Can You Get Lader Treatments When You Have Permanent Makeup

Guidelines for Permanent Makeup Removal

Abstract: Permanent makeup removal– Countenance laser tattoo removal is a ofttimes implemented cosmetic procedure performed by beauticians. From a technical point, PMU is considered a facial tattoo. Failed procedures or a change of mind can lead to the desire to perform the removal of permanent makeup.

The purpose of this retrospective evaluation of patients who came to the clinic with the desire to remove permanent makeup between 2011 and 2015 was to explore the problems, side effects, and results in order to define handling guidelines for other doctors and laser professionals. Dr. Rümmelein from Switzerland evaluated 87 private cases in full. In treatable cases, i.e. 52 out of the 87 cases, laser treatments were performed using a nanosecond Q-switched neodymium-doped yttrium aluminum garnet (Nd: YAG) light amplification by stimulated emission of radiation. Information technology takes betwixt 1-12 treatments to remove the permanent makeup. In three cases, the color of the permanent makeup could not be removed by laser and remained later the treatment.  In two cases, laser treatment had to be terminated due to color changes towards the dark-green-blue spectrum.

Before removing permanent makeup, a laser test spot is urgently recommended equally unforeseeable color changes can cause severe aesthetically unpleasant results. Covered upward permanent makeup (skin color) is particularly susceptible to changes in color. A oestrus-induced shrinking of the eye area can crusade an ectropium. Surgical solutions also take to be taken into consideration. The use of proper eye protection with intraocular center shields is mandatory. This article is an attempt to ready some guidelines for the removal of permanent makeup.

Introduction to Permanent Makeup / Countenance Removal

Eyebrow Light amplification by stimulated emission of radiation Tattoo Removal

Similar to conventional tattoos, cosmetic tattoos called permanent makeups (PMUs) are growing more and more pop. The permanent coloration of the eyelids, eyebrows, and lip outline has been performed with increasing frequency in recent years. In dissimilarity to other tattoos, permanent makeup is not meant to stay for a lifetime but it will vanish after three to five years.  To accomplish this effect, the color is not inserted as deep as information technology is in the example of a conventional tattoo. Bated from aesthetic reasons, permanent makeup removal – eyebrow light amplification by stimulated emission of radiation tattoo removalmight be used together with reconstructive surgery, for example after a mammilla reconstruction or due to medical issues similar alopecia areata totalis. The biggest risk concerning permanent makeup removal – countenance laser tattoo removal is homo failure apropos the incorrect color choice, size, shape, or a procedural error (Figures 1 and 2).

Figure 1. Wrong shape, likewise dark (Source: Premium Tattoo Removal Houston TX)

Figure two. Wrong site, colour change (Source: Premium Tattoo Removal Houston TX)

Almost of the fourth dimension, patients in this situation trustfully consult their aesthetician, who offers a peel-colored cover-up tattoo which is placed right over the failed permanent makeup tattoo. Although this perceived solution sounds very easy, information technology rarely leads to satisfying results as it often looks unnatural in addition to not fully covering up the original tattoo. Since it cannot adapt to the tanning of the skin, it afterwards becomes very visible during summer. Therefore, an aesthetician should not attempt to cover a tattoo. I should consult a doctor and work out a solution with a dermatologist who specializes in laser medicine (Figures 3 and 4).

Figure iii. Misplaced pare-colored cover-upwards (Source: Dr. Rümmelein Zurich Switzerland)

Effigy iv. Covered-upwardly of permanent makeup (Source: Dr. Rümmelein Zurich Switzerland)

Bated from potential artful bug, permanent laser makeup removal – countenance light amplification by stimulated emission of radiation tattoo removalbesides carries a certain risk of medical complications, equally does every tattoo. The risk of infections wound healing complications, keloids, and hypertrophic scars can never be completely eliminated. In very rare cases, eyelid necrosis or ectropion can occur. Lastly, fifty-fifty the inserted color can lead to negative reactions such equally granulomas or allergic reactions (Figure 5).

Figure 5. Granuloma later on permanent laser makeup removal (Source: Dr. Rümmelein Zurich Switzerland)

Present, tattoos are performed with an electric tattoo gun, which inserts unlike colorants into the peel. In the by, these colorants used to be inorganic pigments, merely these days it is ordinarily made of synthetic organic pigments. Colored azo pigments are often used for reds and yellows, while polycyclic pigments are used for dejection, greens, and violets. Normally, the colors incorporate metal ions.

Professional person tattoo artists order their colors from different producers all over the world. Some of that colors are non entirely pure or the ingredients are not clearly stated. Hence, it is no surprise that a lot of consumers do not even know what exactly is getting injected under their skin, which automatically poses a threat to their health. The Europen Plant of Health and Consumer protection made an investigation of lx different colorants in 2015, which resulted in 55% of it being prohibited.

Since 2006, tattoo colorants are regulated past the food law act with statutory chemical and microbiologic quality standards. However, in the Eu, in that location are countries that do not have whatsoever rules or regulations and if they practice, they differ in each country. The method of selection for removing intradermal pigment is treated with a Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) light amplification by stimulated emission of radiation. Q-switched laser utilizes the principle of selective photothermolysis, whereby the wavelength is chosen in accordance with the target chromophore and the duration of the pulse has to be briefer than the thermal relaxation time. If these guidelines are followed properly, unspecific heating of the surrounding peel can be avoided leading to scarring in less than 5% of cases. In the case of multi-colored permanent makeup, dissimilar wavelengths have to be combined (Figures 6 and seven).

Effigy six. Wrongly applied permanent makeup before treatment (Source: University Hospital Zurich Switzerland)

Effigy 7. After treatment (Source: University Infirmary Zürich Switzerland)

Figure 8. Afterwards 4 treatments (Source: Premium Tattoo Removal Houston TX)

The skin depth that the laser calorie-free is able to penetrate depends on the wavelength and the size of the spot on the laser. Longer wavelengths and bigger spots atomic number 82 to increased penetration depth.

When the lite of the light amplification by stimulated emission of radiation enters the peel and meets the color, information technology shatters the pigments into small fragments, which are so removed either by macrophages through phagocytosis or via the lymphatic organisation. A typical reaction observed immediately subsequently treatment is instant whitening of the skin which is caused past the release of gas while heating the pigment.

Materials and methods

In the fourth dimension period betwixt 2011 and 2015, 87 patients requested the removal of their permanent makeup at the clinic of Dr. Rümmelein. Out of the 87, 52 were judged every bit treatable while the remaining 35 were excluded from treatment. The reasons for the exclusion were not-treatable colors, unrealistic expectations, and patients' decision not to undergo treatment because of potential side effects. In each instance, handling was performed with a Nd: YAG nanosecond light amplification by stimulated emission of radiation. Appropriate center protection is crucial; hence, metal protection goggles, specialized laser protection heart-stickers, or intraocular eye shields were used in gild to ensure sufficient patient rubber. The procedure began with an eight-mm spot at an free energy density of 1–1.5 J/cm², depending on the reaction to the colour. The everyman possible free energy to perform immediate whitening was used. During treatment, air cooling was applied. After twenty minutes, a second treatment was performed under the exact aforementioned conditions.

Results

In 47 of the 52 cases, PMU was successfully removed after 1–12 treatment sessions. In three cases, the colour remained after light amplification by stimulated emission of radiation treatments and in two other cases, the color of the tattoo started to change into a bluish greenish color, which led to the treatment being put on hold and ultimately terminated. In those cases, the colour had to be surgically removed.

In summary, out of a total of 87 patients, 52 were somewhen treated and 47 of them take had their PMUs completely removed. No cases of scarring or unwanted pilus loss were observed (Effigy 8).

Effigy viii. Permanent makeup/countenance removal statistics

Discussion

The major take chances of using a laser to remove permanent makeup is a paradoxical darkening of the color, which is, unfortunately, the exact reverse of what the attending physician is trying to accomplish. It seems equally if colors containing brilliant pigments (often peel colour) are most vulnerable to such color darkening. Although this foreign reaction has all the same to be explored in particular, it is rather safe to assume that information technology has something to do with the different states of iron and titanium oxidation,  e.yard., equally Fe2+  (ferruginous colour) oxidizes into Fe3+ (blackness). In most cases, those resulting colors cannot be removed by lasers, which means that surgical methods have to be considered.

Another risk is trying too hard to remove the permanent makeup, instead of just accepting that the pare is non responding to the treatment. This often results in fibrosis and hypopigmentation, particularly after Q-switched ruby- laser treatments. Information technology tin can also pb to hyperpigmentation in the instance of darker skin types. In these cases, a Nd: YAG-light amplification by stimulated emission of radiation is recommended every bit information technology is safer to apply on the epidermis due to its long wavelength. If signs of scarring occur, the actual handling with the Q-switched laser tin be combined by using a fractional CO2-laser which seems to reduce those side effects.

To avoid such complications, a test-treatment should e'er be performed on a hidden surface area of the pare in order to observe how the skin and color react to the laser. Patients should too exist informed that this treatment volition accept more than than a few sessions and that they have to alive with a work in progress for some fourth dimension (Figure 9).

Effigy nine. Discoloration of a skin-colored permanent makeup after laser treatment (Source: Dr. Rümmelein Zurich Switzerland)

Determination

While it is very easy to accept a permanent tattoo done, removing it poses a significantly bigger challenge, which in turn leads to a relatively high number of complications due to unprofessional methods of removal. Failed removal attempts the cases wherein a modify in colour occurs can fifty-fifty exacerbate the problem, leaving excision as the last resort procedure. The major trouble apropos tattoo colorants is its ingredients, which are not regulated by law in many countries.

For pigment removal, the method of choice is a Q-switched light amplification by stimulated emission of radiation. Treatments should only be performed past qualified doctors in gild to avert eye impairment and side effects such as scarring. Our numbers suggest that if applied correctly, the Q-switched laser can accomplish splendid results in a majority of cases. With tattoos that consist of colors other than blackness, a laser with the correct wavelength has to be chosen in order to remove it;  hence a multi-colored tattoo requires the combination of different light amplification by stimulated emission of radiation types.

Which light amplification by stimulated emission of radiation wavelengths for which color?

• 1064 nm Nd: YAG for dark pigments, blackness, dark blue and dark-brown inks
• 532 nm KTP for red, tan, majestic and orange inks
• 650 nm for greenish inks
• 585 nm for blue, sky blue inks

Treatment of colored tattoos can exist tricky, which is why there should also be a exam shot prior to every light amplification by stimulated emission of radiation treatment in order to test the reaction of the colour. This is best performed on a small, hidden area of the skin where a potential color change cannot be seen right away or the area can exist excised in a case of a bad reaction.

If these guidelines are followed closely, the Q-switched laser can be considered the aureate standard for permanent makeup/countenance removal when the light amplification by stimulated emission of radiation treatment is performed by a qualified physician. Unfortunately, patients and even theoreticians oftentimes lack relevant information. Federal regime should earnestly consider patient safety and enforce acceptable regulations.

Take-dwelling house messages:

• A Q-switched laser is the method of choice for removing permanent makeup.
• E'er consult a doctor or a laser professional with a document of competence for laser treatments in case of a failed permanent makeup.
• Ever perform a exam shot small enough to exist excised in a instance of a color alter.
• Eye protection with metallic safety goggles or, if needed, even disposable eye shield stickers are mandatory. When applied on the eyelid, special intraocular center shields have to exist used.

Author Contributions

Dr. Rümmelein presented this topic at the IMCAS Earth Congress in January 2016.

Source: https://www.premiumtattooremoval.com/laser-tattoo-removal/permanent-makeup-removal

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