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Trends in tattoo-related Google search data in the United States: Time-series analysis



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Short Paper
Trends in Tattoo-Related Google Search Data in the United States:
Time-Series Analysis
Benjamin Matthew Kiszla, BS; Mia Broughton Harris, MD
Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
Corresponding Author:
Benjamin Matthew Kiszla, BS
Heersink School of Medicine
University of Alabama at Birmingham
1670 University Blvd
Birmingham, AL, 35233
United States
Phone: 1 251 802 0586
Background: Tattoos are becoming increasingly common in the United States. However, little information is available to help
clinicians anticipate where, when, and on what topics patients will seek guidance regarding tattoo care, complications, and
Objective: The aim of this study was to model web searches concerning general interest in tattoo application, tattoo removal,
and the geolocation of tattooing services.
Methods: Relative search volumes (RSVs) were elicited from Google Trends, filtered to web searches made in the United States
between January 15, 2008, and October 15, 2022. Longitudinal data were analyzed in GraphPad Prism and geospatial data were
visualized with Datawrapper for general interest searches (tattoo and tattoo removal), aggregated geolocating searches (eg, tattoo
shops near me), and symptomatic searches relating to adverse effects (eg, itchy tattoo). Results were compared to previous global
literature and national surveys of tattoo prevalence.
Results: In the United States, the search terms tattoo and tattoo removal have experienced stable RSVs over the past 14 years,
with both showing peaks in the summer and troughs in the winter. RSVs for search terms that geolocate tattooing services have
experienced a general increase in use since 2008. A compilation of results for all collated geolocating search terms localized these
searches mainly to the American South, with lesser involvement in the eastern Midwest and inland West. Increased search interest
in the Southeast at the expense of more populous coastal states and Great Plains or western Midwest states reflects the ongoing
harmonization of tattoo prevalence across regions, as shown by national surveys. Searches for symptoms related to adverse
reactions to tattooing experienced an increase over the period of interest, with the same distribution as previous global findings.
Conclusions: Clinicians should be aware of an increase in search interest regarding tattoos and their removal, especially during
the summer months in the Southeast and Midwest. This increase in interest is occurring together with increased tattoo prevalence
and increased search interest for adverse reactions in a country lagging behind in tattoo ink regulation.
(JMIR Dermatol 2022;5(4):e40540) doi: 10.2196/40540
big data; dermatoepidemiology; infodemiology; tattoo; United States; web search; dermatology; tattoo care; skin care; guidance
seeking; tattoo removal; tattoo application; information seeking; internet search; web searches; adverse reactions
Given that an estimated 2% to 30% of tattoos are complicated
by adverse effects [1], institutions in Europe have incrementally
enacted recommendations and regulations for maximum allowed
concentrations of various injurious compounds and elements
in tattoo inks, beginning with a recommendation in 2008 by the
Council of Europe, ResAP(2008)1 [2]. With comparatively little
research on tattoos being conducted in the United States, and
still less regulation, American clinicians are armed with less
information with which to counsel and care for this patient
JMIR Dermatol 2022 | vol. 5 | iss. 4 | e40540 | p. 1 (page number not for citation purposes)
Research using Google Trends, a website that calculates relative
search volumes (RSVs) of queries in representative samples of
searches for specific time ranges and geographic regions [3],
has shown steadily rising global search interest in tattoos [4]
and their adverse effects [5]. However, such analysis has yet to
be adapted specifically to the US, the world’s foremost producer
of tattoo inks [6].
For this study, data were pulled from Google Trends, a website
that calculates relative search volumes (RSVs) for queries in
representative samples of searches for specific time ranges and
geographic regions [7]. The data are freely available,
anonymous, and unidentified. Queries are indexed as “topics”
or “search terms”; topics include “a group of terms that share
the same concept in any language” and so collate RSVs for
multiple search terms [7]. Search interest was aggregated by
topic to observe general trends over time, while isolating queries
as search terms by subregion (ie, state) enabled observation of
user attempts to geolocate tattooing services. Therefore, we
sought to depict trends in search interest for tattoos across space
and time.
Search Query Selection
To assess general interest in the application and removal of
tattoo ink to and from the skin, respectively, the terms tattoo,
indexed as a “visual art form,” and tattoo removal, indexed as
a “topic,” were selected.
To observe trends in user geolocation of tattooing services,
search terms specific to tattooing that localized the practice
were collected from autocomplete results in the Google search
engine, “top” and “rising” related queries in Google Trends,
and other sources. Search strings with an RSV greater than one
when compared to tattoo shops, the largest by volume, between
January 15, 2008, and October 15, 2022, were tabulated (Table
For each search string in Table 1, an average RSV was
calculated from January 15, 2008, to October 15, 2015, and
from October 15, 2015, to October 15, 2022. The proportions
of these average RSVs to the total RSV for each of the 9 search
terms were calculated for both the initial and final time periods
as decimals.
Lastly, a comparison to prior research was made. Interest in the
adverse effects of tattoos was modeled using symptomatic search
terms adapted from Kluger [5]: itchy tattoo, raised tattoo,
swollen tattoo, tattoo bumps, and tattoo fading. Trends in search
interest were then compared to national surveys of tattoo
prevalence conducted within the study’s timeframe.
Table 1. Google queries geolocating access to tattooing services and their relative search volumes.
Relative search volumes, % (percent in decimal)Search string
Oct 15, 2015-Oct 15, 2022 (final)Jan 15, 2008-Oct 15, 2015 (initial)Jan 15, 2008-Oct 15, 2022 (total)
46 (0.271)62 (0.484)31 (0.31)tattoo shops
42 (0.247)6 (0.0469)21 (0.21)tattoo near me
21 (0.124)37 (0.289)16 (0.16)tattoo shop
20 (0.118)6 (0.0469)10 (0.1)tattoo shops near
19 (0.112)3 (0.0234)10 (0.1)tattoo shops near me
7 (0.0412)1 (0.00781)3 (0.03)tattoos near me
3 (0.0177)11 (0.0859)3 (0.03)tattoo parlor
6 (0.0353)1 (0.00781)3 (0.03)tattoo shop near
6 (0.0353)1 (0.00781)3 (0.03)tattoo shop near me
Search Characteristics
Google Trends was queried on October 23, 2022, with the
selected topics and search terms. Results were filtered to web
searches made in the United States. Results were not filtered
by category, as the appropriate classification of searches as
related to “arts & entertainment,“health,” “shopping,” or other
categories could not be independently verified.
Data Retrieval and Analysis
RSVs for tattoo and tattoo removal were exported as a time
series, with values being reported by Google Trends by month
from January 15, 2008, to October 15, 2022. The data were
imported into Prism 9 (version 9.3.1, GraphPad) to be visualized
as a line graph.
RSVs for the geolocating search terms in Table 1 were exported
by “subregion,” or state, for the periods January 15, 2008, to
October 15, 2015, and October 15, 2015, to October 15, 2022.
Both the initial and final RSVs for each search term were
independently normalized by multiplication with the appropriate
percent in decimal (Table 1). The normalized RSVs for the 2
time periods were then aggregated across the 9 search terms by
state to give an initial and final relative search interest (RSI)
for tattooing services. The pairs of RSIs were imported into the
Datawrapper online app (Datawrapper GmBh) by state for
visualization as choropleth maps of the US.
RSVs for the 5 selected symptomatic searches for adverse
reactions to tattoos were packaged by month over the total time
range of interest, from January 15, 2008, to October 15, 2022.
JMIR Dermatol 2022 | vol. 5 | iss. 4 | e40540 | p. 2 (page number not for citation purposes)
Time-series data for each search term were exported from
Google Trends and imported into Prism 9 for visualization. For
clarity, the 5 sets of monthly data provided by Google Trends
were averaged by year to produce line graphs depicting yearly
mean RSVs with error bars representing the standard error of
the mean.
General Interest Searches
The RSVs for tattoo, when indexed as a “visual art form,” and
tattoo removal, when indexed as a “topic,showed a cyclic
wave pattern correlating with the seasons (Figure 1). Volume
trends typically peaked in the spring and summer and reached
a trough in the fall and winter. For tattoo, the month with the
highest RSVs was typically July (11/14, 79%). The lowest
monthly RSVs were most often reported for November (10/14,
71%). For tattoo removal, the month with the highest RSVs
was most often June (5/14, 36%). The lowest monthly RSVs
were most often reported for December (7/14, 50%).
Figure 1. Relative search volumes for the Google Trends queries tattoo, indexed as a “visual art form,” and tattoo removal, indexed as a “topic.” Results
were calculated by month from January 15, 2008, to October 15, 2022. Shaded areas denote time points for months from the beginning of September
to the end of February.
Searches Locating Access
Geolocating search terms with cumulative RSVs between
January 15, 2008, and October 15, 2022, greater than one (Table
1) had their search interest plotted in Figure 2.
Normalized aggregated RSVs, or RSIs, are visualized by state
in Figure 3. The initial choropleth map revealed no pattern in
RSI density with respect to population or geography, but the
final map showed localization to the American South, extending
into the Midwest, with lesser involvement in the inland West.
This transition was driven by increases in RSI in the mid-South
to the Midwest, paired with decreases in highly populated states
and in the Great Plains. The largest increases in aggregate RSV
over the time period of interest occurred in Alabama (29),
Tennessee (28), and North Carolina (21). The largest decreases
were seen in South Dakota (–16), Kansas (–15), and Texas
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Figure 2. Relative search volumes for the search terms tattoo shops, tattoo shop, tattoo near me, tattoo shops near, tattoo shops near me, tattoos near
me, tattoo shop near, tattoo shop near me, and tattoo parlor calculated by month from January 15, 2008, to October 15, 2022. The dotted line denotes
October 2015.
Figure 3. Relative search interest in tattoo service geolocation by state modeled by relative search volume (RSV). RSVs were calculated from January
15, 2008, to October 15, 2015 (left), and from October 15, 2015, to October 15, 2022 (center). The change in RSV by state, indicated by the Δ symbol
(right), was calculated by subtracting the results of the initial time period from the results of the final time period.
Searches Based on Previous Work
The 5 search terms modeling Google web searches for symptoms
of adverse reactions to tattoos have seen sustained or increased
interest since January 15, 2008 (Figure 4). While yearly mean
RSVs for tattoo fading and swollen tattoo were mostly stable
between February 2008 and October 2022, tattoo bumps saw a
sharp increase between 2008 and 2011, and itchy tattoo and
raised tattoo have had sustained growth.
The results of freely available surveys assessing the regional
prevalence of tattoos among Americans between 2008 and 2022
are tabulated in Table 2. While the West appears to initially
predominate in terms of tattoo prevalence, there is a trend toward
harmony among the 4 regions.
JMIR Dermatol 2022 | vol. 5 | iss. 4 | e40540 | p. 4 (page number not for citation purposes)
Figure 4. Relative search volumes for the search terms itchy tattoo, raised tattoo, swollen tattoo, tattoo bumps, and tattoo fading from January 15,
2008, to October 15, 2022, presented as yearly means. Errors bars represent the standard error of the mean.
Table 2. Percentage of survey respondents with tattoos by region.
Respondents by region, %Surveyor (year)
20131012Harris (2008) [8]
23221721Ipsos (2011) [9]
26182121Harris (2012) [8]
30293230Ipsos (2019) [10]
Principal Results
Analysis of Google Trends data revealed a seasonal pattern in
interest in tattooing and tattoo removal, with interest peaking
in the summer and reaching a trough in the winter (Figure 1).
Within this context, the use of the Google search engine to
geolocate tattooing services has been exponentially increasing
since at least 2015 (Figure 2), particularly in the Southeast
(Figure 3). The localization of geolocation for tattoo services
to the South, eastern Midwest, and inland West, regions
considered more conservative, reflects an increase in popularity
in perhaps more tattoo-naive areas, with consumers lacking
industry knowledge. The decrease in RSI among western
Midwest states and the Great Plains, however, defies this trend.
Perhaps their distinctly rural character has so far delayed an
uptick in tattoo popularity.
Comparison With Prior Work
Increases in searches geolocating tattooing services in the South,
as well as the Midwest, reflect the harmonization of tattoo
prevalence across US regions, which has been noted by national
surveys, although these have been scarce.
The US-derived results of this paper generally reflect findings
from global data. Though general search interest for tattoos in
the US has been relatively stable when compared to the
sustained global increase, which has mainly been driven by
Latin American countries [4] (Figure 1), the RSVs of the adapted
symptom-related terms have stratified in the US in the same
distribution as they have across the Anglosphere [5] (Figure 4).
Google Trends samples data generated from people who have
internet access and use it, but these data are not necessarily
reflective of these people’s behavior. Google Trends simply
samples from a representative pool of queries within a timeframe
and geographic region to generate relative data. Therefore,
Google Trends results for a given timeframe and geographic
region may slightly change with repeated sampling.
Clinical dermatologists should be aware of the seasonal patterns
associated with interest in tattoo application and removal and
the effect of these patterns on tattoo care. Further research and
surveillance are needed to understand the reasons behind and
impact of geolocation of tattooing services, particularly in the
American South in comparison to the Great Plains. Lastly,
dermatologists should be aware of the interest in signs of
localized inflammation when counseling patients on tattoo care
and complications.
Conflicts of Interest
None declared.
JMIR Dermatol 2022 | vol. 5 | iss. 4 | e40540 | p. 5 (page number not for citation purposes)
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Kluger N, Bäumler W, editors. Tattooed Skin and Health. Basel, Switzerland: Karger Publishers; 2015:248-253.
7. FAQ about Google Trends data. Google. URL:
[accessed 2022-11-21]
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news-releases/one-in-five-us-adults-now-has-a-tattoo-140123523.html [accessed 2022-11-21]
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more-americans-have-tattoos-today [accessed 2022-10-23]
RSI: relative search interest
RSV: relative search volume
Edited by R Dellavalle, T Sivesind; submitted 25.06.22; peer-reviewed by I Brooks, N Kluger; comments to author 08.09.22; revised
version received 06.11.22; accepted 17.11.22; published 01.12.22
Please cite as:
Kiszla BM, Harris MB
Trends in Tattoo-Related Google Search Data in the United States: Time-Series Analysis
JMIR Dermatol 2022;5(4):e40540
doi: 10.2196/40540
©Benjamin Matthew Kiszla, Mia Broughton Harris. Originally published in JMIR Dermatology (, 01.12.2022.
This is an open-access article distributed under the terms of the Creative Commons Attribution License
(, which permits unrestricted use, distribution, and reproduction in any medium,
provided the original work, first published in JMIR Dermatology, is properly cited. The complete bibliographic information, a
link to the original publication on, as well as this copyright and license information must be included.
JMIR Dermatol 2022 | vol. 5 | iss. 4 | e40540 | p. 6 (page number not for citation purposes)
ResearchGate has not been able to resolve any citations for this publication.
Full-text available
The production of tattoo ink and pigments in the US is unregulated. There are no guidelines or standards issued by national agencies. However, the practice of tattooing is regulated at the state and local levels but varies widely. Adverse events are addressed when a problem is reported. © 2015 S. Karger AG, Basel.
Introduction: It is not known whether tattoo-related complications are becoming more frequent and, if so, how quickly. Methods: Data generated through Google Trends (GT) worldwide, from January 1st, 2004 to December 31st, 2018, were analyzed for the search volume indexes (SVIs) of selected symptoms ("swollen tattoo," "raised tattoo," "tattoo bumps," "itchy tattoo," "tattoo fading"), diagnosis ("infected tattoo," "tattoo allergy"), and control terms ("tattoo care," "tattoo healing"). Results: For 2004-2018, the mean SVIs for symptoms were: "itchy tattoo" (41) > "tattoo bumps" (31) > "raised tattoos" (30) > "tattoo fading" (24) > "swollen tattoo" (22). The mean SVIs by 5-year periods showed a regular and constant increase for "itchy tattoo." The search for "infected tattoo" saw a slight but progressive increase, whereas the search for "tattoo allergy" remained stable between 2004 and 2018. Conclusion: Analysis of GT shows an increased search for symptoms such as itching, bumps, and induration on tattoos. However, it cannot be confirmed whether this rise points to a real increase of side effects, or to the popularity of tattoos and generalization of internet use as a tool to obtain information. GT could be of interest for detecting and following trends related to tattoo complications. Use of informal terms rather than medical terms is warranted.
Background: Cutaneous complications related to permanent tattoos affect 2-30% of those patients who have tattooed their skin. Little is known about the cases of tattoo complications in Finland. Objective: The aim of this study was to conduct a retrospective review of a series of Finnish patients with cutaneous tattoo reactions. Methods: We collected cases of tattoo reactions from the Department of Dermatology at Helsinki University Central Hospital, from members of the Finnish dermatological society and from various other sources (author's private practice, tattooists, professional internet forum). We analysed the demographics, clinical presentation, diagnosis, and microscopic findings on the skin biopsies, and evaluated the therapeutic outcome. Results: Thirty-one patients (16 men and 15 women, mean age 37.8) were included from 9 cities, mainly from Helsinki. Fifty-two percent (16/31) presented with an allergic tattoo reaction mainly against the red colour (75%, 12/16). Reactions were clinically polymorph ranging from scattered papules or nodules to complete infiltration of a colour. Lesions were itchy and sometimes painful. The reactions were lichenoid, granulomatous, pseudolymphomatous or less specific with a dermal lympho-histiocytic or plasmocytic infiltrate. Other diagnoses included tattoo blow-out (13%), melanoma within a tattoo, naevi within a tattoo (10% each), lichen planus (6%), granulomatous reaction with uveitis, sarcoidosis and dermatofibroma (3% each). Allergic tattoo reactions were mainly treated with local corticosteroid (CS) ointments, CS infiltration or surgical removal. Conclusion: This review is the largest series of tattoo complications in the Baltic area. It illustrates the wide spectrum of complications. Prospective, controlled therapeutic studies are necessary to assess the best treatment protocols for tattoo allergies and tattoo reaction management in general.