LIDOCAINE AND TATTOOING: UNDERSTANDING ITS IMPACT ON THE SKIN AND HEALING PROCESS

ink spread out related to the use of TKTX

Pain is part of the tattoo experience, and it is completely natural to want to reduce it. Lidocaine-based numbing creams are now widely used and often seen as a simple solution to make a session more comfortable. However, their effects on the skin go far beyond pain reduction and can directly influence how a tattoo heals.

Lidocaine is a local anesthetic used in medicine to temporarily block the transmission of pain signals. When applied to the skin, it prevents nerves from communicating with the brain. However, this action also alters the skin’s normal physiological response during tattooing. The skin becomes temporarily less reactive, more difficult to “read,” and its natural protective mechanisms are diminished.

Under the effect of lidocaine, the structure of the skin may feel more relaxed. Subtle cues that help the artist assess proper depth, such as skin tension, dermal resistance, or the body’s immediate response, are less noticeable. In addition, lidocaine is often associated with vasoconstriction, meaning a reduction in local blood circulation. This decreased blood flow can slow the normal inflammatory response, which plays a key role in stabilizing ink within the dermis and supporting the healing process.

When these conditions are present, the risk of the needle penetrating slightly deeper than intended increases. If ink reaches the junction between the dermis and the hypodermis, it is no longer properly confined and can spread under the skin. After healing, this diffusion may appear as blurred lines, greyish halos, or areas where the pigment seems to have “spread” beneath the skin, a phenomenon commonly known as a blowout. These effects are generally irreversible and may become more noticeable over time.

It is also important to understand that pain normally acts as a warning signal. When it is absent, the body does not communicate its limits as clearly, which can lead to unintentional overworking of the skin, even with solid technique and extensive experience.

A Note Based on My Personal Experience

In my own practice, I have observed very clear differences between sessions performed with and without lidocaine. I have tattooed the same client on multiple occasions: the earlier sessions, done without any numbing agent, healed beautifully, with clean lines and stable execution. During a later session where lidocaine was used, the tattoo showed clear signs of ink diffusion and blowouts after healing, despite identical technique and careful execution (see the photo). This experience reinforced my understanding that lidocaine can become a significant and unpredictable variable in the tattooing and healing process.

Every skin is unique, and some people tolerate anesthetics better than others. However, styles that rely on fine lines, dotwork, or delicate details—such as ornamental or minimalist tattoos are particularly sensitive to these variations. Even minimal ink diffusion can become highly visible and alter the overall aesthetic of the tattoo.

The use of lidocaine is neither inherently good nor bad. Rather, it should be approached as a conscious choice, made with a clear understanding of its potential effects on the skin and the final result. Open and honest communication between the artist and the tattooed person is essential to preserve the quality of the work, respect the body, and align expectations.

Tattooing is a collaboration between the artist, the skin, and the healing process. Altering one of these elements, such as through the use of anesthetics, can influence the final outcome. Being well informed allows for thoughtful, respectful decisions that align with the desired experience and result.