Tattoos and melanoma: what should you know?

Tattoos do not increase the risk of melanoma, but they can make it more difficult to identify melanoma or other skin lesions, particularly in individuals with many moles. Pigmentation may mask important warning signs and delay early diagnosis.

For this reason, moles should never be tattooed over and, if a person decides to get a tattoo, at least one centimeter of distance should be maintained. Only in this way is it possible to promptly identify any changes.

The greatest concern for tattoo enthusiasts comes from black ink, which can completely conceal moles. However, other colors may also alter the appearance of changes, and delayed diagnosis can be very dangerous.

Recently, the Italian Senate approved the melanoma bill, which introduces:

• a dedicated awareness day (the first Saturday of May, or the second if the date coincides with the May 1 public holiday);
• mandatory informed consent for tattoo centers. Individuals choosing to get a tattoo will have to receive and sign a document warning them of possible health risks, especially in the presence of moles or skin lesions.

This measure is intended to raise public awareness of the importance of prevention and to promote early diagnosis initiatives for individuals more exposed to risk factors.

“This is a very important initiative,” explains the specialist. “As a plastic surgeon working at Istituto Clinico San Roccosince 1994, over the last twenty years I have observed a clear increase in melanoma excisions, particularly among younger patients: cases have practically doubled. It is a measure that encourages greater awareness and responsibility.”

The incidence of melanoma is rising sharply and is among the fastest-growing cancers. Two factors in particular have contributed to this increase:

• air pollution;
• excessive sun exposure, often without adequate protection.

For this reason, regular use of sunscreen is essential, particularly for individuals with many moles, who are at greater risk.

It is advisable to undergo a dermatological examination every year, preferably with a specialist who uses a videodermatoscope.

Those with many moles or a family history of melanoma should also avoid getting tattoos, although much depends on the size, color, and number of tattoos. The larger and more numerous they are, the greater the risk that suspicious lesions may become hidden.

From a surgical perspective, removing a melanoma on tattooed skin does not present greater difficulties if treated in the usual way. Certainly, the tattoo may be damaged, but the priority is to resolve the oncological issue.

At Istituto Clinico San Rocco, we use a specific laser for this purpose. In the past, only black and blue pigments could be removed, whereas today almost all colors can be eliminated, although red remains the most difficult.

The treatment requires several sessions spaced 45 days apart, as well as the application of an anesthetic cream at least 1 hour beforehand.

From an aesthetic point of view, the outcome depends on the specialist’s experience and the power of the laser used. In general, it is better to proceed patiently, even if more sessions are required.