San Diego, California - Tattoos have become so common, many people think getting one is completely safe.  In most cases, it is. But there can be some health risks, as two San Diegans recently discovered.  After getting tattoos, both were diagnosed with infections caused by a family of bacteria called nontuberculous Mycobacterium (NTM), and both required medical care.

NTM infections have been recently recognized as a health concern linked to getting a tattoo.  Clusters of cases have been reported in other parts of the country, but these are the first cases detected in San Diego. 

“People should be aware of the potential for these types of infections before getting a tattoo,” said Wilma Wooten, M.D., M.P.H., County public health officer.

NTM infections can cause itchy red bumps that can progress to abscesses starting days to weeks after a getting a tattoo.  The infections do not improve with treatment for common skin infections and may require use of multiple antibiotics for up to six months.  Permanent scarring can also occur, even after treatment.

NTM has been found in contaminated tattoo ink and in water used to dilute the ink to create gray areas of the tattoo. Contamination can also happen when the needle is rinsed between colors.  Infection can occur because the area being inked creates an open surface on the skin through which bacteria or other disease-causing organisms can easily enter the body. 

The County Department of Environmental Health (DEH) and the County Health and Human Services Agency are working together with state and federal health officials to investigate the causes of the recent infections in San Diego.

Both the State of California and the County of San Diego have regulations governing tattoo and body piercing shops to ensure safe practices are in place to help prevent infection.  However, consumers should be aware of the potential health risks and what to look for in a tattoo artist and shop.

When getting a tattoo, you should:

  • Make sure the artist is registered and the shop has a permit from DEH
  • Ask the artist any questions you have about hygiene and the tattooing process – the artist should willingly and comfortably answer them for you
  • Request inks and colors that are specifically made for tattooing, not for other purposes
  • Ask if the tattoo artist uses sterile water for diluting inks and rinsing needles  – this is not required by State regulations, but is a DEH Guideline to help prevent infection
  • Be aware of signs of an infection after getting a tattoo – they include redness, heat, swelling or pus on or around the tattoo

If you develop signs of an infection, promptly seek medical care and report the infection to the tattoo artist.   Additionally, report a tattoo-related infection or problem to the DEH Epidemiology Liaison at (858) 505-6814 or .

Additional information on NTM infections and body art regulations can be found at: