Considering Permanent Makeup? Read This

Illustrated by Marina Esmeraldo.
We’re always looking for things to speed up our beauty routines, so we can spend less time in front of the mirror and more time in bed each morning. The more multitasking, efficient, and long-lasting the product, the better — and permanent makeup takes this idea to a whole new level. Imagine waking up with perfectly full brows every morning or never having to worry about smudging your eyeliner. Sounds pretty amazing, right? But obviously, tattooing makeup on your skin is much more of a commitment than throwing a new blush-and-lippy combo into your basket at Walgreens.

Micropigmentation procedures are not only popular with people who want to simplify their beauty routines, but also with those who have undergone chemotherapy and have lost their hair, or have had reconstructive surgery on their breasts and want to define their nipples. Tattoo eyeliner and eyebrows are the most popular, but permanent makeup can also include lipliner, lipstick, beauty marks, and scar camouflage.

Permanent makeup is something to consider carefully — just as one would an artistic tattoo. So we did a little bit of the legwork for you.

The Price You Pay

Permanent makeup can cost anywhere from $50 for a beauty mark to $400 for eyeliner to $800 for eyeshadow, depending on the procedure and where it's being performed. Michael Gold, MD, founder of Gold Skin Care Center in Nashville — which specializes in medical, surgical, and cosmetic dermatology — advises getting it done in a doctor’s office rather than a spa, salon, or tattoo parlor, although it will be more expensive. “Ultimately, the most important thing is the skill level of the provider, and you’ll have more luck finding experienced and skilled technicians or doctors in this type of environment,” he says.

Do Your Research
To ensure your technician knows what they’re doing, ask to see their license first and check that it matches up with state regulations. Once you’ve got that squared away, you’ll want to see their work to make sure it's your preferred aesthetic. Ask to see photos of previous clients or, better yet, if you can see their work in person. “We first advise patients to learn the facts about permanent makeup, as there are people who perform procedures who have no clue what they are doing,” warns Dr. Gold. “I end up needing to use lasers to get rid of the mess that was created — for example, one patient got permanent eyeliner but didn’t like the placement, so I had to remove and redo the tattoo for her.”

Know What You Want
To avoid this situation, Dr. Gold encourages clients to think of permanent makeup as a tattoo elsewhere on the body. “Placement is ultimately an individual decision — the professional shouldn’t force you into anything, but rather give you a professional opinion of what will achieve your desired results.”

Assess Your Risks
Although uncommon, there is a risk of infection. “The biggest con would be if you were to have a reaction to the ink," warns Jennifer Reichel, MD, a Seattle dermatologist and RealSelf contributor. "This is much more likely with red ink in lips. I have seen a few cases of very bad inflammatory allergic reactions that leave the lips looking really terrible."

Heidi Waldorf, MD, director of laser and cosmetic dermatology at the Mount Sinai Medical Center in New York City, says there is also a risk that the procedure could trigger a viral infection or cold sore, if the person is predisposed to these. “If a patient [who is getting their lips tattooed] has a history of cold sores, they should take an anti-herpes medication the morning and evening [of the procedure],” says Dr. Waldorf. She adds: “Tattooing should not be done within six months of finishing Accutane/isotretinoin because of the increased risk of scarring.”

Take Care
Permanent makeup heals just like any other tattoo, says Dr. Gold. “Most people will just be red afterwards, while some experience minimal swelling,” he says. “But the redness and swelling should go down in a few hours.” Apply a mineral-based ointment, like Aquaphor or Avène Cicalfate, for about a week after and be sure not to test out anything new to avoid irritation. It is okay to cleanse your face gently (no scrubbing), even with swelling and redness, but don't submerge it in water (baths, pools, swimming, etc.) for a week. Showering is okay, but try to keep it short and avoid exposing your tattoo to too much water.

Expect Changes
As you age and your skin wrinkles, sags, and stretches, so will your tattoo. Dr. Gold explains that skin ages due to a mixture of genetics, external influencers like the sun or smoking, and gravity. “Tattoos will change size and shape based on one’s changes in size and shape,” says Dr. Gold.

Fight The Fade
“Using sunscreen and dermatologist-recommended products is important, especially for those with tattoos who want to see minimal change,” says Dr. Gold. Getting tattoo touchups is also useful — you may need a color enhancement every two to eight years, says Dr. Reichel. But maintaining good skin health and a dermatologist-approved regimen is ultimately the best fade-fighting option. “Having touchups can help, but remember — a touchup is just another tattoo that needs to be done by an expert and be taken care of well,” says Dr. Gold.
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