Tattoos and the Hidden Truth

Article by Baptist Health South Florida (

Butterflies, suns, moons, arrowed hearts and their more evil-looking counterparts – devils, skulls, flaming dragons and knives – are turning skin into colorful works of art.

Yet tattoos can hide moles that may change color, size, shape and texture, indicating a serious problem – maybe even skin cancer.

Dermatologists report a marked increase in the number of tattooed patients they are seeing in their offices. Not necessarily for skin problems or skin cancer, but just because tattoos are trendy, especially in South Florida.

“Few people consider the health of their skin prior to getting a tattoo,” said dermatologist Alysa Herman, M.D., a micrographic skin surgeon experienced with the Mohs technique affiliated with South Miami Hospital, Baptist Hospital and Doctors Hospital. “And many tattoo artists will ignore existing moles, tattooing right over them.”

The problem with that, she says, is that skin inked by dark dyes does not allow changes in the skin to be easily recognized, delaying necessary treatment. For skin cancers that are allowed to grow over time, they can invade deeper tissues. With melanoma, especially, that invasion can turn a curable disease into a deadly one.

A report published in JAMA Dermatology last year noted that 16 cases of melanoma in tattoos had been previously reported in English-language journals. The authors of the report, who themselves had treated a patient with melanoma in a tattoo, recommended that people avoid getting tattoos near or over moles.

For people who already have tattoos over moles or who notice moles developing within a tattoo, Dr. Herman recommends they have the area checked regularly by a dermatologist.

“As with untattooed skin, skin cancer can develop at any time, and early detection is key to successful treatment,” she said. “It’s important to pay close attention to any skin changes you notice and get them evaluated by a dermatologist.”

It’s especially important for young people to understand the risks associated with hidden moles, Dr. Herman says.

“Tattoos and melanomas are both common among the younger population,” she said. “It’s up to parents and dermatologists, especially, to educate teens and young adults about the risks of tattoos camouflaging skin cancers.”

On the other end of the spectrum, people later in life may want to have their tattoos removed through laser treatments. Dr. Herman advises people in this group to have their skin evaluated by a dermatologist prior to the start of those treatments, too.

“Lasers remove the pigment of moles just like they remove the pigment from the tattoo ink,” she said. “If we remove pigment from a mole that is abnormal or cancerous, we may not be able to recognize the signs of malignancy – changing color, for example.”

There is some good news in all of this, Dr. Herman says. Researchers have been testing whether tattoo dye causes melanoma and other skin cancers, and conclusions thus far indicate the ink is relatively safe. Reports of allergic reactions and infections have been cited, but there’s been no link found between tattoo pigments and skin cancer.

“The key takeaway here is to be aware of your skin and have it checked regularly by a dermatologist,” Dr. Herman said. “Hiding under these trendy works of art could be a life-threatening dark secret.”

Indulge Magazine feature of Dr. Alysa Herman

Dr. Herman is honored as one of Miami’s Top Doctors by Indulge Magazine, highlighting her as one of the city’s few dermatalogic surgeons specializing in Mohs micrographic surgery for skin cancer.

Indulge Top Doc 2017 Indulge Top Doc 2020
Map illustration of Dr. Alysa Herman's office
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