New tattoos always carry the risk of infection. Of course, doing your homework and getting inked at a reputable tattoo shop can help mitigate the chances of your tattoo becoming infected.
Below, dermatologists share how to care for your skin after you get a tattoo, how to tell if your tattoo is infected, and what to do if you think it is.
What happens if you don’t care for an infected tattoo?
It’s important to act as soon as you think something is wrong. “If you don’t care for an infected tattoo, you can risk an undesirable aesthetic appearance of the tattooed area or a disseminated soft tissue infection,” says Dr. Lara Devgan, M.D., a top board-certified plastic surgeon in New York City. “Tattoos are controlled injuries to the skin, so they represent a break in the skin that must be treated like an open wound, with great care taken to keep it clean.”
Though life-threatening conditions are quite rare, things can get even worse if you ignore getting treatment for an infected tattoo. As Dr. Viseslav Tonkovic-Capin, MD, a double board-certified Dermatologist based in the Kansas City metro area and editor of DermBoard.org, explains, “If you don’t care for the infected tattoo, it sometimes may heal on its own, or it may progress with fever, chills, [and] malaise to becoming critically ill, resulting in sepsis that may lead to death.”
How do you care for your skin after getting a tattoo?
“After getting a tattoo, take care to keep the area clean and moist. An occlusive dressing is often applied to protect the skin while the pigment injection sites heal,” says Devgan. “Avoid strenuous activities, profuse sweating, and contact with contaminated environmental exposures such as sand, oceans, and debris.”
If anything strikes you as odd or particularly painful, head to the doctor, says Devgan.
So what are the signs your tattoo is infected?
Pus draining
Seeing pus draining from the tattoo site is the most specific sign that your tattoo is infected. Tonkovic-Capin says you’ll definitely want to visit the doctor if this occurs.
“You may try to wash it with liquid antibacterial soap and apply over-the-counter double antibiotic ointment three-to-four times a day. If you develop a fever, then you should go to the closest emergency room,” advises Tonkovic-Capin.
Redness and warmth
“If you experience spreading pink discoloration or the feeling of pulsatile heat radiating from around your tattoo, you may have an infection,” says Devgan. Make sure to see a doctor as soon as possible for possible topical or oral antibiotics.
Swelling and warmth
“Sometimes this happens without infection, but if it persists for more than three days, or if it is getting worse, then it is an infection,” says Tonkovic-Capin.
You guessed it: See a doctor.
Pseudomonas bacteria or fungal infections
These occur when you tattoo your toes, feet, or ankles.
“Pseudomonas bacterial infections are more common if you wear old, smelly, sweaty sneakers without socks, and fungal infections are more common if you have athlete’s foot/toenail fungus, or walk around barefoot in the gym or public showers, where this fungus likes to lurk,” explains Dr. Tsippora Shainhouse, MD, FAAD, a board-certified dermatologist in Beverly Hills, California, in private practice at SkinSafe Dermatology and Skin Care.
So what should you look for? Infections typically appear red and are hot, swollen, and have an odor, says Tsippora Shainhouse.
Fungal infections can also appear red and have a white scale, like athlete’s foot, he says.
He recommends soaking the area with diluted white vinegar and water, along with using a prescription topical antibiotic.
Firm bumps
“Firm bumps, known as granulomas, may signify a specific type of allergic reaction to the dye,” says New York City-based board certified dermatologist, Dr. Susan Bard, MD.
An itchy rash may also occur as a reaction to an allergy to the dyes used in your tattoo (this is most common in red dyes), adds Bard. Either way, see your dermatologist or primary care physician right away.
Non-tuberculosis mycobacterium infection
“[This results] from unclean water used in tattoo parlors for washing or diluting ink, or afterwards from exposure in other standing water, like nail salons,” say Shainhouse. “These present as a single red, swollen lump and is usually associated with smaller pink spots or red streaks up the arm (or leg) following the natural lymphatic flow with or without swollen glands in the armpit (or groin).”
If you think you may be suffering from this, see a primary care physician, dermatologist or infectious disease specialist, who can prescribe oral antibiotics.
E.coli skin infections
Tattoos on the butt, groin, or pubic areas are at an increased risk of infection because they come into contact with fecal matter, which contains E. coli bacteria, says Shainhouse. Shainhouse explains these would smell, include pus, and look red and swollen.
Oral antibiotics are necessary right away, so get to the doctor’s office as soon as possible after signs appear.
Viral infections
Shainhouse says your risk of contracting HIV, Hepatitis B, or Hepatitis C are slim, but possible. This can happen if equipment is contaminated. “These would not present with acute skin signs, but if you do have other signs/symptoms of Hepatitis or HIV, see your primary care doctor for testing,” says Shainhouse.
One more thing…
Discomfort at the site of the new ink, itchiness, and scabbing can all be normal after getting a tattoo. But if you have any prolonged symptoms, or any reason to be concerned, it’s best to err on the side of caution and see a doctor ASAP.
How to avoid getting an infected tattoo:
Ideally, you’ll have a problem-free tattoo. Follow Tonkovic-Capin’s advice for mitigating risk before scheduling your appointment at the tattoo parlor:
Make sure your tattoo artist is licensed. “Ask your tattoo artist how they clean and sterilize the equipment,” says Tonkovic-Capin. “Make sure that they wear gloves during the procedure. After the tattooing is over, your tattoo artist should provide you detailed written instructions on aftercare.”
Keep it clean. Your tattoo will come with a bandage, which can be removed after about six hours. Gently wash it three times a day with liquid antibacterial soap, pat dry, and apply plain Vaseline from the tube—which is more hygienic than jars. “Never try to pick off the crusting that will typically show up on the surface,” says Tonkovic-Capin. Showers are fine, but you should avoid swimming or bathing for the first seven-to-10 days after getting your new tattoo.