Growing trend of tattooing and its complications in Nigeria.

Tattoo, a Polynesian word meaning 'to mark', is a form of body modification done by inserting indelible ink into the dermis to change its pigmentation. Tattoos are done for social, cultural, and religious purposes. It has been in existence since the 18th century and was associated with sailors, lower class individuals, and criminals. However, since the late 20th century, tattooing has undergone a redefinition and shifted to an acceptable form of expression all over the world, including Nigeria, cutting across almost all age groups and socioeconomic class. This review is aimed at highlighting the indication, complications arising from the procedure as well as removal, and how to manage them. The dermatological complications associated with tattoos can occur either during inking or attempts at removal. Most times, tattoos are obtained through unsafe means by unauthorized personnel, and this is associated with numerous health risks. Of particular importance to the dermatologists are the hypersensitivity reactions, granulomatous skin disease, and formation of both keloid and hypertrophic scars. Treatment options vary and include use of silicone gel and intralesional steroids for hypertrophic and keloid scars, topical medication for hyperpigmentation, and use of LASER for tattoo removal. In conclusion, the trend of tattooing has become a widely accepted form of social expression all over the world and is gradually gaining ground in Nigeria. Patients frequently present to the dermatologists and physicians for solutions to the complications. It is important to proffer solutions and educate patients on the various health risks associated with tattooing.

Complications of chronic use of skin lightening cosmetics.

Skin lightening (bleaching) cosmetics and toiletries are widely used in most African countries. The active ingredients in these cosmetic products are hydroquinone, mercury and corticosteroids. Several additives (conconctions) are used to enhance the bleaching effect. Since these products are used for long duration, on a large body surface area, and under hot humid conditions, percutaneous absorption is enhanced. The complications of these products are very serious and are sometimes fatal. Some of these complications are exogenous ochronosis, impaired wound healing and wound dehiscence, the fish odor syndrome, nephropathy, steroid addiction syndrome, predisposition to infections, a broad spectrum of cutaneous and endocrinologic complications of corticosteroids, including suppression of hypothalamic-pituitary-adrenal axis. In this era of easy travels and migration, African patients with these complications can present to physicians anywhere in the world. It is therefore critical for every practicing physician to be aware of these complications.