+ What is cosmetic tattooing?

Cosmetic tattooing otherwise known as permanent makeup is a specialized technique used for permanent cosmetics, also referred to as “micropigmentation”. The cosmetic tattoo implantation technique deposits colored pigment into the upper reticular layer of the dermis.

Important to know: All permanent makeup techniques are a form of tattooing and not an exact science, but an art. Said procedures carry with it known and unknown complications and consequences associated with this type of procedures, including, but not limited to: infections, spreading of pigment, inconsistent color, allergic reactions.

The results vary in each individual, depending on many factors, such as skin type, body metabolism, post treatment care, lifestyle, medications, etc., therefore can not be guaranteed. To achieve desired results multiple sessions might be necessary which will be charged accordingly.

It is imperative to have realistic expectations and understand that permanent makeup enhances the appearance, but it is not meant to fully substitute cosmetics. It adds enough to the bare face and creates a perfect canvas for effortless application of cosmetics.

+ Can anyone get permanent makeup done? What are candidate requirements?

ATTENTION I won't be able to work with you if you have or ever had permanent makeup done by another artist. As practice shows most cases require a correction because previous pigment is either too saturated, implanted too deep or faded unevenly/patchy, changed the color to undesirable shade, shape is off or skin texture is compromised (for example scarring from previous microblading). I most likely won't be able to provide you the quality work I strive for, therefore I choose not to accept clients with previous cosmetic tattoos. I may consider you as a candidate only after removal of your previous permanent makeup.

If you’re getting COVID vaccine, cosmetic tattoo procedures can be done a minimum TWO WEEKS after receiving BOTH shots. You can’t get it done between shots or right after the second shot.

There are certain things that can prevent you from getting the treatment.

Please, pay attention to additional requirements for eyeliner and lip blush procedures below.

In the following cases procedure CAN NOT be done:

• if you are under 18 years old (bring valid ID)
• if you are pregnant or nursing
• if you have any skin disease symptoms or irritation on your face and area of procedure (e.g. dermatitis, eczema, psoriasis, herpes, rosacea, rash, acne, blemishes) and even if it's not in the area but in active phase (e.g. dermatitis, eczema, psoriasis, herpes)
• if you have a sunburn in the area of treatment
• directly after botox or fillers in the area of treatment (waiting period required: 14 days after botox and 30 days after fillers)
• if you are using Accutane, Isotretinoin, Adapalene (Differin), Tazarotene (Tazorac) or any other vitamin A derivatives, strong retinoids or steroids or anything that is meant to treat acne and obtained with prescription (waiting period up to 1 year for orals and up to 1 month for topicals)
• if you are currently undergoing chemotherapy, radiation therapy, immune or hormonal therapy
• if you are currently on antibiotics or steroids (wait at least two weeks after finishing the course)
• if you have epilepsy
• if you have allergies to colors/pigments/dyes
• if you are prone to keloid scarring (don't mistake hypertrophic scars for keloids)
• if you have HIV or Hepatitis or any other viral or bacterial infections and/or diseases (compromised immune system can lead to unpredictable results)
• if you have active cancer or skin cancer
• if you have hemophilia or any other bleeding disorders
• if you have uncontrolled high blood pressure, major heart problems, healing disorders or develop infections easily
• if you have a pacemaker
• if you are taking following medications: Warfarine/Farin/Coumadin, Clexane, Fraxiparine or similar
• if you currently use any eyebrow hair growth serum or did in the past 6 months (waiting period required for brow procedure, contact me for more info)
• if you have flu, sinus/respiratory infection or cold (get well and reschedule, procedure is possible only after full recovery)

In the following cases procedure CAN be done, but is NOT recommended:

• if you have diabetes (you must bring an approval notice from a doctor)
• if you were recently undergoing chemotherapy, radiation therapy, immune or hormonal therapy (approval notice from a doctor is required)
• if you have vitiligo

Consultation with your doctor and approval notice are required if you have:

• autoimmune diseases
• febrile infections
• congenital immunodeficiency diseases
• other causes of immunosuppression
• organ transplantation

Additional requirements for eyelash enhancement/shaded eyeliner procedures:

• NO eyelash extensions (must be taken off by your lash tech few days prior to procedure)
• NO eye diseases or conditions (e.g. glaucoma, dry eye, eye irritations, etc.)
• NO problems with someone touching your eye area (extreme sensitivity)
• No recent eye surgeries

If you currently use any eyelash growth serum or did in the past 6 months you MUST inform me about it PRIOR to booking an appointment to receive more information (waiting period required).

Additional requirements for lip blush procedure:

• NO severely chapped lips
• NO cold sores or any irritations on and near the mouth area

Lips with natural dark pigmentation are considered a correction and require a different method. Multiple sessions priced accordingly might be necessary to achieve desired results. Dark lips are taken for procedure on a case by case basis. Contact me with pictures of your lips attached for more information.

If you ever had a cold sore (fever blister) on your lips the lip blush procedure can trigger an outbreak, therefore it is highly recommended to obtain prescription antiviral medication (Zovirax/Aciclovir or another) from your doctor and start taking it on the day of the procedure and a few days after the procedure (following the doctor's prescription).

It is recommended even if you've never experienced cold sores before as the virus could be present in your body in the dormant state, which may result in an outbreak after the procedure.

+ Do I have to prepare for permanent makeup procedure?

Yes! Please make sure you follow all the instructions to assure the best results.

• DO NOT take Aspirin, Niacin, Advil/Ibuprofen/Aleve, any other painkillers 24 hours prior. Tylenol is the only one that is allowed. Normally there’s no blood during procedures. But once in a while some individuals with thinner skin can experience tiny droplets of blood during eyebrows or lip blush procedure. All the medications above are blood thinning, so better if avoided.
• DO NOT drink alcohol and coffee for 24 hours prior to procedure. Alcohol is a blood thinner. And not having caffeine in your system will help you to relax more easily, as well as help to relax the facial muscles in the areas we will be working on.
• DO NOT tan or sunbathe one week prior to procedure; if you have a sunburn in the area of work I can NOT perform a procedure.
• NO brow waxing, tinting one week prior to procedure.
• NO microdermabrasion or chemical peels, laser treatments, topical Retin A and other vitamin A derivatives, prescription anti acne creams/gels/foams, topical steroid creams (1 month waiting period for all above)
• You must wait 14 days after getting botox and 30 days after getting fillers in the area of procedure.
• If you’re getting COVID vaccine, cosmetic tattoo procedures can be done a minimum TWO WEEKS after receiving BOTH shots. You can't get it done between shots or right after the second shot.
• Please, don't wear heavy makeup on the area of procedure to your appointment, especially waterproof foundations and glitter. You may fill in your eyebrows the way you normally do.

Additionally for eyelash enhancement/shaded eyeliner procedures:

• If you have eyelash extensions they must be taken off by your lash technician few days prior to procedure
• If you use eyelash serum you must inform me about it prior to booking a procedure to receive special instructions
• If you wear contacts, please, use glasses the day of procedure or bring a container for your contacts, no contacts are allowed in the eyes during the procedure
• If possible, come without eye makeup, absolutely no glitter eyeshadows/eyeliner and waterproof mascara

Additionally for lip blush procedure:

• Gently exfoliate your lips with lip scrub, toothbrush or warm wet towel and hydrate and soften with chapstick or balm the night before
• If you ever had a cold sore (fever blister) on your lips, it is highly recommended to obtain prescription antiviral medication (Zovirax/Aciclovir or another) from your doctor and start taking it the day of procedure and then following a prescription; it is recommended even if you've never experienced cold sores before as the virus could be present in your body in the dormant state, which may result in the outbreak after the procedure

PLEASE NOTE: you may be more sensitive during your menstrual cycle. Also having a good healthy meal prior and being well rested will make your experience more pleasant!

+ What to expect after a permanent makeup procedure?

1. Swelling, soreness, and/or redness may occur for one or two days following the procedure. For eyeliner and lip blush procedures cold compress can be applied to minimize swelling (nothing wet like melting ice bag). Make sure to use clean tissue or paper towel between the area of permanent makeup procedure and compress. Pain medicine can be taken if absolutely necessary.

2. Right after the procedure, the color will be more bold and intense; during the first 7-14 days it will appear to be darker at first, then after the flaking is over it will lighten.

3. It is normal to lose some amount of pigment during the healing process, also after your first session, some areas might not keep pigment well and appear patchy.

4. When completely healed (after at least a month) color will intensify (yet be softer than fresh work) because the epidermal layer of the skin will become translucent again. Although you should be prepared that sometimes skin will push out more pigment than normal and very little will be left after the initial procedure. It's your body’s individual response. That's why we need a touch up. Keep in mind that once in a while some clients require additional touch up till the desired results are reached.

5. Please be patient. Full healing takes up to 30 days and more. At your touch up appointment (in approximately 5-10 weeks) we assess the results and do any adjustments if necessary. After about two and a half weeks from your appointment when superficial healing is over you’re allowed to use makeup in the tattooed area if desired.

+ What is the post treatment care?

Post treatment care for permanent makeup is extremely important! You must follow it properly! FAILURE TO FOLLOW THESE INSTRUCTIONS MAY RESULT IN FULL LOSS/UNEVENNESS OF PIGMENT OR INFECTION. Please review our Aftercare Instructions for each procedure.

+ Why do you only offer powder brows and not microblading at SKN ALLEGIANCE?

Powder brows are longer lasting and not as traumatic when compared to manual technique - microblading. Though currently very popular, microblading is no more than a trend and doesn't work for all, requires more touch ups, tends to fade unevenly, and can put integrity of the skin in danger due to possible scar tissue formation.

I did extensive research in the industry and choose to offer a safer and more effective way, so I no longer practice microblading, and do powder brows only. Because my priorities are your well-being, good condition of your skin and excellent healed results for months and years ahead.

+ How is the best eyebrow shape chosen for each face?

Shape of the eyebrows is created according to the golden ratio and face morphology. We try to achieve symmetry as long as it keeps harmony in the whole face since no one’s face is naturally symmetrical.

+ How is the color chosen for brows and lips?

Color choice is always custom. For brows it is chosen to match and blend with any existing brow hair. If there's no hair at all then color of the skin, eyes and overall appearance are taken into consideration. Lip blush color is chosen based on client's natural lip color as well as taking into consideration the desired color palette: pinks, peaches, reds, etc.

+ How does cosmetic tattoo process work?

The pigment is applied into the dermis layer of the skin using a tattoo machine and a sterile needle. After the full healing, color becomes lighter and adjusts depending on the individual's skin tone.

Required touch up is done between week 5 and 10 after the first treatment; a certain percentage of pigment disappears due to skin's reaction, pigment is a foreign body and skin attempts to push it out as a defensive mechanism.

Color appears darker in the beginning. About a week later it loses its intensity. If you think the color is too bold, do not try to remove it yourself by any means. Patiently wait 7 to 14 days for the color to fade on its own after the superficial healing of the skin is done.

+ How long will the color stay vibrant?

Color duration depends on many factors. Skin type, body metabolism, age, lifestyle, amount of sun exposure all will affect color longevity. On average the expected time until a color refresh is needed is between 1 and 3 years. With no annual refreshes pigment fades over the years, but there's always a chance it might not completely disappear.

+ How many sessions does it take?

The procedure is considered completed after we perform both the initial session and a required touch up 5-10 weeks later. To achieve desired results certain clients with problematic and oily skin or depending on individual body reaction might need additional touch ups, which are charged accordingly. Post treatment care plays a major role in the treatment's success. Consequently obey advice, because if you don't - you risk having very poor or no retention of pigment. Following the aftercare instructions is of great importance.

+ Does cosmetic tattoo procedure hurt?

Pain during the treatment is relative. Some people can be more sensitive, but most clients usually say the level of discomfort is the same they feel when tweezing or waxing eyebrows and often take a nap during the treatment. Topical anesthetic is used throughout the procedure as well.

+ How does laser tattoo removal work?

Laser used for the procedure of tattoo removal is a specialized laser - Nd:YAG q-switch. It is different from other lasers that are used for cosmetic purposes, such as laser for hair removal, laser for skin resurfacing treatments, etc.

Laser for tattoo removal works by applying concentrated light energy that targets particles of ink and breaks it up into much smaller pieces. Then your body’s immune system will take care and dispose of the ink the same way it does with bacteria and viruses that enter your body.

Advantage of laser tattoo removal is that it keeps skin intact, there're no burns, bleeding, scabbing or scarring when procedure is done correctly and aftercare is followed. Laser is the most effective and safe method of tattoo removal nowadays.

+ Can anyone get laser tattoo removal done? What are candidate requirements?

Tattoo removal with the Nd:YAG q-switch laser is generally suitable for most people. However, like all laser treatments there are contraindications and precautions that need to be considered for your own safety as it can prevent you from getting the treatment.

CONTRAINDICATIONS

Conditions affecting your Immune System:

• Systemic Lupus Erythematosus (SLE) an autoimmune disease often referred to simply as “Lupus”
• Severe Rheumatoid Arthritis especially if treated with “Gold Injections” or Methotrexate
• Any other known autoimmune disorder
• Any other disease affecting your immune function e.g. following removal of your spleen
• Liver disease such as Hepatitis A, B, C
• HIV
• Any significant systemic illness or an illness localized in the area being treated

Bleeding Abnormalities:

• Hemophilia, von Willebrand Disease, Thrombocytopenia

Blood Thinning Medication:

• Anticoagulants such as Warfarin, Heparin, Clexane, Dabigatran or similar
• High doses of Aspirin, Ibuprofen, Diclofenac (NB Prophylactic slow release Aspirin at 75 mg day or less is acceptable)

Skin Conditions:

• Known history of skin healing problems or keloid formation
• Vitiligo or any other skin pigmentation problem
• Psoriasis or eczema (on treatment area)
• An active localized or systemic infection or an open wound/irritation/rash in the area being treated
• Having common acquired nevi that are predisposed to the development of malignant melanoma

Cancer treatment:

• Active cancer and chemotherapy/radiation therapy
• Photodynamic Therapy (PDT)

Conditions Where Fragmented Ink Particles Could Cause Harm:

• Being pregnant or nursing
• Acute or Chronic Kidney Disease
• Type 1 Diabetes and Type 2 when on medication
• Implants / Metal Plates/ or Pacemakers

Other:

• Hypersensitivity to light in the near infrared wavelength region
• Taking medication that is known to increase sensitivity to sunlight
• Taking medications that alter the wound-healing response
• Taking or have taken oral isotretinoin within the last 6 months, use of topical within the last 60 days
• Receiving or have received gold treatment (aurotherapy/chrysotherapy)

Conditions that need a doctor’s letter to confirm laser removal is suitable:

• Seizure disorders triggered by light, epilepsy
• Transplant Anti-Rejection Drugs
• Thyroid Disease
• Heart Disease
• Hypertension (high blood pressure treated with medication)
• History of cancer/skin cancer

The list below is of things that require a waiting period until you can start laser removal:

• Active Herpes simplex (cold sores) - wait 2 weeks until it's healed
• Acute fungal infections - wait until the condition has cleared
• UV exposure from sunbathing or tanning beds - wait 4 weeks before starting laser removal and please note you cannot sunbath or use a tanning bed during your course of treatment (unless area of laser removal is completely covered)
• Chemical Peels, Microdermabrasion, Laser Skin Resurfacing at site of treatment - wait 6 months before starting laser removal treatments and do not get in the area during your treatment course
• Chemical depilation or mechanical depilation within the last 6 weeks may interfere with the post-treatment healing process
• Use of fake tanning products within 4 weeks of treatment, such as creams, lotions and sprays; these may interfere with the laser treatment

Drugs & Herbal Remedies:

• Feverfew or St John’s Wort - both of these herbs are photosensitising - stop taking the preparation and wait 4 weeks for the herb to be completely cleared from your system before treatment - otherwise skin can get burned
• Over the counter pain relief e.g. non-steroidal - anti-inflammatory/pain relief drugs such as Ibuprofen and/or Aspirin must be allowed to clear from your system before any treatment – a delay of 1-2 weeks is suggested before treatment begins
• Prescribed drugs for a short term (course of less than 6 weeks) by the GP/Hospital - the course should be finished and time frame of at least 6 more weeks for any drug to be completely excreted from the system before having laser removal treatment (notable drugs that can cause problems during laser are Tetracycline antibiotics and steroids)
• Prescribed long term drug (a course lasting longer than 6 weeks) by the GP/Hospital - a letter of authorisation from prescribing doctor is required to proceed with laser removal treatment (notable long term drugs that can cause problems are Ro-Acutane, Minocin which is an antibiotic frequently used in long term Acne therapy and Amiodarone a drug used in Cardiology)

+ I just got a tattoo. When can I start the removal process?

You must let the tattoo heal first. It is important to follow the after care as improper healing can cause scarring and it will make removal process more complicated.

If it's a cosmetic tattoo such as eyebrows, so called "emergency" removal can be performed in the first 24 hours after getting it done. If time frame has been missed then you must wait for full healing otherwise you risk causing scarring and hypo-/hyperpigmentation.

For safe and more effective removal of new tattoos it is best to wait at least 3 and up to 6 months after getting a tattoo and at least 1.5 months after getting a cosmetic tattoo (permanent makeup).

+ How many treatments are needed?

It takes multiple sessions to significantly fade and especially to fully remove a tattoo. Size of the tattoo doesn't matter, small tattoos can take as many sessions as large ones. The amount of treatments depends on the depth and density of the ink, its chemical composition, age of the tattoo, location of the tattoo on the body, age of the client, skin type and skin color and some other factors such as smoking.

Permanent makeup tattoos such as eyebrows typically take less sessions to fade or fully remove pigment, but amount of sessions will still depend on factors above.

Industry standard for complete removal of traditional tattoos - an average of 10-12 laser tattoo removal treatments, however every person and tattoo is unique and some might require more while others require less.

For tattoos that will be covered up and just need some fading, an average of 2-5 laser tattoo removal treatments will be needed, depending on the pigment density of your current piece, the desired cover-up tattoo and comfort of the artist doing the new tattoo.

As a general guideline treatments will be scheduled 6-8 weeks apart initially. Depending on factors such as pigment saturation, client's age, number of sessions done, treatments could be scheduled further apart.

+ Will the tattoo be completely removed?

In most cases 90-95% of pigment removal can be reached, meaning most people wouldn’t know you ever had a tattoo. There is also a possibility that a small amount of pigment may remain in the skin, so called ghosting, and for most clients, this is acceptable to be considered a removed tattoo.

Certain colors may require more treatments to be removed. Some tattoos such as cover ups, the ones that have a present scarring from tattooing process itself, tattoos with multiple colors (such as yellow, purple, aqua, green, pink) may never fade completely.

There are no FDA regulations on tattoo ink and several hundred different colors, manufactures and formulas so each tattoo fades at a different rate. Because of the inconsistency in tattoo ink and each client being different, you may not see a drastic change after each session, although most clients will see immediate change after the very first treatment.

+ Do I have to prepare for laser tattoo removal treatment?

The area needs to be clean and free of lotions, moisturizers and makeup. If there's excessive hair in the area it's better to shave it the night before (except eyebrows, please, DO NOT shave your eyebrows!!!).

Avoid alcohol 24 hours prior to treatment. It is advised to have a good healthy meal and drink enough water before the appointment. For body tattoo removal wear comfortable loose clothing.

Remember, if skin in the area of removal is tan or sunburned, has any type of irritation or wound, treatment won't be possible. Sunbathing and tanning beds, fake tan creams, lotions and sprays should not be used 4 weeks before the treatment. Chemical depilation, peels and other invasive skin procedures in the area of removal must be avoided for 6 weeks before the treatment.

+ How long does it take and is it painful?

For most tattoos the procedure takes between 30 seconds and a few minutes. Appointment is booked for 30 mins to 1 hour so there's enough time to do an initial consultation, complete the procedure and go over aftercare recommendations.

Each person perceives pain differently, so there is no definitive answer about the pain level. There will be some discomfort that is often associated with hot rubber bands being snapped on the skin. Special cryo chiller machine is used during the treatment to minimize the discomfort. This machine blows cold air up to -22F that helps to decrease the skin temperature and provide a relief.

+ What are the steps of the process at the appointment?

After a consultation and taking pictures you’ll be invited into the treatment room and given a pair of protective eyeglasses. The technician will adjust laser settings and first test your skin's reaction to laser to determine the most effective energy for the treatment. Once it is determined the technician will use the laser to pass pulses of light over the tattooed area that will be absorbed by the tattoo pigment only.

The cryo chiller machine will be used before, during and for a few minutes after the treatment and a cold pack will be provided to be applied to soothe the treated area.

+ What to expect after a laser tattoo removal session?

The feeling in the area can be compared to a sunburn. Redness and local swelling can be present in the area and will resolve naturally in the next 24-48 hours. Bruising is also something that can happen either due to client's individual skin sensitivity, high density of ink at beginning sessions or increased laser energy needed to target little amounts of pigment at later sessions.

It is not uncommon for the tattoo to become darker and more bold within the first 72 hours of treatment, then to start showing signs of fading 14-21 days later.

Since skin stays intact there's no active aftercare such as ointments or wound dressing involved, but there are some important recommendations that would be given after the treatment.

+ Are there any side effects?

Laser treatment is often safer than any other tattoo removal methods. There are very few side effects that you should still be aware of.

The chances of side effects are very low, however it is possible if the aftercare instructions are not followed or client didn't disclose important medical and health information prior to procedure. If tattooing itself was too agressive it could've left scars, so any scars/changed skin texture present prior to the laser tattoo removal will still be there after treatments, only the ink will be targeted and affected.

One of the side effects that may happen after a removal of traditional tattoos is blisters, it's most likely to happen after first few treatments if tattoo is very dark and saturated, especially if there're layers of ink (cover up). Another possible side effect is hypopigmentation, which means the skin that was treated is paler than the skin surrounding it. Or hyperpigmentation, which leaves the affected skin darker than the rest of your skin. These pigmentation issues are often temporary but may take time to resolve or become permanent in some cases.

+ Are there any specifics in the removal of cosmetic tattoos (permanent makeup)?

Some cosmetic tattoos on eyebrows and lips may change color after treatments due to pigment chemical structure change. Organic inks commonly used on eyebrows tend to become a warm contrast shade - orange/yellow that is not a very flattering or desireable color.

At Skn Allegiance we specialize on removal of cosmetic tattoos and there's a special protocol that is used to effectively remove organic inks avoiding adverse color changes making the removal process comfortable for a client without being worried about the appearance.

Mineral based pigments that were red/salmon color to begin with can become a darker shade before starting to fade. The darker color is actually a lot more pleasant to the eye, so it shouldn't be a concern. It is a part of the removal process and changed color is addressed at the following treatments.

All the possibilities in each case will be explained prior to procedure. There's also a possibility that your case may require a solution removal either prior to laser, or at some point after laser treatments. Please, read about solution removal here.

Laser removal is safe for eyebrow hair, it won't cause a hair loss and often even has an opposite effect - stimulates the brow hair growth. In some cases hair can get lighter, it is temporary, the color will come back and it also can be tinted after the procedure. Eyebrow makeup if desired can be applied next day.