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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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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What to do after tattooing

When all the shading is done and you and the customer are completely satisfied, give the tattoo a green soap spray and gently wipe. Coat with a thin layer of vaseline and take a short break. Thoroughly wash the black ink out of the tube and off the needles and bottom of the tube tip. Hold the tube under hot running water, this will knock out all excess ink in the tube tip. Run the machine on folded tissue until the needles hitting the tissue show only water. This must be done or any black ink left in the tube will ruin your colors. Just the force of real hot water going into the tube tip does a fine cleaning job.
Wash the tube and needles described above after each color being used so one color does not mix with the next one.

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