Editorials
2 September 2025
Early Access
Red tattoo allergies after REACH regulation: a continuing problem
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Despite new EU regulations, allergies to red ink tattoos remain an urgent public health problem. Red tattoo pigments continue to occur at a clinically relevant rate. This observation raises critical questions about the effectiveness, scope, and enforcement of the Registration, Evaluation, Authorisation, and Restriction of Chemicals (REACH) regulation. We argue that current tattoo ink restrictions fail to sufficiently protect European consumers from known allergens and that regulatory revisions are urgently needed.
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Citations
1. Kluger N. Epidemiology of tattoos in industrialized countries. Curr Probl Dermatol 2015;48:6-20. DOI: https://doi.org/10.1159/000369175
2. van der Bent SAS, Rauwerdink D, Oyen EMM, et al. Complications of tattoos and permanent makeup: overview and analysis of 308 cases. J Cosmet Dermatol 2021;20:3630-1. DOI: https://doi.org/10.1111/jocd.14498
3. van der Bent SAS, de Winter RW, Wolkerstorfer A, Rustemeyer T. Red tattoo reactions: a prospective cohort on clinical aspects. J Eur Acad Dermatol Venereol 2019;33:e384-6. DOI: https://doi.org/10.1111/jdv.15677
4. Commission Regulation (EU) 2020/2081 of 14 December 2020 amending Annex XVII to Regulation (EC) No. 1907/2006 concerning the Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH) as regards substances in tattoo inks or permanent make-up.
5. Serup J. Chaotic tattoo ink market and no improved customer safety after new EU regulation. Dermatology 2023;239:1-4. DOI: https://doi.org/10.1159/000526338
6. Bäumler W, Hauri U, Liszewski W, et al. Alignment with toxicological and medical reality is urgently needed: A plea after more than one year of European regulation on tattoo and permanent make-up inks. J Eur Acad Dermatol Venereol 2024;38:e896-7. DOI: https://doi.org/10.1111/jdv.19981
7. Brungs C, Schmid R, Wolf C, et al. Tattoo pigment identification in inks and skin biopsies of adverse reactions by complementary elemental and molecular bioimaging with mass spectral library matching. Anal Chem 2022;94:3581-9. DOI: https://doi.org/10.1021/acs.analchem.1c04922
8. Serup J, Hutton Carlsen K, Dommershausen N, et al. Identification of pigments related to allergic tattoo reactions in 104 human skin biopsies. Contact Dermatitis 2020;82:73-82. DOI: https://doi.org/10.1111/cod.13423
9. Moseman K, Noble S, Sanders S, et al. Analysis of blue and green REACH compliant tattoo inks. Analyst 2024;149:5329-35. DOI: https://doi.org/10.1039/D4AN00793J
10. Serup J, Hutton Carlsen K. Patch test study of 90 patients with tattoo reactions: negative outcome of allergy patch test to baseline batteries and culprit inks suggests allergen(s) are generated in the skin through haptenization. Contact Dermatitis 2014;71:255-63. DOI: https://doi.org/10.1111/cod.12271
How to Cite
Red tattoo allergies after REACH regulation: a continuing problem. (2025). Dermatology Reports. https://doi.org/10.4081/dr.2025.10462
Copyright (c) 2025 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
