Despite one in five New Zealanders being tattooed, the vast majority are likely to have never heard of tattoo-associated uveitis.
It’s a condition associated with inflammation in the inner eye that, in some cases, can lead to permanent vision loss. The culprit may be an immune response to certain toxins in the ink used in tattooing.
To give you an idea about how rare it is, a recent study in Australia looked at 40 cases of tattoo-associated uveitis reported between 2023 and 2025 (Aussies are more tattooed than New Zealanders at a rate of one in four, so close to seven million people). However, reported cases globally have doubled since 2010. The cases in the study were often associated with black ink, the most common colour used in tattooing.
Rachael Niederer, an associate professor of ophthalmology at the University of Auckland, is researching the condition in New Zealand. At the same time, the Environmental Protection Agency is re-examining regulations that govern tattoo ink used in New Zealand, following new rules in Europe restricting thousands of toxic ingredients, essentially leading to a ban on green and blue ink.
“Anecdotally, we’re seeing a slight increase over time [of tattoo-related uveitis], but some of that is increased awareness and some of that is the increased rate of tattooing that we’re getting,” says Niederer.
She estimates with a “back of the envelope calculation” that one in 10,000 people who have a tattoo would get associated eye inflammation. Her current study is looking at 20 people in the Auckland area who experienced swelling and bumps at the tattoo site and inflammation in the eye.
There is still much to learn about uveitis and whether it is isolated or associated with another condition called sarcoidosis, says Niederer. Sarcoidosis is a rare inflammatory disease that has also been associated with leaking breast implants and first responders who breathed in high amounts of toxins in the aftermath of 9/11, she says.
Rachael Niederer, an associate professor of ophthalmology at the University of Auckland.
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Niederer’s advice is that if you know you have sarcoidosis, then don’t get a tattoo, as it may increase your risk of having problems.
Those who already have a tattoo and their tattoo was inflamed and bumpy more than what is expected from the procedure, then think twice before getting more.
“…you’re just increasing the load of that on your immune system.”
“It probably increases the risk that you’re going to get other inflammation in your body, particularly your eyes is the bit that we worry about.”
Auckland tattoo artist and co-founder of the Roots Auckland Tattoo Convention Ben Kaye had never heard of uveitis and its association with tattoos until he read the Australian study.
A major concern for Kaye and other established artists is backyard novices using ink bought online from countries that lack regulation. Often that ink is bought off Temu or Trade Me. The same goes for numbing cream that clients want to use while he works on them.
He has never heard of professional tattoo studios using the cheap ink, as reputation is paramount in the industry, he says. There have been huge strides in the quality of ink used in the last three decades, Kaye added.
Tattoo ink is regulated in New Zealand through the Tattoo Ink and Permanent Makeup Group Standard, according to Dr Shaun Presow, the EPA’s hazardous substances reassessments manager
“Ours haven’t been updated for a little while, so it’s definitely about time that we take a look at them, and that’s what we’re doing with this process.”
While the EU has tightened its restrictions, some tattoo bodies have voiced opposition that the rules have gone too far. Presow says the EPA is aware of the increase in tattoo-related uveitis, but reminded those considering a tattoo that it is extremely rare.
“It’s unclear at the moment if this is linked to certain chemicals, or if it’s a more generic response to a foreign body, or something foreign inside the body, and sort of a more generic inflammatory response, so that’s something that we’ll try and dig into a little bit as well.”
– Published by EveningReport.nz and AsiaPacificReport.nz, see: MIL OSI in partnership with Radio New Zealand