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

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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Some advices. “Don´t work more than two or three hours on a large tattoo”

Establish a regular pattern of working hours. During your slow periods, you’ll find many ways to occupy your time. If and when you have a day when you’re tired, distraught or ill, go to bed or go fishing, tomorrow’s another day.
On a busy day, work customers on a rotation basis. First in, first out. Don’t offend anyone by taking on someone else before their turn comes.
You’ll find it better to do large pieces by appointment outside your regular office hours. Some artists work exclusively by appointment, but they are usually well known and established. It’s not a good idea to work more than two or three hours on a large tattoo anyway, it is advisable to spread the work over several or more sittings. Don’t touch it again until the previous work is healed.
You will be approached by people you would prefer not doing business with. There is always one out of ten that are just plain trouble. Don’t be arrogant with them, just explain in a firm way that if you’re not accepting their money, you don’t owe them anything.
From time to time, you might be approached by the media looking for what they like to call a human interest story. While it may be in your interest to cooperate with them, don’t forget that publicity is a double-edged sword. Once they get their foot in the door, they can write it the way they see it. There are those who swear that publicity promotes business, but it would be hard to prove that those customers wouldn’t eventually have found their way to your doorstep anyway. Give it your best thoughts, because in the end, it’s a decision you’ll have to make when you are confronted with it.
Spend some time building good public relations in your community, having friends on your side always helps.
A question that comes up is one about tattoo removal. Tattooists all have their special removal techniques, but you should be advised to stay clear of them all. The best answer is to have the name and address of a reputable dermatologist who specializes in tattoo removal, and send the client there. Your thing should be putting them on correctly. Let someone else’s thing be in removing them correctly.

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Tattoo Business Procedures

Just in case you don’t think you can handle all this on your own, employ the services of a good local attorney. He will always know people in the right places and whom to contact for the information you require. Let him do the leg work, after all, that’s what you will be paying him for and he won’t get the run around as you might get in some instances.
Always keep a receipt for all of the work that you do. Even for the smallest tattoo or whatever services you render. Remember that you are self-employed and you have to pay taxes. A course on bookkeeping would be practical in addition, just to keep your head on straight. There are a lot of deductions a business person can legally make, and one book on small business and another on tax information (from the I.R.S.) is a must. You have to know what you are doing here. It is not as complicated as you might think, but it is absolutely necessary to understand these things if you are going to survive as a self-employed business person.
One more thought about insurance. Today is the day of the lawsuit. People are very excited about getting a tattoo and will brag about them and pay large sums of money for them. But if something ever goes wrong, these same people will not give it a second thought to turn around and sue you right out of business. Some type of thought should be given to protect yourself from this ever happening. This type of protection is called the “trade release form.” This is a legally binding piece of paper between you and your customer, waiving any kind of responsibility on your part for damages or lawsuits of any kind after they leave the shop. It must be signed before you commence tattooing. An example of such a sheet is included at the end of this chapter. It should not be directly copied, it is just an example. Since it is such a great legal document, it is up to the tattooist and his lawyer to make one up. The price paid for this paper is worth it. Once made up, it will last you forever. Just have them copied or printed in quantities. Basically, the release form will cover topics like age and physical requirements, it will release you from liability from lawsuits and damages after the visit and anything else you and your lawyer can think up to protect yourself and keep yourself covered at all times. If a person takes one step into your shop and trips and falls and chips his teeth, you just might be liable (this even before the signing of the release). A sign “Enter at your own risk” in front of the store is at least some kind of coverage releasing you from a possible lawsuit. This kind of “insurance” is a must to have, but remember, it still does not release you from your responsibility. You owe it to everyone to do your best. You must ioW.ow ail the procedures in this site such as bandages and sterilization techniques and it is your responsibility to see to it that you perform them.

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Tattoo Business practices

Before even starting in the tattooing business, the material in this chapter should be given some serious thought. For example, how will you ever start tattooing if perhaps it is against the law in your community? Since it is a tattooing career that you wish to make it in, it would be smart to make sure no authorities will visit you and permanently shut you down. Whether doing business at home or at a shop (which will be the eventual goal), certain local and state ordinances should be looked into in depth.
The first step would be for you to investigate into the local laws at City Hall to see whether there are any conflicts with what you plan to do, and meet what they require on this subject. This also should involve a visit to the Sheriffs Department to check on other requirements and law stipulations. A trip there should be on your schedule regardless, just to clear things up like zoning and businesses.
Another important place to go see would be the Health Department to find out what they require. Be prepared to answer their questions like a pro. Knowing all the information in this site down pat would be an excellent start, and you should practice all the information in this book too, like a professional. Meet all the regulations that are required of you. You want to set up a respectable and permanent business and not be a gypsy outlaw. State, local and health laws vary greatly, so be sure to check them out and any other establishments that they point you to.
There are some other things to consider also, about other general business practices.
Before diving right into a shop, you better know exactly what makes up a legal shop and be prepared to meet those requirements. Also, some knowledge on real estate would help, so you don’t get stuck paying off a shop you can’t use. Look up zoning laws to be sure you can tattoo in the area. Once the shop is located and the deal is going through, it is wise to have business insurance on your shop and your equipment. In case of fire, theft or accident, you will be covered. If you are not covered, it could cost you the shop. An insurance policy is a small price to pay to be protected today.

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Methods for Seeling tattoo Work.

Another method to use is called the grid system pricing guide. This is where a grid is made up on a piece of paper or acetate in one inch square increments. The idea here is to cover the tattoo with the grid and see how many square inches it encompasses. You would charge by the square inch of tattoo space. You will have to determine what you want to charge per square inch. This can save you time, and if you decide on different prices, all you have to do is charge more or less per square inch instead of changing all the flash sheets.

These are just a few examples of pricing and it is probable that the tattooist will find a way of pricing that is both fair to the customer and profitable to himself. Always remember though, don’t be greedy.

Selling Work
Another aspect of tattooing which is linked to pricing is the possibility of drumming up more business. This is self-promotion, and there are endless ways to go about doing it. One way is, as soon as you open up a shop, call the local newspaper and try to get them to do a local story on you. A lot of people will read this that otherwise would not have any other way of knowing about your shop. Advertising yourself always helps and to place an advertisement for tattooing, promoting yourself, will really get you some business. An advertisement in any related type magazine is also good. Business cards are a must to hand out to people and it is a tradition to design them with clever drawings and original ideas. T-shirts, buttons and bandanas with your shop name log silk-screened on them are another way to go. They are like walking billboards, and the price to have them printed up is marginal compared to the business that you will get. Many tattooists photograph all the tattoos that they have done (while on the customer). When a collection of them starts to pile up, arrange them in books or on the walls and they become a great portfolio, showing what you are capable of doing. Proof of your work really puts the odds in your favor when a customer is undecided about actually getting a tattoo. Following these guidelines, it shouldn’t be hard to get more work, and a little imagination in promoting yourself, really adds up to more business. Tattooing advertises itself by word of mouth, and aside from the cost of business cards and some advertising in the yellow pages, they advertise themselves. You can sell the same tattoo over and over again, but to the customers, they’re always new.

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A good idea is to visit other tattoo studios

A door leading off the waiting room gives access to the booth where the equipment and table is set-up and where the actual tattooing is done. If you have windows in the wall so that customers can watch you work, have curtains on the inside that can be drawn as women usually prefer to have their tattoos done privately.

A door at the back of the tattoo booth gives way to the workshop. This is where the tools are kept, and the equipment maintained. Here, there should be a sturdy workbench with a good vise with replaceable three or four inch jaws. Get the best quality vise you can afford, you’ll be glad you did later.
Keep the soldering outfit and all the tools here. The variety and quantity of tools required depends upon whether you buy parts, etc., from tattoo supply houses or make your own. This should be kept locked when not in use.
To really form the best conclusion about shop layout, it’s a good idea to visit a few and see how all the tattooists set-up their own. Everyone sets up a little different. Once you’ve learned the basics, it’s up to experience and personal preference to determine what suits you best.

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A Word About Green Tattoo Color

It seems as though everyone in tattooing at some time or other has had a problem putting green into the skin. Of course there are many and varied reasons for this. I will go into this in detail because I think it is a very important part of tattooing that every artist should know. A tattoo machine is only as good as the artist behind it. For starters, a good running machine with a new set of needles is a must. The most common mistake with green is that the artist doesn’t know when it’s in the skin. This happens because most greens are mixed with white and when tattooed into the skin, appears more white than green. (Example – Spaulding & Rogers Bright Green). The inexperienced artist will overwork the area, thinking he hasn’t got the color in because it doesn’t appear to be green enough. When the area is overworked, the color will just go into a bubble on the skin which will be mostly blood. When cleaned off, the skin will have a fuzzy look, and chances are there will be a thick scab and a sore tattoo to go with it. This you don’t want. So, although your green color may take on a very white look, don’t worry, it’s in there. Another good rule is to work it slowly, the skin will only accept it so fast and beyond that, it’s lost motion.
These same methods apply to all blue colors also. Always use Vaseline on the skin while working colors, it makes clean up more easy. If you find that your green has heated with little white spots showing throughout it, these are called “holidays” and usually comes from working the color too fast. In other words, there are spots you have missed due to an untrained eye. Yellow color is notorious for this and most always requires to be gone over twice during the process of the tattoo. It’s not a hard color to put in, it’s just deceiving to the eye.

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Shading Tips and Tricks

•   Black ink goes in much easier than colors.
•   You might have to run a shader a little faster than an outliner.
•   Grey shading a Japanese sky is gaining popularity. This is accomplished by having a cap filled with black ink diluted with distilled pure water. The more water, the weaker the tone, creating a light, washed out grey effect. Another way of achieving this grey effect is by using undiluted black in the machine, and using distilled water on the skin. You basically wet the area (using a soft brush) before you sweep across it. This is a good way on larger pieces such as the back. Practice this, like in any technique, elsewhere to perfection before doing it on a customer.
•   Single needle and outline needles are used to make fine hair and wispy effects. Dotting effects are also achieved by this method.

•   Shading or feathering also work well with some colors too, especially red and brown.
•   On human figures, use brown or tan shading to show form, curves or muscle bulges. Use the natural skin tone as a highlight and shade to enhance the natural skin.
•  Most of the commercial design sheets have designed shading on them. It is an individual matter to change shading by adding or subtracting to suit one’s artistic tastes. This should be done anyway to put an individual stamp on each tattoo.
•  Just like the outliner, the needle bar loop must be snug on the armature bar nipple. The shaft of the needle bar cannot come in contact with inside of the tube.
•  When you change shader needle bars, you will see a series of grooves in the tip. File these out before putting in a new set of needles. A good tool for this is a specially designed mini file available from Spaulding & Rogers Mfg., Inc. By doing this, it doubles the life of the shader tip.
•  When moving the needle bar shaft up and down manually, it should feel smooth and free. If you feel a rub, correct it. The needles may be off to one side and not parallel to the tip or not spread correctly. Another rubber band may also correct this problem. Needles may be bent slightly down to hug bottom of shader tip. Never bend the needle bar.
•   You may also wish to experiment with a round shader. These are also available from your supplier and hold as many as 14 needles. In appearance they resemble an outliner with a large tip. They have advantages in that they are not prone to cutting the skin up too bad and they can put in a lot of ink at a rapid pace. You will not get the shading effect with the round shader that you will get using a flat one.

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Some advices for doing a good tattoo

If you mentally think about the line that you are about to tattoo, your hand will automatically carry it through. Don’t hesitate, or stop and start again. Let the lines flow smoothly without interruption. Before a really long line, get an ink refill so you won’t run out in the middle of it. If you know the beginning of a line, and the end of it, the middle of it will take care of itself.
Start on the beginning of a line and not in the middle of it. It’s hard to reconnect lines to match perfectly. A perfect sweep is better than broken sections.
When you do points or tips with one stroke instead of two, lift up a bit and lighten up on the pressure so you won’t get a heavy dot at the tip.

Eagle tips, fangs and claws, etc., can be done in one single sweep, but take care that the needle points aren’t ruined and make sure that you have enough ink. On the lines of ribbons or banners, do it in one clean stroke. If not, stop at intersections or places where if you make a bad joining, it can be easily shaded out later.
In ribbons, scrolls and banners which will hold names or lettering, don’t tattoo in the top line of the banner until the lettering is done. That way the top line can be readjusted if need be. Bad lines can usually be hidden by some sort of shading.
The quality of the outline largely depends upon the quality and condition of the needles. If good results are not obtained, check those needle tips carefully with an eye loupe, both the tips and their motion.
When the outline has been finished on the tattoo, give it a green soap wash and gently wipe it with a clean towel. Examine it carefully and see if there are any spots which need touching up. Any disconnected lines or forgotten spots? If so, touch those spots up. Wash it again and coat with Vaseline. Shut off the power pack and give yourself and the client a short break. Mention that the worst part is over. Remove the tube and needle bar from the machine and place the tube in a tray of soapy water so the ink doesn’t dry. Place the used needle bar in a box labeled “used” for later washing and sterilizing for reusing, or for later soldering off and disposal, or to be resoldered with another new needle.

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