Permanent Makeup Risks and Complications

July 20, 2017 Dr. Cardona

My husband shared an article with me last week and I got motivated to share it with you as well as talk about the risks and common complications that involve Permanent Makeup procedures.

Tattoo and permanent makeup share some things in common: The skin is opened and ink is injected into the skin and could involve the same risks and complications.

It was about a tattoo case, but it can also apply to Permanent Makeup. For you, as a Permanent Makeup technician it is necessary to learn how to do the procedure, but also to manage its complications. The following are the most common:

Infection

You must have good practices to prevent Bloodborne exposures and cross contamination. You need to encourage your client to follow the aftercare recommendations in order to prevent infections during the week after the procedure, including, but not limited to keep the area clean, wash his or her hands before applying ointments, and also avoid swimming in the sea, lakes or swimming pools.

Remember that unsterile needles and equipment can transmit infectious diseases, such as HIV, Hepatitis, and skin infections caused by Staphylococcus aureus (“stap”) and other bacteria. Diabetic clients or clients who are taking corticoids are more prone to infections, not only related to common bacteria, but also to rare infections.

A common problem → Dissatisfaction

To prevent dissatisfaction, you need to have a good communication with your client. He or she needs to understand all the risks and possible complications.

1- A common problem that may develop with permanent makeup is the desire to remove it. Your client needs to understand that the color will be darker and the area is going to be swollen for several days and that the color will be at least 30% lighter in a week. Your client must be positively motivated and emotionally stable to do this kind of procedure. He or she needs to understand that removing it can be very difficult and the result is not always good.

2- Although permanent makeup may be satisfactory at first, they eventually fade and change its color due to the natural interaction between the ink and the body’s immune system. You must recommend your client to do touch up every two years to prevent this and keep his or her makeup fresh.

Selecting the proper color and performing a good technique will prevent results like these:

The shape and the color selection was incorrect, and unfortunately, she developed a hypertrophic scar.

In this case, the client wanted individual hair strokes and she also got an unwanted grey shadow. That happens when the needles are tilted while doing microblading, resulting in a hypertrophic scar.

A liquid pigment was injected too deep into the skin and migrated beyond the original site, resulting in a blurred appearance.

4- Another cause of dissatisfaction is that the human body changes over time and styles change with the season.

5- People who plan to have facial cosmetic surgery must be advised that the appearance of their permanent makeup may become distorted.

Removal problems

Despite advances in Laser technology, removing a tattoo is a painstaking process, usually involving several treatments and considerable expense. Complete removal without scarring may be impossible.

Allergic reactions

Although FDA has received reports of numerous adverse reactions associated with certain shades of permanent makeup, marketed by a particular manufacturer, reports of allergic reactions to tattoo pigments have been rare. However, when they happen, they may be particularly troublesome because the pigments can be hard to remove.

Occasionally, people may develop an allergic reaction to permanent makeup they have had for years, they are called granulomas. Those are nodules that may form around material that the body perceives as foreign, such as particles of tattoo pigment.

Allergic reactions are more common after implanting vegetal pigments into the skin. Mineral pigments are safer. People are allergic to different substances and materials involved in the procedure like Latex, and ointments used for aftercare.

You need to explain to your client that allergic reactions are not easily predicted unless he or she knew that is allergic to a specific substance or ingredient contained in any of the products that you use during the procedure.

Keloid formation

If your client is prone to developing keloids and hypertrophic- scars that grow beyond normal boundaries- he or she is at risk of keloid formation. Keloids may form any time the skin is injured or traumatized and is more often after a lip procedure and tattoo removal.

Reporting adverse reactions

FDA urges consumers and healthcare providers to report adverse reactions from tattoos, permanent makeup, and temporary tattoos, as well as problems with tattoo removal.

I always say that communication can prevent complications or if they occur, you may handle these permanent makeup risks much easier.