Technical failure related to tattooing and the tattooist, particularly needle trauma with “overworked tattoo” and injection of too much tattoo pigment with “pigment overload,” are common reasons for medical complications needing hospital treatment. Failures cause secondary infection and different chronic reactions. Overdose of particularly black pigment is suggested to be highly associated with granuloma formation in the tattoo and sometimes auto-immunity, hereby a “rush phenomenon” affecting other tattoos and active sarcoidosis in other organs. An educational gap exists among tattoo practitioners.The prevalence of actinic damage in patients with albinism living in regions with high ultraviolet radiation exposure is elevated. Therefore, a specific approach is needed for treating this highly vulnerable patient population.