AURI REYNOSO, a hairstylist in Englewood, N.J., says she wanted to roll away from bed “looking beautiful.” So 3 years ago, she asked Melany Whitney, a certified permanent-cosmetics professional based in Ny, New Jersey and Florida, to tattoo eyeliner and defined brows onto her face.
Even though the procedure was “a little uncomfortable,” said Ms. Reynoso, now 39, she was delighted together with the results. “Everything for beauty,” she said. “It’s amazing how you can awaken looking absolutely fabulous and make preparations in 5 minutes. I really apply blush, lip gloss and mascara and I’m done.”
Permanent makeup, also called micropigmentation or cosmetic tattooing, goes back for the early 1980s, if it was created to address alopecia, a disorder that causes hair loss (including eyebrows). Since then, the sector has expanded to add burn victims and cancer survivors, patients with arthritis and Parkinson’s disease who may have difficulty using makeup and other people like Ms. Reynoso, who will simply rather limit the time period spent before a mirror.
But even though many are thrilled with their outcomes, all is not rosy worldwide of needles and ink. The word “permanent” is really a misnomer as the color fades eventually. Some patients develop granulomas, keloids, scars and blisters, and they report burning sensations after they undergo an M.R.I.
What’s more, even though the inks employed in tattoo eyeliner and the pigments in these inks are susceptible to the scrutiny in the Food and Drug Administration, regulations for practitioners (electrologists, cosmetologists, doctors, nurses and tattoo artists) vary by state. “You could go on eBay and buy machines and pigment and get in the garage and set up up shop,” said Dr. Charles Zwerling, an ophthalmologist in Goldsboro, N.C., plus an author of the forthcoming book “Micropigmentation Millennium.” He founded the American Academy of Micropigmentation, a nonprofit professional organization that offers certification for practitioners, in 1992.
“We see a large number of faces being destroyed by those who don’t get trained properly, and that’s the most significant problem in permanent cosmetics,” said John Hashey, the property owner of John Hashey’s Advanced School of Permanent Cosmetics in Oldsmar, Fla. Mr. Hashey claimed that 90 percent of his industry is fixing mistakes. “Your average cosmetologist who cuts hair has to do 1,200 to 1,500 hours just to do that,” he was quoted saying. “How is any further important than taking 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 allergies towards the permanent dyes, said Dr. Jessica J. Krant, a dermatologist in Manhattan as well as an assistant clinical professor of dermatology with the SUNY Downstate Medical Center in New York.
A written report with this month’s issue of Clinical Infectious Diseases reported an outbreak of mycobacterium haemophilum, a nontuberculous mycobacterium which induces skin, joint, bone and pulmonary infections, after permanent makeup was applied to patients’ brows. An investigation last September in Contact Dermatitis, a medical journal, investigated severe complications like swelling, burning, and the development of papules in four patients who had had at the very least two permanent-makeup procedures on the lips. “In light from the severe and sometimes therapy-resistant skin reactions, we strongly recommend the regulation and power over the substances” found in the colorants, the authors wrote.
Nancy Erfan, an agent in Monterey, Calif., enjoyed a bad experience. In November 2003, Ms. Erfan, now in her 30s, had permanent color used on her lips and eyes. The technician told her she could be swollen for a few days, and gave her a cream to assist. Nevertheless the swelling worsened, Ms. Erfan said, and soon she had “big bumps” around her eyes and lips.
“I could barely open my mouth to nibble on or speak,” she said. She visited many different dermatologists and cosmetic surgeons, but found no remedy. “They said I was obviously having a hypersensitive reaction, nonetheless they didn’t know where to start.”
It turned out the colors used at one of the dyes by Premier Pigments, a manufacturer, was tainted; once the F.D.A. received greater than 150 complaints, the organization eventually recalled the complete line.
Finally Ms. Erfan found Dr. Mitchel Goldman, a dermatologist in The San Diego Area who focuses on laser removal of tattoos. He did six treatments over a year, for a total of approximately $10,000, which insurance failed to cover. Acupuncture and Chinese herbal medicine helped with facial pain and swelling, she said. Dr. Goldman would like greater F.D.A. supervision of permanent makeup. “I’ve had patients who may have infections on his or her lips and eyebrows because these tattoo artists are eye1iner not regulated,” he said. “They use equipment that’s not sterile. A lot of infections also come from the faucet water. They dip their needles in and transfer infections. The pigment would go to lymph nodes. Who knows if two decades down the line patients may have lymphoma or cancer due to these carcinogens in tattoo pigment?”
Elizabeth Finch-Howell, the dog owner and founder of Derma International, a lasting cosmetics manufacturer in Kempton, Pa., believes no less than 100 hours is enough. (She got a tattoo that matched her complexion to cover up a port-wine colored birthmark on 1 / 2 of her face, performing the process herself because “I didn’t trust anybody else,” she said.)
As for Ms. Erfan, she actually is still angry, years later. It took her over a year and a half to recover, she said, and she still has scars in her lips. She must wear makeup to cover the scars and white lines above her mouth, and also the facial pain persists. “Applying makeup is something, but injecting it into your body? I feel stupid,” she said. “But everything I check out permanent makeup was positive, how even Cleopatra was tattooing her eye liner and lip liner. I think it is safe.”