AURI REYNOSO, a hairstylist in Englewood, N.J., says she wished to roll out from bed “looking beautiful.” So three years ago, she asked Melany Whitney, a licensed permanent-cosmetics professional based in The Big Apple, 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 with all the results. “Everything for beauty,” she said. “It’s amazing the best way to get out of bed looking absolutely fabulous and make preparations in 5 minutes. I really apply blush, lip gloss and mascara and I’m done.”
Permanent makeup, also referred to as micropigmentation or cosmetic tattooing, dates back towards the early 1980s, whenever it was developed to deal with alopecia, a condition that causes hairloss (including eyebrows). Since that time, the sector has expanded to feature burn victims and cancer survivors, patients with arthritis and Parkinson’s disease that have difficulty wearing makeup and individuals like Ms. Reynoso, would you simply rather limit the time period spent looking at a mirror.
But although many are thrilled with their outcomes, all is just not rosy on earth of needles and ink. The word “permanent” is a misnomer as the color fades eventually. Some patients develop granulomas, keloids, scars and blisters, and so they report burning sensations when they undergo an M.R.I.
What’s more, even though inks found in permanent eyeliner makeup and also the pigments in 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 will go on eBay and acquire machines and pigment and get in the garage and set up shop,” said Dr. Charles Zwerling, an ophthalmologist in Goldsboro, N.C., and an author from 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 thousands of faces being destroyed by people who don’t get trained properly, and that’s the largest symptom in permanent cosmetics,” said John Hashey, the property owner of John Hashey’s Advanced School of Permanent Cosmetics in Oldsmar, Fla. Mr. Hashey stated 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 explained. “How is the fact any further important than having a needle to someone’s eye?”
The negative effects to micropigmentation include infections like H.I.V., hepatitis, staph and strep from dirty needles, and allergic reactions 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 The Big Apple.
A study in this month’s issue of Clinical Infectious Diseases reported an outbreak of mycobacterium haemophilum, a nontuberculous mycobacterium which causes skin, joint, bone and pulmonary infections, after permanent makeup was put on patients’ brows. A report last September in Contact Dermatitis, a medical journal, investigated severe side effects like swelling, burning, and the creation of papules in four patients who had had at the very least two permanent-makeup procedures on his or her lips. “In light of your severe and sometimes therapy-resistant skin reactions, we strongly suggest the regulation and control of the substances” found in the colorants, the authors wrote.
Nancy Erfan, a realtor in Monterey, Calif., enjoyed a bad experience. In November 2003, Ms. Erfan, now in her 30s, had permanent color applied to her lips and eyes. The technician told her she would be swollen for a while, and gave her a cream to aid. However 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 various dermatologists and cosmetic surgeons, but found no remedy. “They said I had been obviously having an allergic reaction, but they didn’t know how to proceed.”
It turned out that the colors used within the dyes by Premier Pigments, a manufacturer, was tainted; once the F.D.A. received over 150 complaints, the company eventually recalled the complete line.
Finally Ms. Erfan found Dr. Mitchel Goldman, a dermatologist in San Diego, Ca who is an expert in laser elimination of tattoos. He did six treatments over a year, to get a total of approximately $10,000, which insurance did not 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 definitely have infections on their own lips and eyebrows because these tattoo artists are eye1iner not regulated,” he was quoted saying. “They use equipment that’s not sterile. Lots of infections also range from plain tap water. They dip their needles in and transfer infections. The pigment goes to lymph nodes. Who knows if two decades down the line patients could have lymphoma or cancer as a result of these carcinogens in tattoo pigment?”
Elizabeth Finch-Howell, the homeowner and founding father 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 pay for up a port-wine colored birthmark on 50 % of her face, performing the procedure herself because “I didn’t trust anybody else,” she said.)
As for Ms. Erfan, she is still angry, years later. It took her over a year plus a half to recoup, she said, and she still has scars on her lips. She must wear makeup to pay the scars and white lines above her mouth, and the facial pain persists. “Applying makeup is a thing, 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 thought it was safe.”