Are you a tattoo person? Maybe you have a lot of body art already but had to take an ink hiatus while you were undergoing chemotherapy. One MyBCTeam member said, “I have several tattoos in various places and I love them all!”

Or perhaps after finishing your breast cancer chemo, you may have the desire to get your first tattoo to celebrate the strength of your body. Another member shared their idea for a tattoo: “I think I want ‘Survivor’ written with a ribbon and the date of my diagnosis.”

Maybe you have gotten a double mastectomy along with chemotherapy treatment and would like to get nipple tattoos as part of the reconstruction process: “There are tattoos out there that LOOK like real nipples. It’s called 3D nipple tattooing, and there is one artist in particular that is PHENOMENAL at it,” one member explained.

Before you decide to go under the needle, there are a few health concerns to consider. Here, we answer your questions about when, how, and where you can safely get your next tattoo after chemotherapy.

What Are the Risks of Getting a Tattoo Too Soon After Chemo?

Getting a tattoo always comes with inherent risks. There’s a risk of infection, allergic reactions, and scarring — especially when done by tattoo artists who don’t adhere to standard health and safety guidelines.

Just as chemo attacks surviving cancer cells, it can also attack your body’s infection-fighting cells. After chemotherapy, your immune system may remain weakened. One study of 88 people with breast cancer found that they had lower-than-normal levels of two kinds of immune cells, B cells and CD4-positive T cells, even nine months after their chemotherapy treatment had ended. This means that if you’ve undergone chemotherapy, you face a higher risk for infection and sickness from a tattoo needle than an individual who hasn’t had chemo.

The longer you wait after your last chemotherapy dose, the stronger your immune system becomes as your immune cells regenerate. You can also reduce your risk of infection by going to a reputable tattoo artist and following all aftercare instructions to prevent infection.

Where on Your Body Is It Safe To Get a Tattoo?

When deciding where on your body to get your tattoo, you may want to consider safety as well as appearance. Many breast cancer survivors get decorative tattoos over healed scars following lymph node removal, lumpectomy, or mastectomy. Before doing so, check with your treatment team to make sure the site of your operation is completely healed. The safest practice may be to wait to get a tattoo until you’re over a year out from your most recent breast cancer surgery. This can reduce the chances of your tattoo interfering with the healing of your surgical site.

One member shared, “I’ve had a bilateral mastectomy and reconstruction. I am trying to decide whether to continue the process and get nipples.”

Following breast reconstruction surgery, some people get nipple tattoos directly over their surgical scars. Plastic surgeons recommend waiting at least four months after the surgery is complete to get this kind of tattoo to ensure the breast reconstruction site has healed. This helps to ensure symmetric positioning of the nipple tattoos.

How Does Your Skin Change After Chemotherapy?

MyBCTeam members often discuss the ways that their skin changes after chemotherapy, including developing acne, intense itchiness, and alopecia (hair loss). Tingling or shooting pain, due to nerve damage, can also develop as a side effect of chemotherapy drugs.

As such, people who’ve undergone chemotherapy and are contemplating their first tattoo sometimes worry how painful it might be. Everyone feels pain differently, and getting a tattoo may hurt more on certain body parts than others. The most painful areas generally include the chest, ribs, and stomach. Getting a tattoo on parts of the body with thicker skin and more fat tends to be less painful, including much of the arm and hands.

One member who has had multiple tattoos as well as multiple breast cancer treatments shared reassuring words: “After having mastectomy, lymph nodes removed, expanders, and reconstruction, your pain threshold is probably on a different scale than the person who told you your tattoo would hurt.”

It’s also possible to have an allergic reaction to tattoo pigment. At some studios, you can request a patch test prior to getting a tattoo to see how your skin reacts. Once you get a tattoo, the area will likely become swollen and discolored, and it may also start to itch or bruise. This is normal, though if you see signs of infection, you should speak to your health care provider.

Where Should You Go for a Tattoo?

In general, when getting a tattoo, there are certain certifications and licensures to look out for to ensure you are going to a reputable establishment.

Before you commit to a tattoo artist, take a look at their past work to make sure the style and skill is at a level you are comfortable with. Also consider your budget and location, as prices vary greatly from place to place.

Most importantly, it is critical to go to a state-licensed tattoo artist who observes all hygiene and safety regulations. Using gloves and clean needles and taking other safety measures is important to prevent the spread of disease and the risk of infection of your skin. Always speak up if you’re concerned about hygiene practices.

For a nipple tattoo, you could consider having it done at a plastic surgeon’s or hospital instead of at a tattoo parlor. MyBCTeam members often debate the place to get a nipple tattoo. One member stated, “I personally feel that it’s better to have the nipples tattooed by a professional tattoo artist. There are several who do this kind of tattoo now. Some plastic surgeons also have regular tattoo artists on staff.”

Speak to Your Doctor

When done safely, tattoos after chemotherapy can be a meaningful decision to mark a significant milestone in your life. To prevent infection or other adverse reactions, it’s a good idea to wait a few months to a year after your chemotherapy has ended or your last surgery, depending on where you want the tattoo.

Before you get a tattoo after chemotherapy, talk to your oncologist about when it’s safest for you to proceed with your tattoo plans. They may also be able to counsel you on what to discuss with your tattoo artist, what areas of your body you should avoid tattooing, and how to keep your tattooed skin clean and healing properly.

Talk With Others Who Understand

MyBCTeam is the social network for people with breast cancer and their loved ones. More than 64,000 members come together to ask questions, give advice, and share their experiences with others who understand life with breast cancer.

Did you get any tattoos after finishing chemotherapy? Are you considering getting a tattoo in the future? Share your experience in the comments below or join the conversation on MyBCTeam.