With tattoos becoming more popular than ever and the minimal tattoo trend taking social media by storm, the US Food and Drugs Administration is warning consumers to proceed with caution. The US regulatory body has updated its consumer Q&A page on tattoos, having received 363 adverse reaction reports between 2004 and 2016 related to infections from contaminated tattoo inks and allergic reactions to the dyes.

Linda Katz, Director of the FDA’s Office of Cosmetics and Colors has warned consumers that serious infections, requiring hospitalization and even surgery, can be caused by inks that are contaminated with bacteria and/or mold, as well as when inks are diluted with non-sterile water. “There’s no sure fire way to tell if the ink is safe. An ink can be contaminated even if the container is sealed or the label says the product is sterile,” she warned.

Katz also points out that the FDA has not approved any pigments for injection into the skin for cosmetic purposes, and that inks can contain pigments used in printer toner or paint.