An estimated 15 million people in the UK now have a tattoo — twice as many as two decades ago.
Once associated mainly with sailors, bikers and rock stars, body art has become firmly established in the mainstream. Tattoos now feature on people from all walks of life, including Princess Eugenie, who has a small circle behind her left ear, and Prime Minister Andy Burnham, who has a bee tattoo on the inside of his right bicep.
Demand for body ink has helped tattoo parlours thrive, with Britons spending an estimated £700 million a year on the designs they choose to have permanently etched into their skin.
For most people, tattoos cause few, if any, serious side-effects. Infections, for instance, are reported in about one in 20 cases. However, some scientists have raised concerns that tattoos may be linked to a higher risk of lymphoma — a form of blood cancer diagnosed in more than 16,000 people in the UK each year.
Lymphoma develops when white blood cells known as lymphocytes begin multiplying uncontrollably in the bloodstream.
In a healthy body, lymphocytes form part of the immune system and help protect against infection. But factors including a weakened immune system and prolonged exposure to chemicals such as pesticides or insecticides can cause these cells to become cancerous.
The abnormal cells can then spread through the bloodstream and damage vital organs. About 5,000 people in the UK die from lymphoma every year.
The possible connection between tattoos and lymphoma attracted renewed attention in 2024, after a study published in The Lancet found that adults with even one tattoo were 21 per cent more likely to develop the disease.
Researchers are investigating whether tattoos could raise the risk of lymphoma, a blood cancer that affects more than 16,000 people in the UK each year
Researchers at Sweden’s Lund University compared tattoo histories among around 1,400 people diagnosed with different types of lymphoma between 2007 and 2017 with those of healthy adults aged between 20 and 60.
People with tattoos appeared more likely to have lymphoma. The analysis also found that having one or two tattoos was associated with the same level of cancer risk as having several.
The researchers stressed, however, that their findings showed an association between tattoos and lymphoma — not that tattoos had been proven to cause the disease.
At least one subsequent study has reported comparable findings.
Scientists at the University of Southern Denmark in Odense followed more than 2,500 people, comparing lymphoma rates among participants with tattoos and those without them.
Their results, published in BMC Public Health in January last year, suggested that people with a tattoo larger than the palm of their hand had more than double the risk of developing lymphoma.
In a report outlining their findings, the researchers wrote: ‘We are concerned that tattoo ink interacting with surrounding cells may have severe consequences [i.e. lymphoma].’
So how could injecting ink into the skin potentially be connected to a cancer affecting the blood?
Tattoo ink contains around 200 different chemicals and additives, some of which are considered potentially carcinogenic.
One leading theory is that the immune system identifies chemicals in tattoo ink as foreign substances and sends defensive cells to break them down or remove them.
That response may cause long-term inflammation, creating conditions in which cancer cells could develop. However, it remains unclear why such a process would be linked specifically to lymphoma rather than to other forms of cancer.
There have been cases where suspicious tissue initially thought to be a tumour turned out to be non-cancerous – and this may be because tattoo ink deposits can mimic the appearance of a tumour.
An estimated 15 million people in the UK have a tattoo, including Princess Eugenie and Prime Minister Andy Burnham who sports a bee tattoo on his inner right bicep (pictured)
Numerous studies have found that pigments used in ink can travel through the bloodstream to congregate in lymph nodes – the network of bean-shaped glands throughout the body that helps regulate the immune system’s response to foreign organisms.
These ink molecules then clump together to form a semi-solid mass which – viewed on an MRI scan – can look uncannily like a cancerous growth.
Several cases have been reported in recent years where patients with suspected breast cancer that has spread to the lymph nodes in the armpit have undergone surgery to remove tumour tissue – only for tests to show it’s instead a hard mass made up of ink molecules that have stuck together.
A study published earlier this month in the International Journal of Surgical Pathology looked at more than 1,000 samples of lymph node tissue removed during biopsies from women with suspected breast cancer.
Although the study didn’t count how many had tattoos, results showed more than 8 per cent of them had ink deposits in their lymph nodes.
Dr Jonathan Kentley, a consultant dermatologist at Chelsea and Westminster Hospital in London and spokesman for the British Skin Foundation, says it’s not unusual for some ink from tattoos to settle in lymph nodes.
But he adds there is no good evidence at the moment that it does any damage, even though some chemicals used in tattoo pigment are potentially carcinogenic.
‘The data are not strong enough to say tattoos cause lymphoma – it’s only an association at the moment.’
Indeed, a review by researchers at the University of Nottingham, published in eClinicalMedicine last year, crunched data from three separate studies involving almost 18,000 patients and found no increased risk of lymphoma in tattooed volunteers.
Meanwhile, despite some suggestions that tattoos could be a risk factor, research also suggests there is no good evidence of a link between tattoos and malignant melanoma – which kills around 2,600 people a year in the UK.
There has been a succession of conflicting studies down the years – some suggesting a heightened risk, others ruling it out.
But one of the most recent investigations, at the University of Amsterdam in the Netherlands, looked at melanoma rates in the country over a 20-year period and concluded that there was ‘no evidence supporting a causal relationship between tattoos and melanoma’.
But while the chemicals in ink may not initiate skin cancer growth, they can sometimes make it harder to track changes in suspicious moles – particularly where dark pigments have been used, says Dr Kentley.
‘We use a device called a dermatoscope (a type of magnifying device with a built-in light source) to examine suspicious lesions.
‘But it can be harder to monitor skin pigment patterns that might be of concern when there is dark ink present.’
He warns against getting a tattoo on areas of the body where there are any existing moles – and advises only using one of Britain’s 2,000 or so registered tattoo artists licensed by local authorities who are required to adhere to hygiene standards.
Meanwhile, other well-documented adverse reactions to body art ink range from photosensitivity (where tattooed skin becomes more sensitive to sunlight, causing itching, swelling and a stinging sensation) to allergic reactions – which result in similar symptoms and are most often triggered by certain metals used in red ink.
At least one in ten people who gets a tattoo experiences skin reactions that involve itching, pain, inflammation and swelling for at least three weeks after having it done, according to a study published in 2023 in the journal Dermatology by scientists at the University of Copenhagen, Denmark.
