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Think Before You Ink: Tattoos Can Complicate an MRI Scan

To some, tattoos will always be taboo while to others it is a sign of expression. Regardless of opinion, could they be harmful to your health?

The hardest part of getting a tattoo can be deciding on a design, or placement, or whether or not you want to add some color, but many do not consider, or question how a tattoo can effect their health.

Tattoos are made with pigments inserted into the skin by pricking the top layer with a needle. Health issues can arise if tattoo artists use unsterile needles or equipment that can spread infections and diseases, such as hepatitis, which is why the American Association of Blood Banks requires a one-year wait period between getting a tattoo and donating blood.

While this is a serious and well-known issue, there is another problem you may not have heard about before – tattoos may cause complications for people that have them when obtaining MRIs (magnetic resonance imaging).

“The complications come from some skin irritations caused by the tattoos themselves, but it really depends on the type of tattoos and how big they are,” says diagnostic radiologist Dr. Philip S. Lim. “The most common symptoms the patient may complain of are skin irritation or discomfort where the tattoo is while undergoing a study in the MRI machine.”

An MRI is a test that uses a magnetic field and pulses of radio-wave energy to make images of organs and structures inside the body. Often, an MRI gives healthcare providers different information about structures within the body than can be provided by other tests like X-rays, ultrasounds or CT scans. Similarly, MRIs may show problems that can’t be seen with other imaging methods.

In the Ink
But why have people with tattoos or permanent makeup reported swelling or burning in the tattooed areas during MRIs? According to Dr. Lim, it could be what’s in the tattoo’s ink.

“From what I’ve read, it’s usually tattoos that are black or brown in color that supposedly have more iron oxide in them,” he says. “It’s the potential for metallic components in some tattoo pigments that cause the reaction during MRIs.”

“It’s basic physics,” explains Dr. Lim. “The MRI machine changes magnetic fields and causes an electric current to develop into any type of metal. That’s why patients may have a burning sensation or pain, because that metal in the tattoo is believed to begin to heat.”

Where someone gets their tattoo done may impact how much burning or pain they feel during an MRI as well.

“It’s basic physics. The MRI machine changes magnetic fields and causes an electric current to develop into any type of metal. That’s why patients may have a burning sensation or pain, because that metal in the tattoo is believed to begin to heat.”

— Dr. Lin

“Sometimes, the tattoo ink companies are not well-regulated and certainly have poor quality control. Tattoo artists may get their supply from an ink supplier, possibly from a foreign country that may include metals in the ink,” says Dr. Lin, noting that more metals would mean more skin irritation.

Size and Location Matter Too
Tattoo size and location matter as well. A large tattoo could cause the whole area to be affected during the imaging test. And, in the case of permanent makeup, eyeliner that contains dark iron oxide could cause a lot of discomfort and possibly some low-grade burns of the eyelid.

Beyond the possibility of burning sensations, the tattoo’s location could also interfere with the imaging results.

“If there’s iron oxide in the tattoo, we can see that there’s a black spot overlying the skin and the tissue,” notes Dr. Lim.

If you have a small tattoo on your ankle and your MRI is focused on your knee, Dr. Lim said the ink shouldn’t obstruct the image. But when the tattoo is located in the same place the imaging needs occur that causes problems.

“The iron causes the signal from the body to be distorted – you can’t tell what is in the area of the anatomy anymore,” he said.

Despite the possibility of interference or reactions during MRIs, there are some things you can do if you have a tattoo.

“Usually, we ask patients about tattoos and they are instructed to talk to the MRI tech if they feel any discomfort,” says Dr. Lin. “The tech will check in on the patients and ask them if they’re okay. And the patient can always press a button to talk to the tech at any time.” If you do feel pain or discomfort, your MRI tech may stop the scanning and give you a break until the discomfort goes away. You may also try placing a cold or wet towel or cold pack over the tattoo.

Another type of imaging may be used, depending on what your healthcare provider is looking for.

“If it’s a tendon, an ultrasound can be used – it’s a fantastic way of looking at things. If you’re looking at bones, ultrasounds don’t work; you may need a CT scan for bones,” states Dr. Lin. “However, MRIs are great if your healthcare provider needs to look at the joint itself.”

Also available are different-strength MRIs. The stronger the magnetic field, the more likely the tattoos are going to be a problem and could cause skin discomfort. If you need an MRI, you may want to ask for a lower-strength MRI machine because that may lessen the chance of skin discomfort or burning. With a lower-strength MRI, the clearness or crispness of the image may be affected. The images are much better with a higher-strength MRI, but lower-strength could be an option, depending on what the doctor wants to learn about your body through the test.

From the Experts