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Micropigmentation or Permanent Makeup



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Permanent makeup is also known as micropigmentation. This procedure is done with tiny sterilized disposable needles which are used to implant hundreds of microscopic mineral pigments beneath the top layer of the skin. It is commonly used for camouflaging scars, pigmentation changes in the skin or correcting aesthetic irregularities.

This procedure is not new, as it dates back to the Egyptian days of Cleopatra (the Queen of Egypt), thousands of years ago. Cleopatra is believed to have been adorned with permanent makeup and Egyptian mummies have been recovered with face and body tattoos intact. Also, the ancient Japanese art of Tebori boasts full-body tattooing intricately done by hand.

Permanent Makeup is often referred to as:

  • Micropigmentation

  • Microdermapigmentation

  • Permanent Cosmetics

  • Cosmetic Tattooing

  • Dermapigmentation

  • Dermal Pigmentation

  • Dermal Graphics

  • Paramedical Tattooing

  • Inter-dermal Color


There are still other names given to this artistic procedure, but  "permanent makeup" and "permanent cosmetics" are most widely recognized by the general public

The most important factor with choosing a  cosmetic tattoo artist is that they must have an artistic flare and an eye for detail and symmetry. The technician should have the ability to draw even and symmetrical eyebrows, create eyeliner that is of the same thickness and intensity on both eyelids, and to compensate for any natural irregularities in lip shape.




When scheduling an appointment date for a permanent makeup procedure, you need to keep in  mind the healing aspects of this procedure.  Most patients need a few days afterwards without social plans or strenuous activities.


    Lip Liner or Full Lips

If you get cold sores or fever blisters you will need an antiviral prescription. Physician usually instructs to begin taking it 3 days before procedure, for a 7-10 day course.  Even if you cannot recall having a cold sore since you were a child, you still need to contact your physician for a prescription of an antiviral. The trauma that is done with the lips will activate the virus (which is laying dormant). If you do not take any antiviral, and you do end up with getting cold sores from this procedure, you could lose all the pigment in the healing stages. All the pain, money and time will be for nothing, and will have to reschedule another procedure once you have the virus under control.

The antiviral prescribed drugs for cold sores/fever blishers are:

Any type of lip surgery done within 6 months should probably wait before having permanent makeup applied.  Some of the fillers like Restylane or Collagen can sometimes cause migration of the pigment color or poor color retention.  If the patient has gotten lip implants, some physicians feel it is best to allow the scars to mature at least 6 months before attempting micropigmentation.







Permanent eyeliner micropigmentation, the patient should do the following:

  • If the patient wears contacts, they will need to remove them for the procedure and for at least 24 hours after.

  • Eyes can be sensitive to the light after the procedure, so wearing sunglasses will help your drive home.

  • Do not perm or use dye on eyelashes for two days prior.

  • Do not use eyelash curler the day of the procedure, and arrive with no makeup on the eye area.

  • Any surgery (such as blepharoplasty, cataract, or LASIK) done to the eyes should have a prior clearance given from the surgeon for micropigmentation to the eyes.  The approximate time period is about two months from the actual surgery.







Micropigmentation of the Brows:

  • For two days before the procedure, do not tweeze, wax or dye the eyebrows

  • Electrolysis or laser hair removal should not be attempted to the eyebrows for a week before the permanent makeup procedure is done.






   Permanent makeup is in fact - the art of tattooing. The inks, pigments, or dyes that are used  are regulated by the FDA or other regulation as cosmetic and color additives. The Medical Industry refers to Permanent Cosmetics as Medical Micropigmentation, which is a method of applying micro-insertions of natural pigments into the dermal layer of the skin.

  The permanent make-up consists of fine tiny particles of a iron oxide base pigment compound, which are placed into the dermis (middle skin area) to provide color.  The advanced pigments are dermatologist approved, and most of the time they are mixed to provide customized results.  Iron oxide based pigments are very safe and rarely cause any allergic reactions. 

  During the healing phase or recovery phase, a patient can lose up to 30 - 50 percent of the pigment color, as the skin exfoliates itself.  The area goes through this exfoliation phase, however; it is important to know not to help the process along with peeling the tissue back as this can cause the patient to lose some of the pigment.

  This a typically a two step process with the sessions - anywhere from one or more weeks apart.  The technician who performed the micropigmentation treatment will go over any areas that didn't take with the first round. The implantation process takes time and several steps to achieve the final results.  The pigments are mixed custom each time to closely match the skin tone or hair color of the patient. 

  It is important that you go to someone who is not only accredited to do this procedure, but has refined their techniques so you can get the most natural result possible.  Attempting to create a natural hair pattern with the eyebrows requires the expertise of an experienced pigment specialist.

  The treated area should be kept clean but not scrubbed. Excess pigment on the skin surface will shed without disturbing the implanted pigment. 



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  There will be swelling and possible bruising from permanent makeup application.  Ice packs after the procedure can help some, but mainly used as a comfort measure for the patient. Some patients do need to be careful how long they leave the ice packs on, as applying the cold compresses/ice packs too long could possibly create frost damage on the skin. Using refrigerator temperature cold packs can be safer than ice packs.

Cold Packs or Ice Packs are contraindicated in the following:

  • poor blood circulation

  • Raynaud's Disease

  • cold allergy

  • cole urticaria

  • other skin/vascular/blood disorders that react to cold temperatures


  Permanent makeup procedures are compared to skin deep wound.  All procedures will go through a period of oozing, bleeding, crusting over and then finally exfoliating.

  The area should be kept moist with antibacterial ointment at all times during recovery.

  For at least two days after the procedure, all strenuous activity should be avoided.  Increased blood pressure dilates the blood vessels which contribute to swelling and oozing.

  Keep the area clean.  Keep antibacterial ointment on the area with keeping it moist.  Scabs that dry out end up taking longer to heal than the areas that are kept moist. 

  Absolutely no peeling or picking at the crust that forms over the area.  This has the potential of causing pigment loss, scarring and delayed healing. 

  No swimming for at least two weeks in a chlorinated pool, fresh or salt water.

  Do not expose the area to a tanning bed, as the UV lighting can cause the pigment to fade.

  Avoid having any contact with the area with anti-aging products, as they contain acids, lighteners and tend to increase exfoliation - causing the pigment to fade out.

  Make sure you tell your physician or medical technician if you have permanent makeup, as any treatment with non-invasive laser treatment can also fade and remove permanent makeup.

  Permanent makeup always appears much darker and more severe immediately after the procedure. The color will not look right until you are completely healed. All patients can end up losing 30 - 50 percent of the pigment color, so the technician always has to go darker than the color you choose.

  Excess pigment will shed off as the skin exfoliates. Once that process is done, new skin starts healing over the area on top of the pigment, and tones down the color noticeably. As swelling goes down, the lines (eyeliner, lip liner, and the ending part of the brow) will be much thinner. The color will continue to soften as the healing process progresses.

  The healing process and the results looking natural occur within two to three months.




  Lips seem to take the longest to heal out of all the different procedures.  They tend to ooze and have more swelling.  The area tends to crust over from you sleeping at night.  Rinsing the area with water and applying more antibacterial ointment will help loosen the crust.  Once that is done, dry the area and then reapply the ointment. 

  Try not to pucker or over stretch your lips during the recovery period, as doing this can open up some of the crusted healed over areas and start the oozing cycle once again.  The area between the vermilion border of the lips (where the lip liner would be applied) and the skin surrounding the mouth has a lot of tension when healing from this procedure. The less animated you are with your mouth expressions, the faster the healing process will happen.

  The lips start to peel around day three and will continue for at least a week.  It is best to try and refrain from peeling or picking the exfoliated skin before it is ready, as you can lose some of the pigment from the procedure. Allowing the skin to fall off on its own is best.

  It is normal to feel some discomfort with micropigmentation of the lips.  The following day, the discomfort will ease, and normally by day three or four, the patient is "pain free".  If you are experiencing a great deal of pain during this time, it could mean that either you have an infection, cold sore, or possibly a reaction from the antibiotic ointment. If this pain doesn't go away after switching antibacterial ointments, you should see your physician to see if this is a bacterial or a yeast infection. If it is an infection, the open areas will be discolored or yellow thick discharge.

  Candida lip infections are different, in as much as a lot has to do with the severity or strain of the infection.  Symptoms include, cracking and bleeding near the corners of the mouth.  Itching and burning can also occur along with small granulomas or nodules, blisters along the vermilion border of the lips.



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The benefits of micro-pigmentation can present itself in many ways:

  • Thinning brow hair is a sign of aging and can give the illusion of the face dropping. Micro-pigmentation can make the brows appear thicker with filling in this area with hair like strokes. This will frame the face and showing a much more vibrant appearance.

  • Lip Liner or Full Lip Color can actually make small shrinking lips appear fuller and detract from the fine lines that form around the lip area with age. This gives a much smoother edge to the lips.

  • As women age, sometimes eyesight diminishes. This can have a direct reflection on how their eye makeup is applied. Permanent eyeliner and brows can restore confidence in older women.

  • Medical conditions, medications, or aging can diminish eyelash growth. Permanent makeup can help restore some of the eyelash loss with tiny hair like strokes.

  • Many women loose their brows and eyelashes from chemotherapy treatments - permanent makeup helps tremendously with the physiological and emotional benefit for women.

  • Eyelash hair thins with age, and permanent eyeliner can give the illusion of thicker lashes.
    Self-esteem and confidence is renewed with the youthful appearance of having proper eyebrow shape, lip shape and lash enhancement.

  • Brows that have been shaped, colored and arched can take years off an aging face.
    Brow arches open up the eye area and make a face appear more youthful.

  • Being able to free up your time in front of the mirror with waking up with your "face on".
    Women who are active in sports and other activities can participate with more confidence knowing their makeup will not sweat off.

  • Women who are older might lose some of their mobility in their hands to apply makeup evenly. Permanent makeup can give these women freedom from the problematic day to day makeup applications.

  • Permanent makeup allows for women to look fresh and ready to go right out of the shower or pool.

  • Women who have undergone breast reconstruction due to an accident or breast cancer can have their newly formed breasts appear normal with the areola/nipple complex tattooing. This gives the women the confidence and self esteem back that they might have lost with losing a breast.

  • People who have a noticeable scar can have micro-pigmentation done to even out the color variances and skin pigmentation changes.





Fast Facts regarding the procedure of micropigmentation:


  • Do not apply any makeup before having this procedure.
    Topical anesthetic cream is applied 30 - 40 minutes before the procedure to help ease the pain.

  • If done in a physician's office, a local anesthetic or a dental block can be injected into the lips.

The Treatment:

  • Needles are disposed of after every single treatment.

  • Pigment is implanted into the skin.

  • The color of pigment is darker right after the procedure, as most patients lose 50 percent of the pigment color during recovery.

  • Some might experience slight discomfort with this procedure.

Post Treatment:

  • Stay away from ultra-violet exposure (tanning booths) for at least a few weeks.

  • Wear sun-block or sunscreen on the treated areas to preserve the pigment - sunlight can lighten the color.

  • Do not use Alpha-hydroxy products and Retin-A near the treated areas, as this will bleach out the pigment.


The Results:

  • It takes at least two weeks for the final results to be evident.

  • Touch-ups are normally required.




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Allergic reactions to the pigment is a rare situation and can be hard to remove.  Anytime you implant anything that is foreign into the skin, there is the potential for a reaction to occur, and sometimes can manifest themselves years later with a rash or an immune system allergic reaction.

The top two adverse reactions are either a granuloma (masses that form inside tissue around a  foreign substance) and keloid or hypertrophic scarring (overgrowths of scar tissue or a raised scar)

Keloid scars can appear with the removal of permanent makeup more commonly than with its actual application.


The more common adverse reactions include:


It is so important that you go to a clean place to have micro-pigmentation done, as it is possible to get either Hepatitis C or another blood born disease from the use of unclean needles.  Unsterile tattooing equipment and needles can transmit infectious diseases such as hepatitis.






                                    Image of Subcutaneous Nodules or Granulomas





Another concern is regarding MRI's and having permanent makeup applied. There can be some swelling or burning in the pigmented area due to interactions between the magnetic field and the pigment - which can interfere with the quality of the MRI image. Before you go in and have a MRI done, on the information sheet you fill out, they will ask you specifically if you have any tattoos or micro-pigmentation. The magnetic reaction happens with the iron oxide in the pigment.  It tends to vibrate and can cause a mild inflammatory reaction.  If this should happen, topical steroid cream or Benadryl helps the response.

Make sure you disclose to the radiologist if you do have permanent makeup so that they can know about this ahead of time and make adjustments for the quality of the MRI image. The reaction from the permanent make up will not compromise the quality of the imaging as long as the radiologist is aware of the permanent makeup. Patients just need to tell the radiologist that they have this, so they will not misread the test report. 




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Each procedure can take one to two hours to perform. 


  • An ointment such as A & D ointment, antibacterial ointment or Vaseline must be kept on the area.  Keeping the area "moist" will allow for a faster healing period.

  • Days four through seven - will see a light crust that will form over the area that was treated. This eventually will fall off.

  • It is important not to pick, rub or peel the skin where the pigment has been applied.

  • The healed color will be lighter and softer than what was originally done.

  • A follow up visit will be required anywhere from four to six weeks.  If needed a light layer of color is applied to any area that might have some irregularities from healing.  Adjustments to the shape or color tone is also done at this time

  • Periodic touch ups might be needed anywhere from one to five years.





Because of where the pigment color is implanted to (the reticular part of the dermal layer of the skin), and it cannot be washed is considered by all counts actually permanent. Fading can and does happen often with any tattoo.  Periodic maintenance with color re-enhancement or color refreshing will help maintain the longevity of the tattoo.

Micropigmentation has been referred to as permanent makeup, however the following can fade the procedure out:

  • Aging can create discoloration

  • Sunlight can reduce the strength of the color

  • certain anti-aging products like glycolic acid, non-invasive lasers, etc. can fade out the pigment if applied directly to the area where the procedure was done.







Other Links on Micropigmentation: