With the rising popularity of cover up tattoos in recent years, many view this style of tattooing as the most accessible solution to their unwanted artwork. While a cover up tattoo from an experienced and talented artist may be a viable option for masking ill-conceived ink, is it the safest method for resolving tattoo regret? Experts think not.

Cover ups, like all tattoos, come with several health risks which vary in severity. Infections, while more common amongst amateur tattoos, may occur in any tattoo environment. Even sealed ink containers in professional shops may be contaminated with bacteria which can cause infections. Another concern is the possibility of allergic contact dermatitis. These reactions to certain colors (most notably red pigment) within ink cause raised, scaly red patches to appear on the tattoo. However, it’s also possible to experience a delayed reaction years later.

A lesser known and, to some extent, a lesser understood complication of tattooing is known as Koebner phenomenon. This condition appears as psoriasis-like lesions where the skin has recently experienced trauma, such as a cut or tattoo. While it is more common in those prone to psoriasis flare-ups, this condition also occurs in people without preexisting psoriasis. Psoriatic patches as a result of Koebner phenomenon and other reactions will typically appear within a few weeks of receiving a new tattoo. Those with healing tattoos should not dismiss these symptoms as a normal stage in the healing process. If there is any doubt, do not hesitate to contact a health care professional.

While all tattoos risk infections, dermatitis and psoriasis flare-ups, cover ups raise some additional concerns unique to this specific style. Studies show tattooed skin does not sweat or break down vitamin D the same as unaltered skin. Inked areas already produce only half the normal amount of sweat with a higher concentration of sodium. When ink is layered onto an existing tattoo, it exacerbates these issues. Though this may seem harmless, a lack of sweat during strenuous activity may lead to overheating while low sodium levels interfere with essential bodily functions.

Perhaps most disconcerting is the notion of cover ups causing carcinogenic materials within the older ink to breakdown, allowing them to enter the system. While there is still much to be learned of this phenomenon, a more obvious concern centers on melanoma. High concentrations of ink can obstruct areas of the skin, making it more difficult to recognize abnormal growth or changes in existing moles.

In short, tattoos already provide a number of potential concerns ranging from unsightly to life-threatening. While cover ups may provide fast relief to tattoo regret, we advise you ask yourself if adding more ink will resolve the issue. Consider, instead, eliminating the undesired artwork as much as possible with a series of tattoo removal procedures or try makeup to cover tattoos.

"I don't encourage patients to cover up a tattoo, as it often leads to more issues and even greater difficulty removing the tattoo by laser in the future. There are many reasons to be optimistic about the removal of tattoos now and in the future, and covering them up only serves to muddy the picture,” says Dr. Schlessinger.

While not all regrettable tattoos can be rectified, a good candidate in the capable hands of a skilled dermatologist who has experience with laser tattoo removal can produce excellent results. Remember, think before you re-ink. Consult a dermatologist and cosmetic surgeon about tattoo removal before committing to a cover up.

Are you wrestling with tattoo regret? Express your concerns in the comment section below.