Permanent Makeup Removal



Last Updated On: 2024-01-26

Permanent makeup application—also known as dermapigmentation, micropigmentation, and cosmetic tattooing—is a cosmetic procedure that uses a pen-like instrument

Doctor Medica team

Types of Permanent Makeup

Permanent makeup application—also known as dermapigmentation, micropigmentation, and cosmetic tattooing—is a cosmetic procedure that uses a pen-like instrument or standard tattoo gun to produce designs in the skin that resemble makeup. It enhances color and definition across various regions of the face, such as the eyebrows, lips, and eyelids, as well as the scalp and areolas.

Though cosmetic tattooing is usually done on patients wanting to enhance their features, this procedure is also very useful for those with physical conditions that make applying makeup bothersome, such as severe arthritis and cataracts. Dermapigmentation is also ideal as a reconstructive procedure for patients affected by old age; those with diseases such as alopecia totalis and vitiligo; those who have undergone mastectomies; and those who wish to disguise scars.

Some of the most commonly requested types of permanent makeup are:

  1. Eyeliner: This procedure involves lining the lashes with a permanent tattoo to make the eyes appear larger. Patients should communicate with their physicians about their preferred line shape (e.g. thin, medium, thick, full line, three quarter line, half line, etc.) for best results.
  2. Eyebrow: This procedure involves shading the eyebrows with tattoos that resemble individual hairs, also known as microblading. This makes the eyebrows appear fuller and more well-defined. Patients without natural hair in the area often opt for a solid brow-shaped tattoo.
  3. Lip Color: This procedure involves tattooing the lips with the patient’s desired color for added shape, definition, and size.

Permanent makeup procedures can only be done after each patient has undergone a standard medical checkup and aesthetic assessments. Patients’ medical information regarding their underlying diseases, especially their previous history of allergic reactions, is very important to note, as this will reduce the risk of adverse side effects. Physicians must also discuss desired aesthetic improvements with their patients so that proper pigments are chosen. Following a dermapigmentation session, the patient’s features will be enhanced according to their liking. They may experience some minor side effects, such as redness, swelling, and bruising.

Techniques for Permanent Makeup Removal

Patients may opt get their permanent makeup removed if it no longer suits their style. The three main techniques used to lighten the pigment molecules in the skin are as follows.

  1. Topical Technique: This method involves applying â€?tattoo-removal creamâ€? on areas with permanent makeup. Unfortunately, there are no clinical studies available on its effectiveness in removing tattoos without the use of lasers. These creams may not necessarily be effective, as they may be unable to penetrate into the dermis layer, where the tattoo pigments are embedded.
  2. Non-Laser Technique: This method is usually done by a trained permanent makeup artist. In this method, the skin is opened using a tattoo needle or a permanent makeup machine. The artist will then apply a bonding agent (e.g. salt, glycolic acid, etc.) to the open skin to draw the tattoo pigments to the surface. The effects of a full non-laser session are almost equivalent to two months of topical exfoliation if done right. This technique is usually employed by permanent makeup artists or physicians who do not have access to lasers. It is also quite effective in removing skin-colored pigments with large molecule size. That being said, this method may cause scarring, as it damages the epidermis layer of the skin.
  3. Laser Technique: This method is the most widely used technique in removing permanent makeup due to its efficacy and safety. However, this technique should not be used to remove tattoos that are less than six months old. If a laser is used to remove permanent makeup, the molecule size of the pigments and the wavelengths of the laser must be considered. A Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser with a wavelength of 1064nm is the most effective and gentle removal method, as it has the ability to reach deeper layers of skin tissue than other types of lasers. Patients may require up to 10 sessions for the face and 12 sessions for the body in order for the laser treatment to disintegrate the tattoo adequately.

Makeup tattoo ink

It is important to note that there are differences between the pigment in the ink of normal body tattoo ink and makeup tattoo. The differences arise due to the needs of mimicking the skin color and appear as natural-looking as possible. These differences also impact the technique required to remove them.

  1. Titanium dioxide – For tattoo bearers who have a lighter Fitzpatrick skin type, this ink serves as the “white” base. This pigment derives from the metal titanium that has been oxidized into white powder. However, a chemical reaction may occur when in contact with lasers. It will return the titanium to its original state of dark grey color, especially on eyelids and lips. This creates a coloration to the skin that may be unappealing.
  2. Molecule size – Usually, the micropigmentation sizes vary from one to 20 microns. For cosmetic tattoo pigment, the size may be bigger than the usual carbon black used for body tattoo ink. The ingredient titanium is larger and is also being used to cover up large areas. They are often mixed with agents as glycerin.

Complications of Permanent Makeup Removal

Patients are at risk of developing side effects following permanent makeup removal. A commonly reported adverse effect is scarring, which is usually experienced by patients who have undergone non-laser techniques. However, laser treatments may also result in scarring. To combat this, a competent skin specialist will remove the permanent makeup pigment using the fewest possible laser sessions so as to limit the amount of trauma to skin. For some patients, glycolic acid is a suitable alternative, although can have a negative effect on any existing product applied, like Radiesse.

Please note that some susceptible patients may also experience allergic reactions, which require immediate medical attention.


Permanent makeup removal can be very effective and have few complications if it is done by certified and highly experienced healthcare personnel. It is important that patients are educated on all the possible side effects of this treatment for quick identification and immediate medical intervention if necessary.

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