You may want to rethink getting ink.

About 35% of tattoo or permanent makeup inks sold in the US are contaminated with bacteria, according to new research published Tuesday.

The researchers tested 75 tattoo inks from 14 manufacturers for the presence of aerobic and anaerobic bacteria. The study authors say they are the first to investigate anaerobic bacteria — known to thrive in low-oxygen environments — in commercial tattoo inks. 

“Both types of bacteria, those needing oxygen (aerobic) and those not needing oxygen (anaerobic), can contaminate the inks,” said corresponding study author Seong-Jae (Peter) Kim, a microbiologist for the Food and Drug Administration (FDA) in Arkansas.

The FDA considers the inks used in tattoos — including permanent makeup — to be cosmetics, which do not need premarket approval like a drug or medical device does.

“FDA has not approved any inks for injection into your skin,” its website states.

The pigments used in the inks are color additives, which are subject to FDA approval, but the agency admits it has not historically regulated them. State and local jurisdictions, meanwhile, oversee tattooing practices.

The FDA notes that it has fielded reports of people getting infected from contaminated tattoo inks over the years and even issued a safety alert in 2019 after identifying six tattoo inks contaminated with bacteria.

Infections can lead to rashes or lesions and in some cases, permanent scarring. 

Last year, the agency issued draft guidance to help tattoo ink manufacturers and distributors recognize potential contamination from bacteria, mold or other microorganisms.

Kim said his research showed “no clear link between a product label claiming sterility and the actual absence of bacterial contamination.”

“The rising popularity of tattooing in recent years has coincided with an increase in tattoo-related complications or adverse reactions,” he added.

A Pew Research Center survey last year found that 32% of US adults have a tattoo, including 22% who have more than one.

Kim pointed out that bacterial infections are just one negative outcome of tattoos. Inflammatory reactions, allergic hypersensitivity and toxic responses are potential complications as well.

Kim said his research team plans to develop more efficient contamination detection methods for tattoo inks.

“In light of our study results, we want to emphasize the importance of continuously monitoring these products to ensure the microbial safety of tattoo inks,” he said.

His findings were reported in Applied and Environmental Microbiology, a journal of the American Society for Microbiology.

The study results follow research that found 83% of tattoo inks contain substances not on their label, like different pigments or unlisted additives. A separate study highlighted a potential link between tattoos and lymphoma, a type of blood cancer.

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