Recent years have seen a rise in the number of people getting tattoos, and this has led to an increasingly larger incidence of associated adverse effects. The interesting study by González-Villanueva et al.1 provides the necessary tools for successful management of these emerging conditions. There is a widespread tendency to class all inflammatory reactions affecting tattoos as allergic reactions, even though no such correlation has been established. The authors confirm this observation and provide a useful diagnostic algorithm that fulfills a need in daily clinical practice. Of equal interest is their presentation, through a case series, of the clinical patterns we face and their associated histopathological findings. Moreover, collecting data on inks and performing an allergy workup are especially difficult in Spain: the fact that Spanish regulations on standardization of tattoo inks are among the strictest in the European Union can lead tattooists to use inks from abroad, especially the United States, where the Food and Drug Administration does not take pertinent measures on the grounds that other public health issues have greater priority. Consequently, the difficulties associated with this state of affairs make the work carried out by the Skin Allergy Department of Hospital General Universitario de Alicante all the more praiseworthy. This article is required reading and provides us with an essential tool for the responsible management of tattoo-associated conditions.