D2.237 - Patient-reported changes in urticaria activity after tattoo placement

The popularity of tattoos and permanent make-up has increased substantially in recent years. Many tattoo-related cutaneous complications have been documented, including the onset of urticarial wheals. However, isolated case reports suggest a possible positive effect of tattooing in patients with chronic urticaria. This study aimed to evaluate patient-reported changes in urticaria activity within tattooed skin.

This cross-sectional, questionnaire-based study included 35 adult patients with urticaria and permanent tattoos, recruited from the Allergology Department database and urticaria-associated patient social media groups. Data were collected on urticaria characteristics, disease duration and severity, treatment, and tattoo-related factors. Urticaria Activity Score (UAS) was assessed. Participants were asked to assess overall changes in urticaria activity after tattoo placement and local changes within tattooed skin, particularly in areas previously affected by urticarial wheals.

The mean age of participants was 34.3 ± 9.4 years; 97.1% (n = 34) were female. Chronic spontaneous urticaria was the most common subtype (n = 23, 66%). The majority of patients (n = 21, 60%) reported no change in overall urticaria activity following tattoo placement. Overall worsening of general symptoms since tattooing was noted by 8 patients (22.9%), while 6 patients (17.1%) reported improvement. The mean Urticaria Activity Score (UAS) was 1.8 (median 1, range 0–6). Among 7 patients with pre-existing urticarial wheals in the tattoo area, 3 reported local improvement, 1 reported worsening, and 3 reported no change in wheal activity within tattooed skin.

The impact of tattooing on urticaria activity remains uncertain. While improvement was reported by approximately one-fifth of patients, the responses were variable. The present findings do not allow definitive conclusions regarding the influence of tattoo placement on urticaria.