Q) I was wondering about reactions to red pigments and any solutions to the very difficult heal that comes from it...any advice on severe reactions to red inks?
A) Pigment reactions are always a shock and a disappointment to both artist and client. When something like this happens, the first (and most important) thing is to determine that it is in fact a pigment reaction and not an infection. Infections are more common than pigment reactions, so first look for the telltale signs: Swollen and irritated areas in the tattoo, a red angry zone growing on or around the tattoo, possibly with a vein-like line or lines radiating away from it, accompanied by a hot overall sensation. Blisters or open sores are signs of a more advanced infection. If this seems to be the case, if you catch it early your client may be able to control it by cleaning thoroughly and regularly with antibacterial soap and water, using triple antibiotic ointment, and keeping their dirty hands, pets and greasy car parts away from it. Worse case scenario, they need to see a doctor and get on antibiotics. However, if it is not an infection but a reaction to a color, you won't see the characteristic radiating red lines; instead, the parts of the tattoo containing a particular color will take longer to heal or never quite completely heal; this color will appear as a rash or raised area, sometimes looking milky and thick. In mild cases, a week of hydrocortisone ointment will overcome the skin's irritation and allow it to heal, and that's the end of the story. However, in other cases, months will pass without the skin settling down, causing the client itching, irritation and worry.
In these cases, it's obvious that the skin is simply very unhappy about having to share space with that particular substance and is trying to reject it. Dermatologists generally don't seem to have effective means of dealing with this other than to keep you on antibiotics. If there is no infection present, my advice is to work over the inflamed areas using a magnum needle, low power and distilled water or witch hazel. The purpose of this is simply to open the skin and give it a way to reject the unwanted ink. In most cases you will only need to do this once. After the area has healed and settled, you can judge whether it needs a second pass. Usually the inflammation will go away after this procedure, along with much of the unwanted color. Give it 6-12 months after that before re-coloring it; this time, though, use a different color. If you have a pigment that causes reactions in more than one client, throw it away. If you are using a brand that has more than one or two problematic colors, stop using that brand entirely. However, if you have a particular client that seems to have color reactions more than other people because of sensitive skin, try doing small test dots of each color somewhere that can easily be covered later; let these test dots settle for a year, see some sun exposure etc.; only after this can you proceed on that client with confidence. But this is an extreme case; most of the time, pigment reactions are rare and can be dealt with on a case-by-case basis.