I found out out the issue, for me at least. It was a texture issue for my tattoo (but this can happen for any cc item.) I forgot to check the generate mip maps tag when I saved the image as a .dds image. I thought it was an old or broken body preset that I had for the longest time, but I noticed if that was the case then the sim's skin tone would turn black as if the cc skin tone was removed from the game.
Here's a dated recolor tutorial that I still found very helpful on S4Studio: https://sims4studio.com/thread/12/tutorial-standalone-recolor-custom-thumbnails