Tattooing as a job

I always say to the young people who come to me for advice: Don’t consider tattooing as a job, forget about money, think art. If your style is not mature yet, take drawing classes, learn how to apply the color. There are no secrets, no special techniques, just plain talent.

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Cosmetic tattooing legislation.

Legislation
Legislation regulating the practice of cosmetic tattooing is being implemented rapidly. An up-to-date status of legislation by State is posted on the Internet at: www.micropigmentation.org.
The American Academy of Micropig-mentation provides nationally recognized Board Certification which includes rigorous written, oral and practical exams for candidates with at least one year experience. Tattoo artists who wish to perform cosmetic tattooing benefit from extra training in eyeliner and lipcolor safety and pigment selection and can find Board Certified trainers at www.micropigmentation.org.
Pigment Removal
Importantly, cosmetic tattooing cannot be hidden from sight by clothing as can body tattoos. Misplaced or undesirable color on the face is not often easily removed by laser due to discoloration which occurs from photochemical changes in pigments such as iron oxides and titanium dioxide. Non-specific chemical irritants or exfoliants can result in scarring, unsatisfactory results and prolonged redness. This may be due in part from overworking the skin with needles rather than the actual product. Pigment removal is illegal in many States and the FDA pays close attention to such products. “Most states are inclined to consider this topic to be a medical/surgical one and outside of the scope and training of dermatechnicians and tattooists” writes Dr. Chip Zwerling of the Academy of Micropigmentation.
Cooperation and Education
The exchange of information between the traditional and cosmetic camps of tattooing will benefit both the artists and their clients. It is not a battle of talent or skills but rather an earnest desire to achieve excellence and understanding that will gain respect between these diverse professionals.

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Complications of cosmetic tattoos

Complications of PC
1. Corneal Abrasions: In a survey of permanent makeup instructors taken in 1997, a 40% incidence of corneal abrasions was reported. Dr. Charles S. Zwerling, MD states that it is probably closer to 100% of technicians that have experienced a client with a corneal abrasion. Dr. Zwerling goes on to state “the reason corneal abrasion is not reported more frequently is that the signs and symptoms are not recognized by many dermatechnicians”. With the advent of topicals with a physiologic pH range of 7.4-7.69 (Numquick™ Purple, DOTC Blue™), corneal abrasions are largely limited to those inflicted mechanically or from other chemical factors.
Signs of corneal abrasion include a sensation of a “rock in my eye” or a gritty sensation, sensitivity to light, pain and blurred vision. Practitioners should refer their patient or client to an eye care physician or Emergency Room immediately.
Such a complication is an embarrassment to the practitioner and physicians have expressed concern about non-medical professionals performing permanent eyeliner procedures.
2. Allergic Reactions: Antibiotic ointments, latex, nickel and pigments head the list of allergic reactions related to permanent makeup procedures. Allergic reactions can be either immediate or delayed and both types have been reported in the literature. Glycerin may rarely elicit an allergic reaction.
Lipcolors can be a problem in permanent cosmetics. Rare but real, an allergic reaction to red or yellow can be disastrous for the client, technician and the manufacturer of the problem pigment. Referral to a physician for prompt diagnosis and treatment is the standard of care. Do not try cortisone ointments or “bleeding out the color” by over-tattooing the area. A tiny punch biopsy will reveal the diagnosis and determine further treatment.

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Cosmetic tattooing. The Face versus the Body as a Canvas

Permanent makeup, unlike traditional tattooing, often requires two or three sessions to achieve the desired result. Seasoned tattoo artists are the first to admit that tattooing on the face is much more difficult than other parts of the body. Always exposed to the sun and environment, the face provides a tough, yet vulnerable “canvas” in which to implant color. Inks cannot be used on the face as readily as the body and pigments do not “fly” into the skin as readily as inks.
Few artists would consider starting their painting on a canvas with blue, yellow, red or green backgrounds. Yet that is the challenge facing the permanent makeup artist. The end result may vary widely from the desired result after the skin has healed and the colors have been subjected to the body’s environment. Raspberry brows, purple lips and blue (not black) eyeliner reflect the inability of the practitioner to predict with surety the combination of various pigments when placed into, not onto, the facial skin.
Permanent cosmetics are not easily removed or camouflaged. Practitioners are often faced with the need to correct their own work and the work of others. Fortunately, more resources are available to guide in color and pigment selection than ever before. Practitioners learn quickly how certain pigments behave and “word of mouth” advice flows quickly about remedies and favorite suppliers. It is important to realize that permanent makeup is still a young profession and no controlled studies exist with regard to pigments.

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Colors and pain control on cosmetic tattoos

Colors
Talc-free pigments, whether iron oxide or organic are vital to prevent foreign body reactions. The debate continues about the safety of inorganic versus organic pigments and particle size of pigments used in permanent makeup. Because no pigments for tattooing are FDA approved, the suppliers of pigments are largely responsible for the purity and safety of the colorants used in their products.
Inert colorants, dyes, iron oxide, carmine and organic pigments are readily available from various sources. Most labeling of these colors does not reflect the ingredients contained in the pigments and their dispersal agents. Some even say “Not for Implanting Into the Skin”. Little attention is paid to such warnings by practitioners.
Commonly, dispersal agents have included alcohol, witch Hazel, castor oil, propylene glycol, glycerin, distilled water, and alkalinizing or acidifying solutions needed for a colorant to stay in solution. The use of alcohol, Witch Hazel and high or low pH inks and dyes causes severe burning of the eyes and corneal damage. A pH neutral, alcohol-free dispersal agent for colorants needs to be perfected for use on eyeliner.

Pain Control
Women who would otherwise enjoy the benefits of permanent cosmetics have avoided the procedures due to the pain which they fear they would have to endure. Ice cubes, Valium, pain killers and designated drivers were required by those who underwent permanent makeup prior to 1996 and the advent of topical anesthetic creams and gels which are both safe and effective. Dentists are rarely needed for “dental block” anesthesia for lipcolor.
With safe and effective topicals DOTC Blue™, NumQuick™ Purple and TAG#45 Gel to control pain, swelling and bleeding, clients enjoy excellent analgesia and practitioners are able to work faster with less stress.
In a 1993 written statement concerning eyeliner safety, the FDA acknowledged that local anesthetics are routinely used in permanent makeup procedures. There are no final monographs (regulations) for local anesthetics considered safe and effective for OTC use except for preparations for diaper rash, anorectal discomfort and male genital desensitizers.

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Who does cosmetic tattooing?

A survey of dermatechnicians in 1996 revealed that over 70% were cosmetologists, electrologists and estheticians by training. Most cosmetic tattooing is performed in salons and some cosmetic surgeon’s offices. Physicians as a whole are not knowledgeable about cosmetic tattooing and many frown upon the practice as dangerous and unnecessary. This is due to the negative publicity as well as lack of training and competence of practitioners in this largely unregulated emerging profession.
Traditional tattoo machines have given way to lighter, quieter rotary machines and hand tools for permanent makeup practitioners. The Spaulding and Rogers PUMA Quick Change and Revolution II are favorites among experienced dermatechnicians. Lightweight, quiet rotary pens from Asia are popular and less intimidating to many new students of permanent makeup. And tools for the hand method have been refined by SofTap, Inc. and Dermigi-aphics, Inc., both California companies. Proficiency in the use of traditional tattoo machines, rotary machines and hand tools provides the dermatechnician with the skill and ability to do beautiful work in a variety of challenging situations. Do not try to cut corners when purchasing your equipment. Get the best quality machines and needles for the best result.

Needles
Many practitioners are unaware of needle sizes and groupings. Those trained on Asian “pen” machines have never used a flat or magnum or oval needle configuration. And tattoo artists are few and far between in this field of permanent makeup as they are not allowed to tattoo above the neck in many states. There is little mingling between the two camps of artists. Permanent makeup technicians can and do learn a wealth of information from traditional tattoo artists. But most cosmetic tattooists are reluctant to approach, or have been unsuccessful when seeking training by a seasoned tattoo artist.

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Cosmetic tattooing

Permanent makeup, or cosmetic tattooing of the eyelids, eyebrows and lips has exploded in popularity in the nineties. More and more women, and some men, want to “Wake Up with Makeup”. The most common reasons women seek permanent makeup are for convenience, difficulty applying conventional makeup, allergies to makeup, visual impairment, arthritis, active outdoor lifestyles or demanding work schedules. Few want to look like Cleopatra… rather they want to look like themselves – only better. Camouflage helps many with unsightly scars and vitiligo and requires advanced training. Permanent makeup can give back what the years have taken away and save time and money for women who ordinarily spend 30-60 minutes every day applying makeup, only to have it smudge, smear and disappear with time.
The critical difference between traditional tattooing and cosmetic tattooing (micropigmentation) is the location of the tattoo. Special safety considerations need to be taken when working near the eye for eyeliner. Unlike traditional tattooing, control of pain, swelling and bleeding is vital for the successful practice of permanent makeup. Clients are not uncommonly baby-boomers and their mothers who may suffer from a variety of common and rare medical problems such as high blood pressure and multiple sclerosis. Others have a history of herpes simplex (lips) or other conditions which the practitioner must take into consideration prior to performing the procedure. Pregnancy and clients taking blood thinner medication are absolute contraindications for cosmetic tattooing.
The variation in skin thickness, elasticity and color on the face presents special challenges for the dermatechnician. Traditional black tattoo inks are not flattering when used on eyebrows due to the grey-blue hues that result as time passes. Streaking or migration of pigments and inks used around the eyes for eyeliner often needs laser or surgical removal. Lipcolors may “pull blue” even in the hands of experienced practitioners. A thorough understanding of color is needed to achieve the desired result in permanent makeup. Mixtures of pigments may look good in the bottle but result in bizarre brow and lipcolors when healed.

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