danger in performing MR imaging on women who have tattooed eyeliner or similar types of permanent cosmetic injections. AJR Am J Roentgenol 1995; 165:1546-7.

U. S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, Office of Cosmetics and Colors Fact Sheet, Tattoos and permanent makeup. November 29, 2000.

Gomey M. Tattoo pigments, patient clothing, and magnetic resonance imaging (Risk Management Bulletin #12748-8/95), The Doctors' Company: Napa, CA. August, 1995.

Halder RM, Pham HN , Hreadon JY, Johnson HA. Micropigmentation for the treatment of vitiligo. J Dermatol Surg Oncol 1989;15:1092-8.

Jackson JG, Acker H. Permanent eyeliner and MR imaging. (letter) AJR Am J Roentgenol 1987;149:1080.

Kanal E, Shellock FG. MRI interaction with tattoo pigments. (letter) Plast Reconstr Surg 1998;101:1150-1.

Kreidstein ML, Giguere D, Freiberg A. MRI interaction with tattoo pigments: case report, pathophysiology, and management. Plast Reconstr Surg 1997;99:1717-20.

Lund A, Nelson ID, Wirtschafter ID, Williams p A. Tattooing of eyelids: magnetic resonance imaging artifacts. Ophthalmic Surg 1986;17:550-3.

Sacco D, et al. Artifacts caused by cosmetics in MR imaging of the head. Am J Roentgenol 1987;148:1001-1004.

Shellock FG. Magnetic Resonance Procedures: Health Effects and Safety, CRC Press, LLC, Boca Raton, FL, 2001.

Shellock FG. Guide to MR Procedures and Metallic Objects: Update 2001. Seventh Edition, Lippincott Williams & Wilkins Healthcare, Philadelphia, 2001.

Shellock FG. Reference Manual For Magnetic Resonance Safety, Implants, and Devices: 2006 Edition. Biomedical Research Publishing Group, Los Angeles, CA, 2006.

Tattoos. FDA Medical Bulletin 1994;24:8.

Tope WD, Shellock FG. Magnetic resonance imaging and permanent cosmetics (tattoos): survey of complications and adverse events. J Magn Reson Imaging. 2002;15:180-184.

Vahlensieck M. Tattoo-related cutaneous inflammation (burn grade I) in a mid-field MR scanner. (letter) Eur Radiol 2000; 10:97.

Wagle WA, Smith M. Tattoo-induced skin burn during MR imaging. (letter) Am J Roentgenol 2000: 174:1795.

Weiss RA, Saint-Louis LA, Haik BG, McCord CD, Taveras JL. Mascara and eyelining tattoos: MRI artifacts. Ann Ophthalmol 1989;21:129-31.

Answer 2

It is not true. I had one done and I have a big tattoo of a frog on my lower back. They just really don't like to do them when you have a tattoo because the ink has a metal in it that reacts with the chemicals used in the mri, catscan, and xray machines. The metal can heat up in the tattoo and sometimes it will blister. They just told me to relax and that if I start to feel a burning in my back let them know. It did not bun though it was no problem at all.

Answer 3

a lot of tattoo inks (even the best stuff out on the market) use minerals, metals, organic substances and chemicals in the manufacturing of the tattoo ink, which create the desired pigment of each ink color. some metals used could include antimony, arsenic, beryllium, cobalt, lead, lead compounds, nickel and selenium, collectively referred to as toxic metals.

these amounts of metal are very small and in most cases not harmful. however there is an exception to every rule.

20 years ago there were larger amounts of metals in inks and while it is still debatable, there were reports of discomfort and distortion to MRI scans from people have have had tattoos done over 20 years ago. but this is also rare, but could be a concern nonetheless.

this is something you will most likely never face today, despite the continuance of metals in some inks today.

people shouldn't speak and throw their guessed opinion on something they don't truly know about. you had a legitimate question and it desearves to be accurately and intelligently answered with researched and supported facts.

hope i helped.

Answer 4

Acctually, you can get an MRI even if you have the metallic ink in your skin, it'll just feel like the pattern is being ripped out of you skin. If you're going to get a tattoo, you may want to ask the tattoo artist what kind of ink is used in the process

Answer 5

not true. if you do it right and get a right tattoo at a certified tattoo parlor, you should be fine..if you decide to go the cheap route and find the cheepest place you can..no guarantee they wont mix it with a little metal. if you get it done right, then it shouldnt have any metal in it at all... if you get tattoos in jail they definitely have metal so that isnt good either.. if you already have it and arent sure, take a strong magent and hold it over your tattoo and if you feel it pull at your skin...then it has metal in it...even if you need a mri, when you got to the hospital, they can put a certain type of lead blanket over your body if it is on your arm or leg (like they do if you have metal plates in your arm).hope this helps!

Answer 6

I don't know where that came from. My husband has like 8 tattoos & he's been getting MRI's for 2 years now with no problems.

Answer 7

That is curious I have tatts and alot of metal in my leg. So I never
considered the tatts. There have been some new sparkle inks on the market. My guess is this is false. The FDA wouldn't allow if there were a risk.

Answer 8

Never heard of that before. I have two tattoos and have had plenty of MRI's and never had any problems.

Answer 9

For sure a myth..I have 5 plus a metal plate and screws in my knee and never had a problem! In fact I have never even heard of that before interesting!!

Answer 10

I have a tattoo and have had an MRI done, they never asked me if I had one???

Answer 11

Nope! I have a tattoo and have had MRIs done.