What’s hiding in your tattoo?

Tattooing is a custom dating back thousands of years, and today is a booming $3 billion industry. But as more people are getting inked, there’s a growing concern among dermatologists that tattoos are covering up signs of skin cancer, or worse, melanoma. 

According to Dr. Mona Mofid, a dermatologist with Sharp Community Medical Group, people with tattoos — particularly on their back and arms — tend to show them off when they’re outdoors. All that frequent exposure to sunlight increases the risk of developing skin cancer. 

“It’s estimated that 40% of adults between 18 and 50 in the U.S. have at least one tattoo. That’s significant because skin cancer can form on the skin underneath a tattoo, but it’s not easily spotted because it’s camouflaged by ink,” says Dr. Mofid. 

“That’s compounded by the fact that those with full back or arm tattoos display the artwork. In doing so, they unintentionally get more ultraviolet light exposure. For example, many men go shirtless outdoors, whereas wearing clothing would otherwise protect their skin.” 

Skin cancer generally refers to three types: basal cell, squamous cell and melanoma, with melanoma being the most dangerous. One in five Americans will develop skin cancer at some point in their lives, and every hour someone dies from melanoma. 

“The first sign of melanoma is often a change in an existing mole. Recently, a patient had a full tattoo on his back, but he couldn’t see the changes in his skin. It turned out to be melanoma, and sadly, he passed away,” she says. 

The most common place for melanoma on men is on the back; and for women, it’s the back of the calves — both popular areas for tattoos. 

If you’re considering getting a tattoo, try to avoid areas that have moles or birthmarks. Dr. Mofid advises to have your doctor check your moles beforehand. She points out that 50% of melanoma arises from preexisting moles. 

“Protect all of your skin from harmful ultraviolet rays with clothing or sunscreen of at least SPF 50, and be particularly aware of any changes of color or texture in tattooed areas,” she says. 

She adds, “If you already have a tattoo, protect it from the sun whenever possible, check it monthly along with the rest of your skin, and use your ‘ABCDEs’ to check for warning signs in moles.”

The “ABCDEs” of moles are:

A = Asymmetry: One half looks different from the other 

B = Border: There are uneven or irregular edges

C = Color: There is an uneven mixture of colors

D = Diameter: Bigger than a quarter of an inch and is growing

E = Evolving: Changes over time, including size, shape, color and texture or bleeding  

“To tattoo or not to tattoo is a personal choice, but be vigilant and seek out medical attention immediately if you see changes in your skin, particularly occurring on a mole,” she says.