25.01.2021

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How to take care of tattooed skin

Prof. Luca Valgimigli


The tattoo is a form of communication, a form of art in which one’s skin is used as a painter’s canvas, a way to express oneself and talk about oneself, as are clothing and body care.

This form of visual art has seen its popularity grow exponentially over the past 20 years, raising important questions; among these one in particular: how should tattooed skin be treated?


Certainly, our skin is not a canvas, as it is alive and is constantly changing. In doing so, it inevitably interacts with the pigments it hosts, with two important consequences. The first is that pigments could cause inflammatory or allergic interactions; the second is that the pigments could diffuse, be altered or gradually removed, ruining the “painting”.


What skin reactions can occur after a tattoo and what to do?


In a popular article, the AAD (American Academy of Dermatology) identifies several possible skin reactions that could occur following a tattoo.

Among these, the skin infection, which could occur immediately after getting tattooed or in a short time, is the most predictable, but also the easiest to manage. It can normally be avoided by an experienced tattoo artist, with appropriate hygiene precautions and responsible behavior by the tattooed. If something goes wrong, however, it is advisable to contact a doctor.

An allergic reaction to pigment components may be more subtle and show up even after years. In the most severe cases it requires medical intervention, but in milder cases the problem can be transitory and can be treated with particularly delicate soothing-protective products such as lino-dÉrmAâ designed for newborns’ dermatitis, if you want to use a natural remedy without resorting to the classic cortisone ointment.


Photo-sensitization or “sun allergy” is another of the possible negative interactions, due to the fact that the pigments, although not in themselves toxic or irritating to the skin, absorb sunlight and can act as energy-transfer agents against the skin, causing erythema.

It is always advisable to expose ourselves to the sun while protecting the tattooed areas with a very high protection in the first periods after the tattoo, possibly with a very delicate, photo-stable and allergen-free sunscreen such as Crema Solare SPF50+. However, even when the tattoo is well “integrated” into our skin, it is always advisable to expose yourself to the sun with good protection such as Crema Solare SPF30 and renew the application several times in case of prolonged exposure.

In some rare cases the tattoo could trigger inflammatory or autoimmune skin diseases such as psoriasis, vitiligo, lichen planus or others, acting as a trigger for a latent disorder, even without this being the real consequence of the pigments used in the tattoo.

Finally, rarely, some pigments could cause “skin burns” when undergoing medical diagnostic methods such as magnetic resonance imaging (MRI) for their interaction with the strong magnetic and electromagnetic fields to which one is subjected.


How could the tattoo get damaged? What things should be avoided if you have a tattoo?


The first advice indicated by the AAD is to avoid cosmetic products based on petrolatum on tattooed skin! If you need another good reason to avoid petrolatum, here it is: they cause the pigment to spread into the skin, discoloration of the tattoo and the appearance of “smudges” of the design.

The second good tip is to always protect the tattoo from the sun. In addition to the problem of photo-sensitization, which concerns our skin, the pigments of the tattoo may undergo photo-degradation, i.e. be chemically damaged by the action of UV radiation, discolouring or changing color. So, excessive exposure to the sun can cause obvious damage to the tattoo, which will be irreversible.

Finally, it is very important to avoid dehydration and dryness of the skin. Our skin continuously loses water in the form of vapor, even if this process is slowed down by the protective hydrolipidic film.

Frequent cleansing, which is a correct hygienic necessity, impoverishes the hydrolipidic film, increasing dehydration. In addition to choosing delicate cleansers that respect the hydrolipidic film such as Shampoo & Doccia, it is always important to keep the skin hydrated by applying suitable products. 

This applies to both men and women, and becomes indispensable in the case of tattooed skin. Poor hydration leads to peeling (even if not apparent) and loss of pigment, with the consequence that the tattoo will gradually fade or get discolored.


How to keep tattooed skin in perfect health while protecting the tattoo?


As we have seen, it is important to always keep the skin hydrated with delicate products that respect the physiology of the skin. It is also important to avoid petrolatum and the products that contain them: contrary to what many mistakenly think, they can ruin the tattoo and cause it to fade. 

It is advisable to moisturize the skin with a natural lotion that soothes any irritation, protects the skin and maintains its elasticity.

. BeC recommends two formulations that contain all these requirements and are ideal for the health of the tattooed skin: SE’â, an entirely natural body cream very rich in antioxidants that also has a toning action on microcirculation and BodyBiâ an extremely delicate and light-touch organic lotion, to meet the needs of different skin types.

Let’s not forget to protect our tattoo from the sun: it is advisable to apply Crema Solare SPF30 every time we expose ourselves to the sun, possibly applying it 15 minutes ahead of exposure to give the skin time to fully absorb it.

Cyclooxygenase, lipoxygenase and the inflammatory process

Cyclooxygenase and lipooxygenase are the two families of enzymes that are commonly involved in the inflammatory process, through a complex of reactions which is called arachidonic acid cascade. This complex of reactions develops as follows: a first enzyme, a phospholipase cleaves the phospholipids of biological membranes, releasing arachidonic acid, a polyunsaturated fatty acid with 20 carbon atoms (eicosa-5Z,8Z,11Z,14Z-tetraenoic acid ; C20:4; ω-6). The arachidonic acid is then transformed by two parallel enzymatic pathways, that is, by two families of enzymes: the cyclooxygenase which transforms it into prostaglandins and thromboxanes and the lipooxygenase which transforms it into hydroperoxides which in turn transform into leukotrienes .
There are two cyclooxygenase isoforms indicated with type 1 and type 2, briefly COX-1 and COX-2. COX-1 is the enzyme present in most cells (except red blood cells), and is constitutive, that is, it is always present. COX-2 is an inducible cyclooxygenase isoform: it is constitutively present in some organs such as brain, liver, kidney, stomach, heart and vascular system, while it can be induced (i.e. developed if necessary) following inflammatory stimuli on the skin, white blood cells and muscles.
There are various types of lipooxygenase that lead to different products, the most important in the inflammatory process is 5-lipooxygenase, 5-LOX.

Prostaglandins, Thromboxanes, and Leukotrienes

Prostaglandins, Thromboxanes, and Leukotrienes are chemical messengers or mediators, that is, molecules that bring a message to specific cells and activate or deactivate metabolic responses in these cells. They, therefore, have a function similar to hormones, only that, unlike what hormones do, the chemical message is carried only at a short distance, that is, only to the cells that are in the vicinity of the place where the mediators were produced. There are different prostaglandins, different thromboxanes and different leukotrienes that carry specific messages. In many cases these act as mediators of the inflammatory process , therefore they trigger all the events that are involved in inflammation:
– vasodilation with consequent blood supply (redness),
– increased capillary permeability with consequent fluid exudation (swelling or edema),
– stimulation of nociceptive nerve signals (pain),
– on-site recall of immune system cells that attack a possible invader (chemotactic action)
– activation of the biosynthesis of fibrous tissue to strengthen or repair the affected part (even if there is no need)
– generations of free radicals that can chemically destroy an invader (but also damage our tissues, i.e. they just “shoot in the middle”).
Prostaglandins and thromboxanes, however, also play important physiological roles in normal conditions, i.e. in the absence of inflammation. For example, they regulate the secretion of mucus that protects the walls of the stomach, they regulate the biosynthesis of cartilages and synovial fluid in the joints, they regulate vasodilation, hence the correct flow of blood in the various local districts, and more.

Triglycerides

Triglycerides are the main components of most oils and fats. These are heavy, non-volatile and little polar molecules, insoluble in water, made up of glycerol (or glycerin) esterified with three molecules of fatty acids: therefore, it is a tri-ester of glycerin, from which the name derives. Each fatty acid contains 8 to 22 carbon atoms (commonly 16 to 18) and can be saturated, mono-unsaturated or poly-unsaturated. The size of the fatty acids and their saturation determines the physical and sensorial properties of the triglycerides, which can appear as oils (liquids at room temperature) or fats (solid or semi-solid) and can have greater or less greasiness and smoothness on the skin. Unsaturated triglycerides or with shorter fatty acids are more fluid and have greater flowability.

Fatty acids (saturated, mono-unsaturated and poly-unsaturated)

The name fatty acids is commonly used to indicate those organic acids that are found in the composition of lipids, that is, in animal and vegetable oils and fats, both in the free form and in the form of esters with glycerol (e.g. in triglycerides), or they are esterified with “fatty” alcohols, that is, long chain alcohols, to form waxes. Fatty acids are carboxylic acids (formula R-COOH) which have a long carbon chain (R), unlike common organic acids such as acetic acid and propionic acid, which have 2 or 3 carbon atoms in total, respectively. Fatty acids are defined as saturatedif they do not have double carbon-carbon bonds, (called “unsaturations”), they are defined mono-unsaturated if they have only one, they are defined mono-unsaturatedpoly-unsaturated if they have two or more double bonds (see figure). The term omega-3 (ω-3) or omega-6 (ω-3), refers to the position of the first double bond starting from the bottom of the chain of carbon atoms: if the first double bond is encountered after 3 carbon atoms the fatty acid is classified as omega-3 , if after six carbon atoms omega-6 , as shown in the figure. The most common saturated fatty acids are palmitic acid (16 carbon atoms and no double bond, C16: 0) and stearic acid (18 carbon atoms, 18: 0), the most common mono-unsaturated is the oleic acid, typical of olive oil (18 carbon atoms and 1 double bond in position 9, C18: 1; ω-9), while the most common poly-unsaturated are linoleic acid and linolenic acid, progenitors respectively omega-6 and omega-3 (see figure).

Terpenes and terpenoids

Terpenes or terpenoids are a large family of natural molecules, typically containing 10 to 30 carbon atoms, which are biosynthesized from a common “brick”, isopentenyl pyrophosphate (IPP), containing 5 carbon atoms (see figure). The discovery that the repetitive brick consists of 5 carbon atoms is relatively recent, while it was once assumed that the entire family was created by repeating a brick of 10 carbon atoms, which was called “terpene”. Therefore, the molecules with 10 carbon atoms (such as limonene, see figure) were called mono-terpenes, i.e. composed of a single brick, diterpenes those with 20 carbon atoms (e.g. the cafestol that gives the aroma to the coffee), triterpenes those with 30 carbon atoms (e.g. beta-carotene). Since molecules made from 15 carbon atoms were also found (such as bisabolol), it was thought they contained a terpene and a half, and were called sesquiterpenes (from the Latin semis = half + atque = and). Today it is known that the repetitive unit is composed of 5 carbon atoms, therefore it is easy to understand how mono-terpenes contain two (see figure), sesquiterpenes three, diterpenes four, triterpenes six.