Can Tattoos Negatively Impact Your Running Performance

A 2012 Harris Poll revealed that 21% of US adults have at least one tattoo. Which means that the popularity of tattoos among US adults has increased by 7% from 2003 and 5% from 2008, respectively. And while the reasons for getting a tattoo varied from “feeling more rebellious” to “feeling more attractive and strong” and “feeling more spiritual”, the majority of poll participants (86%) have never regretted their decision to get inked.

Even the popularity of running-related tattoos appears to have blossomed over the past few years, with countless athletes proclaiming their devotion to the sport through the strategic placement of inspirational skin markings. And while this kind of commitment certainly is admirable, it also brings a few questions to mind. Like, for instance, the following: What are the potential long-term health implications, if any, of getting a tattoo? And how can these potential implications impact a runner’s performance, if at all?

Getting a tattoo: How it works

But before we take a closer look at these questions, let’s just remind ourselves what the process of getting a tattoo entails. In short, tattooing basically involves permanently depositing ink under the skin at a depth of approximately 3 to 5 mm. (Which is also the depth at which eccrine sweat glands can be found.) This is usually done by puncturing the skin with a needle and then injecting ink, dyes, or pigment into the skin by hand.

Tattoos and exercise

Which brings us to the potential impact of skin tattoos on running performance. A team from the Department of Integrative Physiology and Health Science at Alma College in Michigan recently set off to determine exactly that. Their study, published in Medicine and Science in Sports and Exercise in 2017, focused on comparing the sweat rate and sweat sodium concentration of non-tattooed vs. tattooed skin.

As part of this study, sweat was collected from a tattooed and non-tattooed section of skin, respectively, of 10 healthy men. (Note that each study participant had a “unilateral tattoo covering a circular area at least 5.2 cm”.) Both the sweat rate and sweat sodium concentration were subsequently determined for each study participant for both sections of skin.

And the results? According to the research team, “the mean sweat rate from tattooed skin was significantly less than nontattooed skin”. And, in addition, “the mean sweat sodium concentration from tattooed skin was significantly higher than nontattooed skin”. Which means that not only does tattooed skin secrete about 50% less sweat than non-tattooed skin, but it also secretes sweat containing more concentrated levels of sodium. Which may, in certain instances, lead to sub-optimal thermoregulation.

So, does this mean that the tiny butterfly tattoo on your right ankle will negatively impact your running? Probably not. According to one of the study’s authors, Professor Maurie Luetkemeier, problems may, however, arise “where tattoos are very prevalent, and if they’re exposed to high heat and a heavy workload”. Like, for example, extensive tattoo coverage in areas like the back or arms or other areas with a high concentration of sweat glands. In these instances, proper thermoregulation while running in hot conditions could potentially become a problem. Professor Leutkemeier cautions, though, that the discussions around these findings are still very speculative and that more research is needed.

Other potential health risks associated with tattoos

And while more research is certainly needed on the subject of tattoos and athletic performance, a number of other studies have reported potential health risks of getting a tattoo. These include the following:

• A potential link between melanoma and red tattoo ink. In a case study published in a 2015 edition of Archives of Plastic Surgery, plastic surgeon Cormac Joyce and his team describe the case of a patient where the malignant melanoma was found only in the red ink sections of an elaborate chest tattoo. And while reports linking melanoma to tattoos are extremely rare, this case can potentially be explained in one of two ways. Firstly, the patient may have had existing melanoma that the tattoo artist unknowingly hit with his needle, thereafter seeding other, healthy portions of skin with malignant cells. Or, alternatively, the red ink may have caused an inflammatory reaction in the skin that eventually led to malignant transformation.

• Bacterial infections could potentially be spread through tattoo ink. At the beginning of 2012, a cluster of nontuberculous mycobacterial infections, which manifested through the formation of red papules on grey-colored portions of newly acquired tattoos, were reported to the FDA. After a thorough investigation, it was found that the outbreak strain of mycobacteria occurred in unopened bottles of tattoo ink, implying that contamination most likely occurred somewhere during the ink production process. Contamination, therefore, did not, as was initially speculated, occur during application at tattoo parlors.
• Some tattoo inks may contain carcinogens. In a 2016 report by Australia’s National Industrial Chemical’s Notification and Assessment Scheme, it was revealed that polycyclic aromatic hydrocarbons (or PAHs), a known carcinogen or potentially cancer-forming substance, were present in one-fifth of 49 specific tattoo inks sampled. A staggering 83% of all the black tattoo inks sampled furthermore contained PAHs.
• Tattoo ink may contribute to medical misdiagnosis. A case study published in Obstetrics & Gynecology in 2015 details the case of a young woman with cervical cancer, which her doctors believed had spread to her lymph nodes. During the surgery to remove these nodes, doctors discovered, however, that what appeared to be malignant cells on her PET-CT scans, actually turned out to be depositions of tattoo ink.

So, once again, does this mean that everyone who gets a tattoo will suffer from a bacterial infection or eventually get skin cancer or be medically misdiagnosed? Of course not. For now, according to adjunct professor Terry Slevin, specific concerns regarding tattoos causing or masking skin cancer seem to be unfounded. He stresses, however, that “we have no idea what, if any, long-term health effects go with having tattoo ink injected into the human skin”. There is, therefore, a pressing need for more long-term scientific studies comparing the health of those with tattoos to those with none.

The takeaway

So if you’re thinking of taking the plunge and proclaiming your love for running through getting inked, do your research first and take note of the potential risks. And if you decide to go ahead, be sure to have your tattoo done in the safest possible way.