Permanent Makeup: The New Tattoo
(Published in “Day Spa Magazine”, Dec. 2001)
By Melissa J. Schoffer
Nancy was interviewed and quoted in this important article describing permanent makeup!
Imagine waking up in the morning and not having to spend time in front of the mirror applying makeup. Imagine the convenience of exercising, swimming, or doing any type of athletic activity without the concern of makeup wearing off. Imagine a solution to the effects of mastectomy surgery, breast reconstruction, Alopecia and Vitiligo for instance, that does not involve surgery. Imagine no longer: The growing field of permanent cosmetics offers men and women the opportunity to look and feel their best at all hours of the day.
Derived from the ancient art of tattooing, and once limited to the needs of celebrities on the West Coast, the industry of permanent cosmetics has gone mainstream. As women and men of all ages seek to enhance their individual features, improve upon nature’s imperfections, and treat problems that result from certain medical conditions, a number of salons around the country are expanding their services to include the permanent beautification business. “The increasing popularity of permanent cosmetics is a fact,” said Marjorie Grimm, Publicity Director for the Society of Permanent Cosmetic Professionals(SPCP). “Across the nation the number of trainers, of technicians, for inquiries about these services has increased ten-fold in the past three years alone.” As with any procedure that offers lasting changes in appearance, permanent cosmetics require a well-trained, knowledgeable technician and a comfortable, prepared client. Under proper conditions, permanent cosmetics can provide people with the freedom and confidence that they have long sought.
COMMON PROCEDURES
Permanent cosmetics go by many names, from simply permanent makeup or cosmetic tattooing to the more technical, derma-pigmentation or micro-pigmentation. According to the SPCP, the three most common applications are for eyebrows, eyeliner and lip liner. As with any form of tattooing, the procedures involve the depositing of pigments through the epidermis and into the dermis. This may cause mild discomfort, which most patients describe as a stinging sensation. Eyebrow treatments seldom require an anesthetic, but many technicians use a topical anesthetic on eyeliner clients. In addition, an anesthetic injection containing epinephrine is generally used in the lip-liner process. “It provides total anesthetic blocking, which prevents involuntary twitches or lip curling that may occur in such a sensitive area,” said Mary Jane Haake, Technical Advisor for the SPCP. “The epinephrine is also vital in preventing the swelling which occurs in that deeply vascular area of the mouth. This combination creates a most comfortable and stable working surface for the application of permanent makeup.” While swelling is a natural response to this superficial breaking of the skin, and usually subsides quickly after the initial treatment, bruising remains unusual in the big three of permanent makeup - eyeliner, eyebrows and lips. “However, if you are working on scar tissue or other larger areas, some bruising may occur,” said Haake. Sheila May, who opened her permanent makeup studio in Pacific Palisades, California in the late 1970s, suggests giving clients ice packs to take home and use intermittently for at least 24 to 48 hours, even though most people are presentable within a few hours. It is also important to warn clients that the makeup may initially appear bolder than it will after a week of healing, during which the skin will flake and peel to reveal their new look.
Permanent cosmetics, however, extend far beyond the needs of the daily face makeup user. This developing form of beauty technology reaches out to those with eyesight impairment, unsteady hands due to Parkinson’s disease, multiple sclerosis, arthritis or paralysis, as well as people who suffer from the results of other serious medical conditions.
AREOLA REPIGMENTATION
Women who have had a mastectomy or breast reconstruction have two options when it comes to reconstructing the areola, or nipple. The first is a skin graft, which would require more plastic surgery in the future. The second is to have permanent makeup used to simulate the areola. In this process, color and shape are matched to the intact side. Otherwise, a new
color and shape are selected for both breasts, and permanent cosmetics blend with the shape of the new breast and the client’s skin tone. “That is an extremely rewarding part of the business,” said Shelly Finkelstein of Beauty Graphics in Dallas, Texas, referring to her breast cancer patients. Permanent makeup provides a less expensive option as well as a shorter healing time and fewer traumas to a body that has already endured considerable stress.
ALOPECIA
Permanent cosmetics are also an option for those with Alopecia, an immune system disorder that causes hair loss in patches or throughout the entire body. Blepharopigmentation is a procedure that can produce the effect of eyelash enhancement, and a hair stroke method of tattooing can be used to replicate the appearance of eyebrows. “Natural-looking eyebrows can be created by dotting against the lash line to give a look of eyelashes that would not be as severe as a line,” said Finkelstein. “Both procedures help return self-confidence and self-esteem.” Aside from cortisone injections that can return brow and head hairs on a temporary basis, there are not many permanent and non-medical alternatives for those with Alopecia.
“Clients came in with total baldness, and two out of three had lost both eyebrow and eyelash hairs as well,” said Nancy LaTouche* of “Always Look Your Best” Permanent Makeup in Irvine, California. “Permanent makeup can restore these facial features, and salons offer hair systems, custom hairpieces and hair extensions too.” Permanent cosmetics are also a wonderful option for cancer patients, who have undergone chemotherapy, and subsequently experienced a loss of hair.
VITILIGO
Vitiligo is a progressive loss of pigmentation in the skin that affects one in every 200 men, women and children. This skin condition results in white patches and can be either localized or widespread. It is attributed to a deficiency in the melanocytes, or cells containing dark pigment, to produce appropriate amounts of melanin. “Prior to micropigmentation, the only two treatments available to patients were camouflage makeup and the use of Psoralen Ultraviolet A Light,” said Barbara McCoy of the Center for Dermagraphics in San Diego, California. “Micropigmentation as a treatment modality will require multiple sessions, but has proven successful in the management of those cases that are poorly responsive to PUVA treatment in the more exposed areas of the hands, lips,
face and feet.”
At the same time, this type of treatment remains controversial. According to LaTouche, “this is mainly because if Vitiligo continues to spread, it becomes a losing battle.” However, if the affected area has not changed for a significant time, permanent makeup can often be used to blend the affected area with the original skin tone. If pigment loss does continue following permanent makeup application, further blending would present a challenge. “An exact match can be very difficult to achieve, but the face is an area that responds the best,” said Finkelstein. “This is more an art than a science, and a technician with good color knowledge is extremely important.”
SCAR CAMOUFLAGE AND CLEFT LIP CORRECTION
Scars, such as those that result from surgery, burns or accidents, can be camouflaged with permanent makeup. The most successful cases are those scars that are flat and a lighter color than the surrounding skin. A similar technique is used to treat male baldness, in which the technician fills in the bare area by matching the color to the client’s existing hair. Although surgery corrects cleft-lip formations, the patient typically is left with what appears to be an incomplete lip. Permanent cosmetics can reconstruct the lip line, by applying full lip color either in a natural tone or a cosmetic color, depending upon the preference of the client. “Permanent cosmetics help normalize their lives,” said Grimm.
RESTRICTIONS
There are no specific age limits for permanent cosmetic procedures, but proper judgment is certainly necessary in deciding who may or may not be a suitable candidate. The SPCP does not recommend permanent makeup for clients under the age of 35. These young people are at an age where they may not be entirely comfortable with the commitment of a life-long change in appearance. Furthermore, permanent lip color does not always work well on people with ethnic skin, such as those of Latino, African-American and Asian backgrounds. “The final product is a combination of the pigment and the skin tone growing over the top,” said Haake. “If that skin is dark in nature, it obscures most of the color tattooed beneath it.”
Haake advocates the importance of being aware of particular warning signs when selecting a client. As a rule, she looks out for the following: People who have hip replacements, pacemakers or other foreign bodies inside them that require special antibiotics; those with chronic immune-suppressed diseases, such as lupus, who may be in danger of poor healing; also, people with diabetes who suffer from circulation problems and poor skin healing. Those who spend a considerable amount of time in the sun or in tanning booths may not be the best candidates either, as the UVA rays alter the pigment tones. In all cases, potential clients should consult a doctor before undergoing any permanent makeup procedure.
SAFETY
A major concern with regard to permanent cosmetics is whether pigments will cause cancer. The answer is no. Pigments are mostly iron oxides, the same powder found in common cosmetics and used safely in tattooing. This iron-based consistency can be affected by strong magnetic fields such as an MRI scan, but should not prohibit anyone from having an MRI. Another concern pertains to the bleeding of pigments in the skin. This is predominantly a result of inadequate training. When a qualified technician applies permanent makeup properly and in a sanitary environment, it is a safe procedure.
“The other important factor is that now people can have this done in a doctor’s office which has stricter guidelines on sanitation and sterile conditions,” said Kristin Moore, a permanent makeup technician at the medical offices of Dr. Melinda Myers’ Premier Skin Care and Laser Center in Walnut Creek, California.
According to the Centers for Disease Prevention and Control in Atlanta, not any cases of HIV have been attributable to tattooing; nor has there been any increase of hepatitis in the last ten years. Maintaining a proper setting for permanent makeup procedures means using pre-sterilized equipment, and making sure all parts of the machine/device are either disposed of, or sterilized in an autoclave or dry heat sterilizer after use. Chemical sterilization is insufficient, since spores can survive throughout the process. A single component, manual device is designed to be used and then disposed. All handles must be disposed or sterilized between uses, and biohazard containers need to have an opening able to accommodate the size of the devices. “Complete disposability of all equipment is the safest way to avoid cross-contamination of blood pathogens,” says Ginette VanWaardenburg of Dermagraphics, Inc. Founded in 1985, Dermagraphics Inc. manufactures the only 100-percent disposable permanent cosmetics tool currently on the market. The Dermagraphics Pen is a non-machine method that allows for complete control on the technician’s behalf. “Individuals with Alopecia, especially men, appreciate a more natural eyebrow hair design, so that it does not look so artificial and solid,” said VanWaardenburg. “The Dermagraphics Pen is also ideal for scar camouflage and areola pigmentation.”
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