AURI REYNOSO, a hairstylist in Englewood, N.J., says she wished to roll out of bed “looking beautiful.” So 36 months ago, she asked Melany Whitney, a qualified permanent-cosmetics professional based in The Big Apple, New Jersey and Florida, to tattoo eyeliner and defined brows onto her face.
Although the procedure was “a little uncomfortable,” said Ms. Reynoso, now 39, she was delighted with all the results. “Everything for beauty,” she said. “It’s amazing ways to get out of bed looking absolutely fabulous and prepare in 5 minutes. I just apply blush, lip gloss and mascara and I’m done.”
Permanent makeup, often known as micropigmentation or cosmetic tattooing, extends back on the early 1980s, whenever it was designed to handle alopecia, a disorder that causes hairloss (including eyebrows). Since that time, the area has expanded to include burn victims and cancer survivors, patients with arthritis and Parkinson’s disease who have difficulty putting on makeup and individuals like Ms. Reynoso, would you simply rather limit the time spent facing a mirror.
But while many are thrilled making use of their outcomes, all is not really rosy in the world of needles and ink. The saying “permanent” can be a misnomer for the reason that color fades as time passes. Some patients develop granulomas, keloids, scars and blisters, plus they report burning sensations once they undergo an M.R.I.
What’s more, even though the inks used in permanent eyeliner makeup along with the pigments during these inks are at the mercy of the scrutiny in the Food and Drug Administration, regulations for practitioners (electrologists, cosmetologists, doctors, nurses and tattoo artists) vary by state. “You may go on eBay and get machines and pigment and get in the garage and set up up shop,” said Dr. Charles Zwerling, an ophthalmologist in Goldsboro, N.C., and an author of the forthcoming book “Micropigmentation Millennium.” He founded the American Academy of Micropigmentation, a nonprofit professional organization that provides certification for practitioners, in 1992.
“We see a large number of faces being destroyed by individuals who don’t get trained properly, and that’s the greatest symptom in permanent cosmetics,” said John Hashey, the dog owner of John Hashey’s Advanced School of Permanent Cosmetics in Oldsmar, Fla. Mr. Hashey mentioned that 90 percent of his company is fixing mistakes. “Your average cosmetologist who cuts hair has got to do 1,200 to 1,500 hours just to achieve that,” he was quoted saying. “How is any longer important than going for a needle to someone’s eye?”
The side effects to micropigmentation include infections like H.I.V., hepatitis, staph and strep from dirty needles, and allergic reactions to the permanent dyes, said Dr. Jessica J. Krant, a dermatologist in Manhattan and an assistant clinical professor of dermatology on the SUNY Downstate Medical Center in New York.
A study in this month’s issue of Clinical Infectious Diseases reported an outbreak of mycobacterium haemophilum, a nontuberculous mycobacterium that causes skin, joint, bone and pulmonary infections, after permanent makeup was put on patients’ brows. Research last September in Contact Dermatitis, a medical journal, investigated severe side effects like swelling, burning, and the development of papules in four patients who had had a minimum of two permanent-makeup procedures on his or her lips. “In light from the severe and sometimes therapy-resistant skin reactions, we strongly suggest the regulation and charge of the substances” used in the colorants, the authors wrote.
Nancy Erfan, an agent in Monterey, Calif., experienced a bad experience. In November 2003, Ms. Erfan, now in the 30s, had permanent color put on her lips and eyes. The technician told her she could be swollen for a while, and gave her a cream to assist. Nevertheless the swelling worsened, Ms. Erfan said, and very soon she had “big bumps” around her eyes and lips.
“I could barely open my mouth to eat or speak,” she said. She visited a number of dermatologists and plastic surgeons, but found no remedy. “They said I had been obviously having a hypersensitive reaction, however they didn’t know what to do.”
It ended up the colors used in one of the dyes by Premier Pigments, a manufacturer, was tainted; once the F.D.A. received over 150 complaints, the organization eventually recalled the whole line.
Finally Ms. Erfan found Dr. Mitchel Goldman, a dermatologist in The San Diego Area who is an expert in laser elimination of tattoos. He did six treatments spanning a year, to get a total around $ten thousand, which insurance failed to cover. Acupuncture and Chinese herbal medicine helped with facial pain and swelling, she said. Dr. Goldman want greater F.D.A. supervision of permanent makeup. “I’ve had patients that have infections on his or her lips and eyebrows because they tattoo artists are eye1iner not regulated,” he said. “They use equipment that’s not sterile. Plenty of infections also come from the faucet water. They dip their needles in and transfer infections. The pigment goes to lymph nodes. That knows if 20 years down the line patients will have lymphoma or cancer as a result of these carcinogens in tattoo pigment?”
Elizabeth Finch-Howell, the dog owner and founder of Derma International, a permanent cosmetics manufacturer in Kempton, Pa., believes a minimum of 100 hours is enough. (She got a tattoo that matched her skin tone to pay up a port-wine colored birthmark on 1 / 2 of her face, performing the method herself because “I didn’t trust anybody else,” she said.)
Concerning Ms. Erfan, she is still angry, years later. It took her more than a year as well as a half to recoup, she said, and she still has scars on the lips. She must wear makeup to pay for the scars and white lines above her mouth, and also the facial pain persists. “Applying makeup is one thing, but injecting it in your body? I feel stupid,” she said. “But everything I find out about permanent makeup was positive, how even Cleopatra was tattooing her eye liner and lip liner. I think it is safe.”