How Permanent Makeup Helps People with Skin and Hair Conditions

Beyond serving as a replacement or enhancement to makeup, cosmetic tattooing — also called permanent makeup — can help camouflage certain hair and skin conditions, providing individuals with increased self-confidence.

Most people associate permanent makeup with getting eyeliner or lipstick tattooed on to achieve that never-without-makeup look, but this kind of tattooing can also serve a kind of medical purpose by helping to empower those with certain health conditions.

That’s according to a new study in the Journal of the American Academy of Dermatology, which outlines the ways in which permanent makeup can be used to hide medical conditions and offers tips for what to consider when choosing to get it.


According to the study, while permanent makeup is commonly used to tattoo eyeliner or darken eyebrows, it can also be used to camouflage surgical scars, birthmarks, alopecia, and vitiligo, as well as for nipple-areola reconstruction, which is typically performed after breast cancer or breast reduction surgery.

It can also be used as makeup for those who have trouble applying it due to a medical condition, such as arthritis and tremors.

“We often think about permanent makeup being used to enhance a person’s lips or eyebrows,” said study co-author Walter Liszewski, MD, FAAD, assistant professor of dermatology and preventative medicine at Northwestern Feinberg School of Medicine, in a news release. “However, for people with conditions like vitiligo or alopecia, permanent makeup can be transformative.”

Permanent makeup involves applying ink to a part of an individual’s face or body in the same way as a regular tattoo. But the study authors say it isn’t risk free, and individuals considering the procedure should be informed about what to look for before going through with it.

The risks

According to the study, possible adverse outcomes of permanent makeup include infectious, allergic, and inflammatory complications. Liszewski says he’s seen an increase in complications relating to infectious and allergic reactions, as the demand for procedures also increased during the COVID-19 pandemic.

These complications may be more common if proper hygiene and aftercare practices are not followed, the study says. And if the underlying skin is treated with cosmetic fillers or local anesthetics, the permanent makeup may shift or be altered in its appearance.

Specifically, potential complications include bacterial and fungal infections, blood-borne infectious diseases, and allergic reactions to tattoo ink. There is also a risk of transmission of syphilis, hepatitis B, hepatitis C, HIV, and other infectious diseases when procedures are performed in a non-sterile environment.


To reduce the risk of complications or being unsatisfied with the result — which is actually the most common adverse outcome — the authors suggest first consulting with a board-certified dermatologist to discuss the results you’re looking for and whether there may be potential complications due to skin allergens.

Some board-certified dermatologists actually do the procedure themselves and can offer it to patients. Those who don’t may instead be able to recommend credible and trustworthy permanent makeup artists.

It’s also important to note that there are no standard training or regulatory guidelines for permanent makeup artists in the United States, and regulations can vary by state or municipality.

While some states require years-long apprenticeship programs, others require courses as short as four hours, making adequate research all the more important before making a decision.

As a result of the lack of uniform guidelines, the Academy of Dermatology recommends seeking artists who’ve been trained and passed examinations on sanitation, sterilization, the anatomy of the skin, common skin conditions and infections, universal body fluid precautions, proper medical waste disposal, and wound care.

Tattoo artists should always use medical-grade protection gloves, appropriate instrument sterilization techniques, and exercise universal precautions against blood-borne infections as recommended by the Centers for Disease Control and Prevention, they add.

Artists should also always provide proper skin care instructions to patients, which includes washing hands before touching a healing tattoo, only using fragrance-free products, and contacting the artist and a board-certified dermatologist if signs or symptoms of an infection occur.

“[Permanent makeup] can be used as a tool to restore confidence,” Liszewski says. “[It] empowers these patients to find a sense of renewed self-assurance with cosmetic results that current medications can’t deliver.”


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