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Diabetes and Tattoos: Case Study and Guidance

Jan 7, 2020

Issues to be aware of with diabetes and tattoos

A 29-year-old woman with insulin-dependent diabetes noted a painful erosion at the site of the tattoo which she had gotten 7 days before. A culture isolated staphylococcus aureus confirming the clinical impression of staph. This diagnosis was not entirely unexpected, since patients with diabetes mellitus are predisposed to staphylococcal infection. An oral cephalosporin cleared the cellulitis, leaving the tattoo a little distorted. The tattoo artist blamed the cellulitis on the patient’s failure to take proper care of the wound site. However, the lack of recurrent infections in the patient’s history indicates that she probably was not a carrier, and the infection grew from a new source.


Tattoos are very popular, especially with teens. But the tattoo application process and aftercare, which can be long, painful and stressful, can create some problems for our diabetes patients. Blood pressure and blood sugar levels can both rise while a tattoo is being applied, and high blood sugar levels can also complicate the healing process, increasing the risk of infection.

Other things to consider before getting a tattoo include:

Tattooist quality

The tattoo studio should be licensed and/or accredited. The patients can also research the company’s reputation, and hygiene and safety practices.

Safety and awareness

The tattooist should be informed of the patient’s diabetes so they can tailor both the procedure and aftercare information.


Certain areas should be avoided including those with poor circulation, such as:

  • Buttocks
  • Shins
  • Ankles
  • Feet
  • Common insulin injection sites such as arms, abdomen and thighs.

Tattoos in these places usually take longer to heal, which can lead to complications (e.g. infection).

Other Risks
  • Allergic reactions – reaction to the substances used in the inks and equipment.
  • Skin infection – the tattooed area of skin may become infected if the studio and/or tattoo equipment is not clean or proper aftercare is not applied.
  • Scarring – tattoo application can cause the formation of an oversized scar known as a keloid, which can be irritable and slightly painful.
  • Blood-borne diseases – if the tattoo needle or ink has not been sterilized, there is a risk of blood-borne illnesses such as HIV and Hepatitis B or C.
  • Wound healing – abnormally high levels of blood glucose could delay healing of the tattooed skin and increase the risk of infection.
If the patient feels unwell or sees any sign of infection after the tattoo has been completed, they should seek immediate help from their doctor or diabetes healthcare team. 
This guidance adapted from information found on the Diabetes UK website at http://www.diabetes.co.uk/tattoos-and-diabetes.html.


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