Mankind has been practicing the process of applying tattoos for a long time, they have not lost their relevance in our time. The application of both black and white and color images to the skin is today a fashionable trend and a way of self-expression among people around the world: 11–24% of population have tattoos. The process of creating tattoos/permanent make-up consists of intradermal injection of various pigments, which leads to the formation of a permanent picture on the body. After tattooing, inflammation of the skin occurs that accompanies the tattooing process, in the literature this is described as a «normal inflammatory reaction», development of which is associated with extensive mechanical trauma. At the same time, the introduction of foreign pigments into the skin can cause the development of toxic and immune-mediated adverse reactions, the clinical manifestations of which can appear both in the near future and delayed, as well as after retattooing. In rare cases, the formation of generalized reactions is possible. An analysis of the literature was carried out in order to establish the possible reasons for the development of adverse reactions associated with tattoos, their clinical variants, as well as approaches to the treatment of these conditions. A clinical case of a lichenoid reaction to the red pigment of a tattoo is considered.