are your tattoos hiding signs of skin cancer?

Nothing raises our spirits like summer and sunshine. But time outdoors raises another thing — the risk of too much time outdoors. Paying close attention to freckles, moles and areas of the skin frequently exposed to sunlight is one of the ways dermatologists look out for melanoma, the scientific term for skin cancer.

Recent studies suggest tattoos make it more difficult to detect melanoma lurking beneath the skin. Though tattoos are a form of self-expression, there's evidence that they can prevent us from catching disease early and easily. For those with tattoos (or those considering getting one), we interviewed both a dermatologist and tattoo artist to give you the most accurate information to help make an informed decision.

A dermatologist for Simple Skincare, Dr. Debra Luftman practices both general and cosmetic dermatology in Beverly Hills and Calabasas, California. She is also a clinical instructor at UCLA and co-authored The Beauty Prescription, an informative guide to inner and outer beauty. When asked if skin cancer is harder to discover if a tattoo is placed over a freckle, mole, or birthmark, Dr. Luftman immediately says, “Yes — tattoo pigment can disguise or cover a mole, freckle, or birthmark, and colored tattoo ink may make it harder to detect an underlying skin cancer.”

So, how exactly does melanoma look (if it can even be detected, for that matter) when there’s a tattoo over it? “A tattoo over a malignant mole may look like the color of the tattoo, possibly blue, pink, or red,” says Luftman. “Whereas, for comparison, a malignant mole with no tattoo fits the ABC rule, meaning it has asymmetry, an irregular border, and multiple colors, including red, white, blue, and black."

Luftman reassures us that there are ways to prevent putting yourself in either of these situations: “Most importantly, wear daily sunscreen and get annual skin exams,” says Luftman. “If you are set on getting a tattoo, make sure the tattoo artist does not directly ink moles or freckles, always put sunscreen on your tattoo, and get it checked out regularly by a dermatologist.”

Next, we caught up with Patrick Cornolo, who has been tattooing since 1994, and completed his formal apprenticeship in 1993. In 2008, Patrick and his wife opened Speakeasy Custom Tattoo in the Wicker Park neighborhood of Chicago. Patrick says, “We work hard and try to do the right thing for our clients and artists. All of our artists do custom, one-of-a-kind pieces that can't be found on a wall.”

We first wanted to find out from Patrick how melanoma is discussed during a tattoo artist’s apprenticeship. “I was taught to avoid moles whenever possible, especially if they were raised, dark or large,” says Patrick. “There is no tattoo ‘handbook’ that specifies how to handle moles, but a good rule of thumb is that if it looks suspicious, raised, dark, or large — go around it.”

When asked about freckles, Patrick says, “Freckles are usually fair game, unless it would somehow compromise the design.” (Note: Above, Dr. Luftman advises against directly tattooing freckles.)

But something Patrick and Dr. Luftman agree on is the importance of sun protection. “When clients ask me about sun exposure and their tattoos, I tell them that the best thing is to keep them out of the sun completely,” he says. “The sun is the enemy of tattoos, mainly because the rays fade the ink and can prematurely age the tattoo.”

While Patrick recognizes and upholds his responsibility to educate clients about tattoos and risks associated with them, there’s only so much he can do. “If I see something concerning on a client's skin that alerts my radar, it's my job to let them know, but their job to consult a dermatologist,” says Patrick. “It's the client’s responsibility to let me know if they have had any adverse skin history, as I am not a doctor or mole specialist in any way.” 

Dr. Luftman and Patrick agree that if you’re smart about getting a tattoo and taking care of it, you’re on the right track to maintaining healthy skin. Though tattoos can make it harder to detect melanoma, choosing a well-trained, informed tattoo artist, always wearing sunscreen, and getting annual skin exams prevents you from being put in that position to begin with — letting you enjoy your health and ink.