Psoriasis is an autoimmune disease that leads to a buildup of extra cells on the skin’s surface. Thick, scaly patches called plaques can develop, causing itchiness, burning, or soreness of the skin. People with psoriasis may think a tattoo will hide their condition, but tattoos likely won’t conceal patches and could in fact cause skin irritation or a worsening of symptoms. RELATED: My Memories of Being a Teenager With Psoriasis “Many patients want to hide certain skin-related conditions, so it’s a good question to ask your doctor if a tattoo could make your condition worse,” says Edward Prodanovic, MD, an assistant professor of dermatology at Eastern Virginia Medical School in Norfolk. Here Dr. Prodanovic answers some common questions about the dos and don’ts of getting tattoos, especially if you’re one of the 7.5 million Americans living with psoriasis.

Q: What Are the Biggest Risks of Getting a Tattoo?

A: Tattoo ink contains various chemicals, such as aluminum, iron oxide, manganese, and mercury sulfide. These ingredients can cause an allergic reaction such as a rash or swelling. Yellow and some red tattoo inks that contain cadmium sulfide pose the greatest risk of a photoallergic reaction, which is triggered by exposure to sunlight.

Q: If You Have Psoriasis, Can Getting a Tattoo Cause Symptoms to Flare?

A: The risk for people with psoriasis is what we refer to as the Koebner phenomenon. Psoriasis plaques form at the site of a skin irritation or, in this case, a tattoo. It typically shows up in two to four weeks, but it can also occur months to years later. Not everyone with psoriasis will have this reaction. But if you have ever had a cut or burn that led to a psoriasis flare, then you may react similarly with a tattoo. If psoriasis plaques do develop, see your dermatologist.

Q: Are Henna Tattoos Safer?

A: Henna tattoos are nonpermanent, and they’re painted onto the skin with a brush resulting in a brownish stain. Henna is approved by the Food and Drug Administration only for use as hair dye, and black henna contains the chemical p-phenylenediamine, which can cause a severe skin reaction. Even though the process is less invasive than a traditional tattoo, there is still a risk of the Koebner phenomenon.

Q: What Should a Person Consider When Choosing a Tattoo Parlor or Artist?

A: Go to a tattoo artist who is licensed and a tattoo parlor that is registered. Any ink they use should be specifically approved for tattoos and not have expired. It’s important that the tattoo studio use proper sanitization processes. People with psoriasis can be more susceptible to infections following any injury to the skin. The tattoo artist may not be familiar with your condition, so inform them about it and make them aware of the risks.