Permanent Makeup Isn't Always Pretty

WEDNESDAY, June 27 (HealthDay News) -- Permanent makeup, which is essentially just a tattoo in place of cosmetics such as eyeliner or lipstick, may cause serious problems in some people, particularly those with a history of allergy, a new study suggests.

Ironically, the study found that the very procedures that are supposed to enhance beauty may actually result in unsightly side effects, such as swelling or bumps.

The news isn't all bad, however. Most of the adverse reactions included in the study were caused by a single product line of inks, and those inks were recalled in 2004.

"The Centers for Disease Control and Prevention study confirms that permanent makeup can cause severe health problems in some women," said the study's lead author, Masja Straetemans, a senior epidemiologist at the Robert Koch Institute in Berlin, Germany, who was with the CDC at the time of the study.

"Of the 92 women [included in the study], 89 had used ink shades from the specific company in at least one procedure after June 1, 2003, before the development of health problems," she said, adding that data on the ink used was missing for the remaining three women.

Like a regular tattoo, the permanent makeup procedure injects pigment into a deep layer of skin called the dermis, according to the American Academy of Micropigmentation (AAM). The epidermis is the layer of skin you normally see, and the one that constantly sheds and renews itself. Permanent makeup may also be called cosmetic tattoo or micropigmentation.

According to the AAM, there are many reasons people choose to have cosmetic tattoos, including wanting to save time, having difficulty applying makeup, and thinning eyebrows or eyelashes, among others.

No U.S. government agencies or national organizations track the number of people who undergo these procedures, so accurate estimates on the prevalence of permanent makeup aren't available. The procedure is generally done in a salon or a tattoo parlor, which are regulated by local authorities, not the U.S. Food and Drug Administration. The FDA can, however, regulate the inks used in tattoos and permanent makeup.

And, when the FDA noticed a dramatic jump in the number of adverse events being reported, it began the current study. Between 1988 and 2003, there were only five adverse events from cosmetic tattoos reported to the FDA. But, beginning in 2003, more than 150 people reported problems, according to the study.

Researchers from the FDA and CDC interviewed 92 of the people who reported problems and found that the most common adverse reactions were tenderness, swelling, itching and bumps.

"The body sees the pigment as a foreign body and reacts to it, causing a chronic inflammatory reaction," said Dr. Ellen Marmur, chief of dermatological surgery at Mount Sinai Medical Center in New York City. "The area gets swollen, bumpy and red. It looks like a bad, bumpy scar. It's very unattractive."

Marmur said it's impossible to know ahead of time who will have a reaction and who won't, although most of the people interviewed for the study -- 74 percent -- had a history of allergies. Additionally, the study found that people with allergies took twice as long to heal, on average, Straetemans said.

Sixty-eight percent of the study volunteers were still experiencing a reaction at the time of the study interview, and the duration of symptoms ranged from 5.5 months to three years.

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