Very typical cases of red reaction. Quite common, especially before the 90's. This is probably caused by Cinnabar, or Mercuric Oxide.

Hi,
 I was recommended to look at your site because I'm currently having a problem with the reds in my backpiece, I would like to hear your opinion. The tattoo is a reproduction of a painting by Kandinsky, and contains several shades of red.

It had been completed for almost a year and had healed without problems, but before Christmas the red areas started  to raise up and became flaky, they are still like this. I've shown it to the artist who did it, he took advice from another artist who is very well respected in the UK, and who also supplied him with the pigment.

They think I've had some kind of allergic reaction to the red pigment, and they advise that I get it tattooed over lightly with antiseptic, the artist who did the original tattoo would do this for me at no charge. I'm hesitant to do this because I'm not sure it sounds like a good idea, and was wondering if you'd ever heard of that practice before, or could offer me any alternative advice. I'm in the UK, by the way.

 Love, Kate.

Dear Kate,

     Antiseptic is not a great idea.(note, the antiseptic in question is Dettol, and while many artists are having luck with this, it is not widely used enough for me to endorse it) The causes of red reaction have more to do with the pigment itself being mildly toxic or reactive. My advice is always see a doctor, but I can provide some information to help make the doctor better informed. His choice may be removal, although a good surgeon can do this without destroying your tattoo. The artist will have to rework it, but you probably need to actually remove the red. Here is what you and your doctor need to know:
  There are several reds available for art supply, only some used in
tattooing. Cadmium and Barium are used in finer paints, very toxic, not used for tattooing. 

   After that comes Red Oxide, which is Iron oxide. This is stable in most skin, although it seems to me that the iron may continue to
decompose under the skin, causing flaking and scarring.

     Next down the line are reds based on Cinnabar. I do not know as much about this pigment, but I do know reactions are common.

(Thanks to Jim Mowreader, I now know that Cinnabar is made from mercuric oxide)

  All of your symptoms point to red reaction, and these reactions are usually due to Cinnabar and Red Oxide. I have heard that some old timers put Mercurochrome in their reds to make them brighter, also causing the reactions you describe, but this practice is VERY rare.

  Next down the line is Naptha Red, which is the only red I use at all. I change the shades with addition of other colors. Tell your artist this is the safest red and is usually known as Crimson. Very rich deep red, and safe for all humans,  never a problem. What you need to keep in mind is your artists choice of using several commercial reds. He should stick with the crimson and cut it himself. The more different reds one uses, the more of a chance of reaction. I am not by any means blaming your artist. With all the commercial sales of tattoo equipment, most people feel all of the stuff is safe, and MOST of the time it is, but certain reds and yellows will hurt human skin, and it is good for them to take it as a lesson, pick out which red it was and tell everyone to avoid it. The tattooists' avoidance of these colors will eventually cause them to be discontinued.

  This problem happens all over the world every day, but many good tattoo artists don't know it because they are ashamed to talk about it. If your artist would like to speak with me tell him I will answer any questions he has to the best of my ability.
   Please follow up with me, it is important to the health of my clients as well as anyone else's.

A very atypical case of red reaction. Note the tightness of skin caused by the red NEVER healing after 4 weeks. See how thin and compromised the top layer of skin is in this case? This would leave the wearer open to chronic infections and abscesses. This is a very rare case.

Red reaction usually pops up long after the tattoo heals.

Here goes:
the tattoo was four weeks when the photo was taken, everything was fine with it apart from the red, everything else Black, Greywash, white, healed normal (within days) and where in that post-healing-shiny-state.
the red was put in with a magnum, after it had been used for greywash, all red was affected, the small hearts and diamonds too, even though it doesn't show readily on the photo, sorry for the bad scan.
the photo was taken under bad light conditions I took the photo, I did not do the tattoo)
I have also used premiums for many years and have never had a problem,
I've been suggested the reaction was staphylococcus infection which it does look like, but then, why only the red??

I would say it's an aggravation caused by impurities in the red pigment. Most likely caused by the pigment having too much of a concentration of aggravating metals (iron, cadmium, barium, mercury, and so forth) OR a chronic Staph infection on an otherwise healthy person who would not succumb to such a problem. Hopefully the immune system would fight an infection like this off.

I'd like to note that in the fall/winter of 2003 a batch of red from a very popular pigment company was contaminated by a mold, causing a very high reaction rate on a global scale. This tattoo was shown to me around that time, and he could be a victim of that contamination. Red reaction is very uncommon these days and this incident had nothing to do with the pigment itself, but in contamination during the mixing process.

Albert B  Jeffers III