Cosmetic Tattoo Research Articles

Ocular and Periocular Tattoo Adverse Effects: A Review.

Ocular and periocular tattoos, involving ink application to the eyeball or surrounding skin, have gained popularity as forms of self-expression. However, this trend raises significant concerns about potential complications that can adversely affect ocular health and esthetics. Awareness of these risks is crucial for both patients and practitioners. A comprehensive literature review was conducted, focusing on studies discussing complications related to ocular and periocular tattooing. Relevant studies were identified through the MEDLINE, PubMed, and Ovid databases. The reviewed papers were evaluated based on study design, including blinding, sample size, control use, randomization, and objective endpoints, and classified according to the Oxford Center for Evidence-Based Medicine evidence hierarchy. The review identified a wide range of complications, including immediate issues like bleeding, infections (conjunctivitis, endophthalmitis), and allergic reactions. Delayed reactions included granuloma formation, often requiring further treatment. The most serious risk identified was potential visual impairment due to improper technique or ink placement. With the growing trend in ocular and periocular tattooing, there is an urgent need for increased awareness of associated risks. It is crucial to ensure that only qualified professionals perform these procedures, emphasizing the importance of understanding ocular anatomy. Developing strict regulatory guidelines and prioritizing research on the long-term effects of these tattoos are essential for patient safety. A collaborative approach among healthcare providers, regulatory bodies, and educational institutions is needed to mitigate risks and promote best practices in cosmetic tattooing.

WHAT TO EXPECT FROM MICROBLADING OF THE EYEBROWS

Microblading of the eyebrows, a kind of cosmetic tattooing that has become very popular in the last decade, it can nevertheless cause adverse skin reactions at the tattoo site, including infections, allergic reactions, and even sarcoid reactions. These reactions can lead to a reduction in the quality of life. We report tow cases of adverse reactions following microblading of the eyebrows, the first patient 40-year-old women presenting with a 7 -month history of erythematous lesions on the eyebrow, A biopsy was performed, which came back a sarcoidosis granulomatous reaction, Our patient was put on intralesional corticosteroid and synthetic antimalarials with good improvement, the second patient have 38 year-old women consulting for erythematous, oozing, pruritic lesions after 3 days of application microblading of the eyebrows, . The dermatological examination revealed the presence of edematous erythematous plaques surmounted by vesicles with crumbling contours located on both eyebrows. The diagnosis of contact eczema was retained, and the patients was put on a low-class topical corticosteroid for 10 days with good improvement.

Picosecond Nd:YAG laser for the removal of cosmetic tattoos of the eyebrow: a single-center retrospective review

Picosecond Nd:YAG laser for the removal of cosmetic tattoos of the eyebrow: a single-center retrospective review

P073 Cosmetic tattoo models: a novel approach for laceration repair instruction

P073 Cosmetic tattoo models: a novel approach for laceration repair instruction

Lasers for the treatment of eyebrow microblading and cosmetic tattoo pigment: a review of the literature.

We aim to discuss the use of laser for the treatment of eyebrow microblading and cosmetic tattoo complications through a review of the literature. Our research question is whether quality-switched or picosecond laser is superior for the removal of eyebrow tattoos. This structured review was conducted using a PubMed search using the search terms "laser tattoo removal" AND "cosmetic tattoo" AND "eyebrow" with the article type filtered to "case reports," "clinical trial," and "randomized controlled trial" ranging from dates 1994-2023. All case reports or series evaluating the effect of laser on eyebrow cosmetic tattooing pigment were included. We summarize the results of 11 studies evaluating the use of laser for cosmetic tattoo removal, with 129 patients treated specifically for eyebrow pigment. Most studies (8/11) report Fitzpatrick skin type or race. Seven studies utilize quality-switched (QS) neodymium-doped yttrium aluminum garnet (Nd:YAG), alexandrite or ruby, three used picosecond (PS) Nd:YAG or alexandrite, and three used carbon dioxide (CO2) laser. We report laser energy, spot size, and pulse duration, as well as treatment outcomes and adverse events. Historically, methods of pigment removal included dermabrasion, cryosurgery, electrosurgery, radiofrequency, infrared light, intense pulsed light, and surgical excision; however, these methods often led to poor cosmetic outcomes including scarring and further dyspigmentation. QS laser treatments provided superior cosmetic outcomes and thus were considered the gold standard treatment option for pigment removal. However, the advent of PS lasers has challenged this given their increased selectivity, lower fluence requirements, and reduction in surrounding thermal damage. Our review demonstrates that PS Nd:YAG is quicker and more effective that QS Nd:YAG in the treatment of eyebrow tattoos. Additionally, the paradoxical darkening seen with QS lasers is less common with PS lasers. We also demonstrate that CO2 laser may be a helpful adjunct to QS or PS laser. This review focuses on Fitzpatrick skin type and race, providing a unique perspective on the use of laser treatment in skin of color, which often poses an additional treatment challenge.

Clinical Issues - October 2023.

Pregnant personnel in the magnetic resonance environment Key words: magnetic resonance (MR), pregnant personnel, zone IV, exposure, scanner. Patients with tattoos in the magnetic resonance environment Key words: tattoo ink, permanent cosmetic tattoo, magnetic resonance (MR), scanning, burns. Robotic procedure emergency preparedness Key words: emergency readiness, conversion to open, robotic surgery, checklists, undocking. Communication during robotic procedures Key words: communication, teamwork, robotic procedures, familiarity, perioperative team.

Laser Removal of Cosmetic Eyebrow Tattoos with a Picosecond Laser

This current retrospective study, including 98 patients aged 21 to 71 years, aims to assess the safety and the efficiency of a picosecond 755 nm/532 nm laser in the removal of complex eyebrows tattoos. Patients were treated with a picosecond laser at 755 nm with fluences ranging from 0.69 to 6.37 J/cm2 and at 532 nm with a fluence of 0.64 or 1.12 J/cm2. Analyses of Variance (ANOVA, single factor) and comparison tests (F-test) were conducted. A total of 70 subjects finished the full treatment. An average of three laser sessions were necessary to achieve the patients’ objective (total removal, attenuation for redo, or correction). The number of sessions was significantly higher if cosmetic tattoos contained visible warm pigments (red, orange, yellow). A total of 18 patients experienced immediate grey discoloration, although this was not found to significantly influence the number of laser sessions. The main side effects were redness, swelling, and bleeding points. One patient experienced a bruise immediately after laser shots. This retrospective study has shown the picosecond laser to be safe and efficient in removing complex cosmetic tattoos. Further investigation is ongoing to assess optimal parameters for treating red and white pigments.

A review of treatment of port-wine stains with pulsed dye laser in fitzpatrick skin type IV-VI.

Port-Wine Stains are a congenital vascular malformation that affect 0.3-0.5% of newborns. It is a benign capillary malformation that commonly occurs on the head and neck. It is formed by progressive dilation of the post-capillary venules, and as the patient ages it may be associated with hypertrophy and nodularity which can lead to cosmetic disfigurement and psychological aggravation. There are many choices of treatment such as cryosurgery, cosmetic tattooing, and dermabrasion, amongst others. The treatment of choice is pulse dye laser (PDL) because it is both effective and safe to use.In darker skin types (Fitzpatrick skin types IV-VI), treatment is more difficult. Caution when treating darker skin types with PDL comes from the fact that there is an inverse correlation between vessel specificity of the PDL and skin pigmentation. In this review, we will be reviewing the literature and discussing the manuscripts that describe the treatment of PWS on patients with fitzpatrick skin type IV-VI. Authors searched the PubMed Medline in the English language from database inception through December 2022 for eligible articles. The keywords searched included "PDL," "pulse dye laser," "skin of color," "Fitzpatrick skin types IV-VI," "fitzpatrick," "pigmented skin," "Port-wine stain," "PWS", and "pulse dye laser." The articles that were included discussed PDL in the treatment of PWS in patients of skin of color. Any additional similar articles that were cited in our search were also included. Articles that were excluded did not discuss Fitzpatrick skin types IV-VI, darker skin type, or PDL. Data collected from each article included the number of participants, Fitzpatrick skin type, age, and laser parameters. There were 120 articles that were reviewed from our search and a total of nine articles met inclusion criteria with 241 patients that were considered Fitzpatrick skin type IV-VI. The patients were of a wide range of ages from 1month to 74years old. In our review, patients who are treated at a younger age had better results than when treated at an older age. The results show that darker skin individuals have better results when treated at a younger age compared to adults, they can experience complete resolution. Adults who were treated saw a variation of results, from improvements in the appearance to hyperpigmentation/hypopigmentation or scarring of the treated area. Patients who are Fitzpatrick skin type IV-VI are at higher risk of adverse events when treated with PDL for PWS when compared to patients of other skin types. Studies show that PDL can be beneficial for PWS in patients of skin of color; however, there are risks of hyperpigmentation, hypopigmentation, and scarring that are important to take into consideration when treating these patients. Further research is warranted to improve the understanding of PDL for PWS in patients of skin of color.

Retrospective Review of the Laser Removal of Facial Cosmetic Tattoos.

Cosmetic facial tattoos have proven difficult to remove despite advancements in laser technology. Review safety and efficacy of picosecond laser removal of cosmetic facial tattoos. Retrospective chart review from January 2015 to January 2022 of patients undergoing tattoo removal of facial cosmetic tattoos. A total of 33 patients were included in the review. The average number of treatments to obtain satisfactory results was 3. Sixty 6 percent of subjects were rated as "very much improved" with 76% to 100% of the tattoo removed and 34% of subjects were rated "much improved" with 51% to 75% of the tattoo removed. Thirty percent of subjects experienced unexpected changes in the tattoo color after initial treatment with 1,064-nm picosecond laser. Picosecond laser is an effective and safe treatment for cosmetic tattoos, and it highlights the underreported unmasking of an orange color postlaser treatment that can be successfully treated with a 532-nm PS laser.

On the mechanism of painful burn sensation in tattoos on magnetic resonance imaging (MRI). Magnetic substances in tattoo inks used for permanent makeup (PMU) identified: Magnetite, goethite, and hematite.

Persons with cosmetic tattoos occasionally experience severe pain and burning sensation on magnetic resonance imaging (MRI). To explore the culprit magnetic substances in commonly used permanent makeup inks. 20 inks used for cosmetic tattooing of eyebrows, eyeliners, and lips were selected. Ink bottles were tested for magnetic behavior with a neodymium magnet. Eight iron oxide inks qualified for the final study. Metals were analyzed by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The magnetic fraction of inks was isolated and analyzed by X-ray fluorescence(XRF). Magnetic iron compounds were characterized by Mössbauer spectroscopy and powder X-ray diffraction (XRD). ICP-MS showed iron in all magnetic samples, and some nickel and chromium. Mössbauer spectroscopy and XRD detected ferromagnetic minerals, particularly magnetite, followed by goethite and hematite. This original study of cosmetic ink stock products made with iron oxide pigments reports magnetic impurities in inks for cosmetic tattooing, e.g., magnetite, goethite, and hematite. These may be the main cause of MRI burn sensation in cosmetic tattoos. The mechanism behind sensations is hypothesized to be induction of electrical stimuli of axons from periaxonal pigment/impurity activated by magnetic force. Magnetite is considered the lead culprit.

Sarcoid Granulomas and Systemic Sarcoidosis Triggered by Cosmetic Tattoos.

Cosmetic tattooing of eyebrow and lips has become very popular and is expected to be paralleled by more frequent complications. We present 4 cases of granulomas in cosmetic tattoos complicated by regional or systemic manifestations of sarcoidosis including affection of the lungs in 2 cases, the activity triggered by the tattoo. Three cases of traditional decorative tattoos on extremities serve as reference. It is noteworthy that cosmetic tattoos despite small size and thereby low relative dose of pigment injected in the skin can trigger fully developed systemic sarcoidosis. It is hypothesized that iron oxide pigments popular in cosmetic tattoo inks of red or brown color may be prone to elicit sarcoid reactions and thus carry a special risk of granuloma. In decorative tattoos, carbon black is the commonest trigger. It is emphasized that the finding of granulomas in tattoos shall be followed by search of other manifestations of sarcoidosis through patient history and diagnostic examinations to exclude pulmonary, ocular, and other organ manifestations. Patients with granulomas in tattoos shall be informed that active sarcoidosis, if not already present, can become manifest later with a latency of months or years and often with abrupt debut when the triggering tattoo may be overlooked by the doctor who is unfamiliar with this less common type of sarcoidosis.

Tatoo Ink, Magnetism and Sensation of Burn during Magnetic Resonance Imaging, and Introduction of Hand-Held Magnet Testing of Commercial Tattoo Ink Stock Products prior to Use.

Cosmetic tattoos may cause burning sensation during magnetic resonance imaging (MRI) and interrupt the procedure, and thereby any diagnostic workup. Tattoos also may cause disturbing artefacts in MRI images. The sensation, which can be painful, is due to magnetic elements in the tattoo ink deposited in the tattooed skin. It is not a thermal burn but a subjective sensation of burning. Tattoo ink bottles can be tested for magnetic properties by the artist in the studio, before cosmetic tattooing is performed, using a simple magnet test. This test and the pitfalls of the test are described. Hospital departments and clinics should be aware of the problem, and patients assessed prior to MRI regarding their tattoos, particularly eyebrows and eyeliners made in brown and dark colors. Red tattoos exemplified by tattooed lips are not prone to MRI-induced burning sensation. The problem is related to inorganic pigments with ferromagnetic properties.

Technical and Clinical Complications of Cosmetic Tattooing.

Cosmetic tattooing and medical tattooing of the face share basic principles and to some degree types and spectrum of technical and clinical complications known from decorative tattooing of other parts of the body. Cosmetic tattoos recently have grown exponentially in popularity in industrialized countries all over the world. The different complications and their clinical symptoms, pathophysiology, diagnosis, treatment, and prevention are analyzed versus culprit pigments and updated. Eyeliner tattooing is associated with special complications because of the subtle anatomy and the closeness to the eye, and the risk of meibomian gland damage. The spectrum of cosmetic tattoo complications includes early-onset complications (infections particularly with herpes simplex, healing issues, aesthetic and technical mistakes with regret), and late-onset complications (color fading and color shift, "blowout" pigment escape to surrounding skin, papules, nodules, granulomas associated with sarcoidosis, allergic reactions in lip tattoos with lichenoid dermatitis, eye irritation, and fibrosis and scaring especially after microblading); miscellaneous complications include severe burn sensation in tattoos during magnetic resonance imaging later in life. Corneal tattooing and subconjunctival/episcleral tattooing performed on medical indication by ophthalmologists, and for decoration by tattooists carry special risk of intraocular complications. It is recommended for the purpose of research harmonization that terms and diagnostic classification of tattoo adverse events follow the system introduced by the Tattoo Clinic of Copenhagen and already accepted in specialized tattoo clinics in other centers.

A Practical Approach to Cosmetic Tattoo Removal with the Nd:YAG Laser.

The Q-switched neodymium-yttrium aluminium garnet (Nd:YAG) laser remains the gold standard method for tattoo removal including cosmetic tattoos. Modern picosecond lasers are referenced to the Nd:YAG laser and essentially do the same job. Persons with cosmetic tattoos in the face are especially eager to achieve perfect removal or correction and from start are critical to suboptimal results. Customers mostly request complete removal; sometimes the goal is fast treatment and bleaching to prepare for a cover up tattoo. Removal or correction of eyebrows is the largest group, followed by lip tattoos and eyeliners. The article gives a systematic and stepwise introduction to routine cosmetic tattoo removal by laser in an Austrian private medical practice. Rationales and selection of customers who can benefit from treatment, preparation, performance, and aftercare is reviewed. Emphasis is given to qualified power adjustment of the laser equipment and the treatment strategy, e.g. the delicate navigation between efficient removal and the risk of short-term and long-term adverse effects. Treatment relies on a partnership between provider and customer. Over the months of treatment, customers gain more insight into the possibilities of treatment, so that they get an understanding of the realistic results that can be achieved. Therefore, customers are also satisfied even with results that are not always optimal since best treatment was given a fair chance.

History of Cosmetic and Medical Tattoos.

Tattooing for medical purposes may have been around more than 5,300 years ago, but most of the interest and changes have occurred during the last 100 years as a consequence of scientific advances leading to quicker, cleaner, and less painful insertion of pigment into the skin as well as advances in medical knowledge allowing for more relevant individual information to be transmitted by the embedded pigment. These changes are ongoing. Cosmetic tattooing or tattooing for camouflage of body surface imperfections, likewise, has advanced during the last 50 years concurrently with the rise of social media, internet access, and the popularity of personal electronic visuals.

Psychological and Social Aspects of Cosmetic Tattoos versus Conventional Cosmetic Care.

Cosmetic tattoos are in the same family as medical tattoos and conventional cosmetic care and fall within the overall concept of body modification. Each discipline has its own segment of users and its own techniques and professional providers. However, they all serve the higher aim of shaping the skin and the body and improving image and self-esteem.

The Sudden Rise of Cosmetic and Medical Tattoos on All Continents.

Cosmetic tattooing dedicated to beautifying the normal anatomy such as the eyebrows, the eyelines, or the lips is in a remarkable growth all over the world. Medical tattooing with reconstruction of the areola and the nipple after breast surgery, correction of the lost color of vitiligo and scars is a spin-off, which has made tattooing cross the barrier and become accepted and used in clinics and hospitals in service of the quality of life of patients. The last years have seen a major development of machinery, inks, techniques, experiences, and services. The overwhelming rise of the activity created by client pressure and business opportunity, however, also has its cons: amateur work and even malpractice. The development is driven by elite technicians, but competence is little transparent to clients, and there is no distinct authoritative recognition of practitioners based on a recognized educational curriculum. National regulations of the industry are highly variable and scattered. Some countries have no restriction and in others cosmetic tattoos shall be performed by medical doctors. The challenge of the coming decades is to parallel the success of the industry with quality assurance to better control practices and safeguard clients, and the patients.

Cosmetic and Medical Tattoos, National and International Regulatory Requirements on Instruments and Commercial Ink Stock Products.

This chapter explains the international regulative framework on equipment and inks for cosmetic and medical tattooing. In the following text, the word "tattooing" refers to body tattooing, permanent makeup, and microblading. From a global perspective, regulation of equipment for cosmetic (decorative) tattooing, and especially inks, is inconsistent and mainly based on a diversity of national laws. In contrast, regulation of equipment for medical tattooing is subjected to the internationally harmonized medical devices regulation. Even though dermal invasiveness and biological mode of action are identical for cosmetic and medical tattooing, the regulatory requirements are separated in two divergent regulative frameworks.

Microblading Technique for Tattooing of "Hairstrokes" That Simulate Natural Hair: Eyebrow Tattooing and Correction of Medical Conditions.

Microblading is a rapidly expanding technique in cosmetic and medical tattooing, used for eyebrow correction and conditions of hair loss. Tattooing is performed by hand using a special blade; tiny cuts in the outer skin are filled with dark pigment to simulate a natural hair. Indications, the technique, and the microblading procedure step-by-step are considered in what follows. Details on client selection and a range of pitfalls are discussed. The leading application of microblading is cosmetic tattooing of the eyebrows adding pigmented "hairstrokes" to the natural brow area. Tattooed "hairstrokes" fade in color over months and a repeated "touch up" procedure may be required. Pretreatment with laser removal of tattoos of the past may be indicated when a client requests a "touch up" with another brow in another style, shape, or extension. Microblading carries the risk of scarring. The combination with conventional machine-driven needle tattooing for background shading the skin of the brow is also discussed. Microblading is also used as a corrective intervention in a range of dermatological and medical conditions. Having grown exponentially for cosmetic purpose in the first phase of microblading parallel to acquired refinement, the method is now mature and ready to make further progress on medical indication in the coming second phase. The medical community should welcome this opportunity for supplementary correction with restoration of the normal brow anatomy added to other achievements in dermatological and medical therapy.

Infectious Risks, Universal Hygiene and Occupational Risks for Tattooing Technicians.

Emerging virus diseases are a major threat to humans and public health. Over the past two decades, there has been mounting interest in the increasing number of viruses causing unexpected illnesses and epidemics among humans. Emerging diseases also include as yet unrecognisable infections, or a previously recognised infection that has expanded into new ecological niche often accompanied by a significant change in pathogenicity. In the wake of these discoveries, the need for stronger infection prevention measures for personal services such as tattooing and cosmetic tattooing procedures needs to be revisited and re-established through more rigorous measures. This study provides an overview of some of the more common viruses and highlights their covert and sometimes non-symptomatic nature that tattooing practitioners need to be mindful of. It also presents precautionary measures that practitioners must take to protect against cross-contamination through infection prevention protocols. This study also looks at the importance of education and updates in education and the role of mandatory regulations.