Cosmetic Tattoo Research Articles

A Study on Adult Women's Cosmetic Tattoo Experiences and Comparison of Health Concern and Health Practice between the Cosmetic Tattooed and Non-cosmetic Tattooed Groups

Purpose: This study was conducted to compare the level of health concern and the health practice of adult women depending on their experiences with cosmetic tattooing. Methods: The participants were 396 adult women in Jeonnam and Jeonbuk Provinces and G City. Their levels of health concern were measured using the 5-point-5-item scale designed by Kim. For measuring their health practice, the 5-point-12-item scale designed by Kwak was used. Results: The percentage of cosmetic tattooed women was 58.8%. The average score of their health concern was 3.12 and that of their health practice 3.54. As for their levels of health concern, no differences were observed between those with cosmetic tattoo experience and those without. However, the group with cosmetic tattoo experience exhibited a higher level of health practice. Also, most members of the cosmetic tattooed group decided to visit their tattoo shops based on the availability of tattoo shapes or prices rather than considering infection risks. Conclusion: Health education is necessary to increase people`s sensitivity to infection. This study shows that urgent attention for the management and regulation of the relevant ministries is required. Also, this study provides foundational information that will serve health education.

Standardization of SMP Procedure and Its Impact On Outcome

Background:Cosmetic deformities can result from various types of alopecia or even post hair transplantation procedures. Patients with such deformities seek aesthetically appealing longer-lasting options. Scalp concealers are commonly used by men and women to camouflage these deformities. Scalp micropigmentation (SMP) is one of the concealers recently gaining popularity.Objectives:SMP is a novel technique wherein microdot tattoos are placed in a stippling pattern to mimic hair follicles that are cut close to the scalp and various variables affecting its outcome were evaluated.Methods:Forty-five subjects were recruited for the study. The various factors affecting outcome of SMP—angle of needle against the scalp, depth of needle into the scalp, time of the needle contact in scalp, speed of the rotor, resistance of scalp, color of pigment, viscosity of dye, needle number, needle thickness, and pattern of dot placement—were systematically studied in 15 patients through clinical photographs and trichoscopy. Ideal depth of pigment deposition was assessed through histopathological examination. After using these optimum variables, standardized SMP was performed in 30 patients with hair loss (3 patients with cicatricial and 27 patients with diffuse non-cicatricial alopecia). SMP was also used to create an aesthetically denser hairline. The outcome of the procedure was evaluated using standardized global photographs.Results:The ideal parameters were established to achieve standard reproducible results. There were great patient satisfaction and acceptance of the procedure. All the patients showed moderate to great improvement after the procedure with satisfactory scalp coverage. Adverse events were transient which were seen in the form of edema and redness.Conclusion:SMP offers a non-medical, tattoo-based cosmetically appealing and effective “cover-up” that hides the unsightly conditions. The cosmetic tattoo placement creates an illusion of thicker hair.

ART OF TATTOOING: MEDICAL APPLICATIONS, COMPLICATIONS, ETHICAL AND LEGAL ASPECTS

The art of tattooing has been practiced since the ancient times for a variety of reasons. The descriptive, decorative patterns have not only been used as a means of identification but have established itself in the field of medicine as well, being employed as a therapeutic modality or diagnostic method. These include corneal tattooing, gastrointestinal tattooing during endoscopy, reconstructive and cosmetic tattooing for camouflage, radiotherapy field marking etc. An emerging application of tattooing is medical alert tattooing often practiced by the patients themselves without medical consultation inscribing their disease condition or allergy to a particular medication which may affect diagnosis or treatment. However, tattoos indicating advance health directives (do not resuscitate/do not defibrillate) or the organ donor tattoo pose ethical and legal problems as they may not reflect patient’s current wishes. Furthermore, they are not recognized as meeting any of the legal requirements, so they cannot be considered as valid directives or as consent, but only as a way to guide treatment decisions. In this paper, we outline a brief review of the numerous applications, its advantages, potential drawbacks along with the ethical and legal issues related to it.

Prevalence, determinants and genetic diversity of hepatitis C virus in the multi-ethnic population living in Suriname

Prevalence, determinants and genetic diversity of hepatitis C virus in the multi-ethnic population living in Suriname

Cosmetic tattoo pigment reaction

BackgroundCutaneous reactions to tattoos are most commonly granulomatous or lichenoid.PurposeWe describe a woman who developed a lymphocytic reaction following a cosmetic tattoo procedure with black dye. The reaction occurred not only at the site of the tattoos (eyebrows and eyelash lines), but also in non-tattooed skin (bilateral malar cheeks).Methods and MaterialsWe reviewed PubMed for the following terms: cosmetic, dye, granuloma, granulomatous, lichenoid, lymphocytic, perivascular, pigment, pseudolymphoma, reaction, and tattoo. We also reviewed papers containing these terms and their references.ResultsHistopathologic examination of the left eyebrow and left cheek punch biopsies showed predominantly a perivascular lymphocytic reaction secondary to exogenous tattoo pigment.ConclusionsPerivascular lymphocytic reaction is an uncommonly described complication of tattooing. Our patient had an atypical presentation since she had no prior tattoos, became symptomatic only a few days after the procedure, reacted to black dye, and involved skin both within and outside the confines of the tattoos. Her symptoms and lesions resolved after treatment with systemic and topical corticosteroids and oral antihistamines.

Laser tattoo removal: an overview of ink fragmentation and elimination

Laser tattoo removal is increasingly being sought by individuals for the removal of amateur, professional, cosmetic, medicinal and traumatic tattoos. Tracy Butler evaluates the effectiveness of Q-switched lasers for the eradication of tattoo ink, discusses potential treatment-related side effects and adverse events, and describes the processes of ink fragmentation and elimination

Complications of cosmetic tattoos.

Cosmetic tattoos, which are better known as permanent make-up, have become popular in the last decades. This same procedure can be used to camouflage pathological skin conditions, to mask scars and to complete the aesthetic results of plastic and reconstructive surgeries. The risks and complications of tattooing procedures include infections and allergic reactions. Scarring can occur. Fanning and fading of the colorants and dissatisfaction with colour and shape are not unusual. Different lasers can offer solutions for the removal of unwanted cosmetic tattoos, but complications due to the laser treatment, such as paradoxical darkening and scarring, can arise.

Orange color: A dermoscopic clue for the diagnosis of granulomatous skin diseases

Orange color: A dermoscopic clue for the diagnosis of granulomatous skin diseases

Effects of tattoo ink's absorption spectra and particle size on cosmetic tattoo treatment efficacy using Q-switched Nd:YAG laser.

The mechanisms responsible for variable responses of cosmetic tattoos to Q-switched laser removal treatment remain unclear. We sought to investigate the properties of tattoo inks that may affect the efficacy of laser-assisted tattoo removal. The absorption of white, brown, and black inks before and after Q-switched neodymium-doped yttrium aluminum garnet laser irradiation were analyzed by a reflectance measurement system. Rats were tattooed using the three inks and treated with the same laser for two sessions. Skin biopsies were taken from the treated and untreated sites. Black ink showed strong absorption, reduced after laser irradiation, over the entire spectrum. White ink had low absorption over the visible light spectrum, and brown ink had strong absorption at 400-550 nm wavelengths. White and brown inks turned dark after laser exposure, and the absorption of laser-darkened inks were intermediate between their original color and black ink. White, brown, and black tattoos in rat skin achieved poor, fair to good, and excellent responses to laser treatment, respectively. Transmission electron microscopy showed that white tattoo particles were the largest, brown were intermediate, and black were the smallest before laser. After laser treatment, white and brown tattoo particles were mixtures of large and small particles, while black particles showed overall reduction in number and size. Black tattoo ink's excellent response to Q-switched lasers was associated with its strong absorption and small particle size. White tattoo ink's poor response was associated with its poor absorption, even after laser darkening, and large particle size.

Cutaneous pseudolymphoma occurring after traumatic implantation of a foreign red pigment

Cutaneous pseudolymphoma is an uncommon, benign lymphoproliferative disorder of the skin. Although this condition is most commonly idiopathic, its occurrence has been associated with cosmetic tattoos. We report a unique case of cutaneous pseudolymphoma that occured after accidental, traumatic inoculation of a red pigment in a healthy 33-year-old woman.

Cosmetic Tattooing of Free Flaps following Head and Neck Reconstruction

Free flap reconstruction of the head and neck is a widespread procedure. The aesthetic outcome is frequently compromised by color mismatch between the donor site skin and the complex pigmentation of the face. Various surgical procedures have been described to improve the appearance of external skin paddles. Medical tattooing is commonly used for nipple pigmentation in breast reconstruction and cosmetic procedures such as permanent makeup. This article describes the technique and its application to head and neck reconstruction. Medical tattooing can be used to improve the cosmetic appearance of head and neck free flaps. There is no donor site morbidity and subtle changes in color can be replicated. The article describes the technique of medical tattooing with the use of illustrative cases. Medical tattooing is a viable alternative for improving the appearance of cutaneous skin paddles following head and neck reconstruction with free flaps. Its advantages include no donor site morbidity, availability of an infinite range of colors, no requirement for general anesthesia, and the ability to use multiple colors in the one flap for complex pigmentation requirements. Its disadvantages include the need for specialized skills and equipment and the fading of color over time.

Treatment of cosmetic tattoos with nonablative fractional laser in an animal model: A novel method with histopathologic evidence

Cosmetic tattoos are difficult to treat using Q-switched lasers. We introduce a novel method for the treatment of cosmetic tattoos using a nonablative fractional laser and investigate the underlying pathophysiological mechanisms in an animal model. Ten rats were tattooed on their backs with white and flesh-colored pigments. One-half of each tattoo was treated with a 1,550-nm, erbium:glass fractional laser system with energy settings of 17 mJ and 169 MTZ/cm(2) × 2 passes for five sessions at 1-month intervals. The untreated half of each tattoo served as the control. An independent physician reviewed the photographs and scored the clinical response. Serial skin samples were obtained at baseline and at various times after laser treatment. These tissue sections were stained with hematoxylin and eosin, and immunostained for types I, III, and IV collagen; laminin; fibronectin; and α-smooth muscle actin. White tattoos showed excellent responses in two rats and good responses in eight rats, whereas flesh-colored tattoos showed excellent responses in four rats and good responses in six rats (P = 0.001 in both cases compared with baseline). Both tattoos exhibited a similar clearance rate (P > 0.05) and histological reactions. Microscopic epidermal necrotic debris (MEND) containing tattoo pigments and collagen fibrils appeared on day 1, increased on day 2, and was exfoliated after 5 days. The dermal-epidermal junction lost integrity 30 minutes after treatment, but recovered completely on day 3. The expression of fibronectin and collagen-III, which play key roles in wound healing, increased around the microscopic treatment zone on days 1-5 and 4-7, respectively. A few myofibroblasts appeared on days 4-7. Nonablative fractional lasers (NAFLs) successfully remove cosmetic tattoos by transepidermal elimination of tattoo pigments through the disrupted dermal-epidermal junction. This action is facilitated by the wound healing process.

Cosmetic tattooing and ethnic skin

Cosmetic tattooing and ethnic skin

Treatment of Cosmetic Tattoos Using Carbon Dioxide Ablative Fractional Resurfacing in an Animal Model: A Novel Method Confirmed Histopathologically

Treating cosmetic tattoos using quality-switched lasers is difficult. We used carbon dioxide ablative fractional resurfacing (CO2 AFR) to remove cosmetic tattoos and examined the pathophysiologic mechanisms involved in this technique in an animal model. Twelve rats were tattooed on their backs with white and flesh-colored pigments. Half of each tattoo was treated with CO2 AFR (5 sessions at 1-month intervals), and the other half was the untreated control. An independent observer reviewed photographic documentation of clinical response. Serial skin samples obtained at baseline and at various times after laser treatment were evaluated using histologic and immunohistochemical methods. Four rats had excellent responses to laser treatment and eight had good responses. White and flesh-colored tattoos had similar clearance rates and tissue reactions. Histologic analysis showed immediate ablation of tattoo pigments in the microscopic ablation zones. Tattoo pigments in the microscopic coagulation zones migrated to the epidermis and became part of the microscopic exudative necrotic debris appearing on day 2 that was exfoliated after 5days. Increased fibronectin expression around the microscopic treatment zones during the extrusion of tattoo pigments indicated that wound healing facilitates this action. CO2 AFR successfully removes cosmetic tattoos.

830 nm light-emitting diode low level light therapy (LED-LLLT) enhances wound healing: a preliminary study

The application of light-emitting diodes in a number of clinical fields is expanding rapidly since the development in the late 1990s of the NASA LED. Wound healing is one field where low level light therapy with LEDs (LED-LLLT) has attracted attention for both accelerating wound healing and controlling sequelae. The present study evaluated LED-LLLT in 5 wounds of various etiologies. There were 5 patients with ages ranging from 7 to 54 years, comprising 2 males and 3 females. The study followed 5 wounds, namely 2 acute excoriation wounds; 1 acute/subacute dog bite with infection; 1 subacute post-filler ulcerated wound with necrotic ischemic tissue and secondary infection; and 1 subacute case of edema and infection of the lips with herpes simplex involvement after an illegal cosmetic tattoo operation. All patients were in varying degrees of pain. All wounds were treated with multiple sessions (daily, every other day or twice weekly) using an LED-LLLT system (830 nm, CW, irradiance of 100 mW/cm(2) and fluence of 60 J/cm(2)) till improvement was achieved. Full wound healing and control of infection and discomfort were achieved in all patients, with wound condition-mediated treatment periods ranging from 1 to 8 weeks. No recurrence of the herpes simplex case was seen in a 4-month follow-up. 830 nm LED-LLLT successfully brought about accelerated healing in wounds of different etiologies and at different stages, and successfully controlled secondary infection. LED-LLLT was easy and pain-free to apply, and was well-tolerated by all patients. The good results warrant the design of controlled studies with a larger patient population.

A Delayed Granulomatous Reaction to a Cosmetic Tattoo of the Eyebrows: A Report of Total Regression After Intralesional Corticosteroid Injections

A28-year-old woman presented with a 3-month history of asymptomatic bumps on both eyebrows (Figure 1A). She had had cosmetic tattooing of these areas approximately 1.5 year before the manifestation of the lesions and depilated her eyebrow hairs using tweezers. Her medical history was positive for diabetes mellitus type 2, for which she used metformin. She denied other symptoms such as shortness of breath. On physical examination, multiple hard yellowish–red papules were observed arranged in a linear fashion within the tattoo ink. When examined using diascopy an apple-jelly color was observed. The remaining skin showed no other abnormalities. The clinical differential diagnosis included a granulomatous foreign body reaction, sarcoidosis, or xanthomas. A 3-mm punch biopsy of the left eyebrow revealed a granulomatous dermatitis without necrosis (Figure 2). Serum analyses (angiotensin-converting enzymes [ACEs] and lysozyme) and a chest X-ray were normal, excluding sarcoidosis. A diagnosis of a delayed granulomatous reaction to tattoo ink was made. The lesions were injected using Dermojet with triamcinolone acetonide A10 1:1 diluted with lidocaine. When the patient visited the hospital 6 weeks after the triamcinolone acetonide injection for follow-up review, all lesions had resolved (Figure 1B). The lesions did not recur during 4 months of follow-up.

Tinea Faciei by Microsporum gypseum Mimicking Allergic Reaction following Cosmetic Tattooing of the Eyebrows

A 63-year-old healthy female patient presented with well defined itchy erythematous lesions on the area of her eyebrows. Her eyebrows had been tattooed two months before her visit to us. The lesions had previously been treated by application of steroid ointment and anti-histamine and steroid tablets by mouth without success. We suspected the lesions to be contact dermatitis caused by some metal element contained in the dye used for tattooing. Treatment was continued for two weeks, but the lesions spread to her cheeks and forehead. No fungal element was found from the lesions by direct microscopy at this stage. The patch-testing to 20 metal substances on her skin showed no allergic reaction. After one more week of treatment, we reexamined the scale taken from the lesions by direct microscopy, and fungal elements were found at that time. Microsporum (M.) gypseum was isolated from the scale taken from the lesions. The lesions cleared after treatment of 11 weeks' oral intake of itraconazole 100mg daily. It was found that the patient was accustomed to sleep with her dog, a Chihuahua. On examination by a veterinarian, no skin lesions were found on the dog. We speculate that the paws of the dog might have carried soil contaminated by M. gypseum, a geophilic fungus, to the area of her eyebrows which had minor trauma after being tattooed.

Rising Concern over Cosmetic Tattoos

A rise in popularity of cosmetic tattoos has led to an increase in adverse reactions. Due to more pressing concerns, the Food and Drug Administration (FDA) has not traditionally enforced its authority over tattoo inks. To raise awareness of the dangers of cosmetic tattoos. We reviewed FDA policies regarding tattoo ink, different ink components, adverse reactions, and various treatment options for cosmetic tattoo removal. An increase in consumer complaints has prompted FDA investigation into tattoo inks and their safety. It is important that further complications be reported to the FDA to promote regulation of cosmetic tattoo inks.

Successful Treatment of Cosmetic Mucosal Tattoos Via Q-Switched Laser

Tattoo removal using Q-switched lasers is well established in the medical literature, but it is not clear how tattoos on mucosal membranes should be treated because of their infrequent presentation. To report successful cosmetic tattoo removal using Q-switched laser irradiation on the oral mucosal surface. Three men with cosmetic tattoos on the orolabial mucosa of the lower lip sought permanent removal. Each patient received treatments using a Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser to the desired endpoint. Treatment of the affected area with the Nd:YAG laser resulted in clearing of the pigment without scarring. Q-switched laser treatment is a safe and very effective means of removing cosmetic mucosal tattoos on the inner lip and should be considered the criterion standard treatment option.

Cosmetic corneal tattooing: evolution of the tecnique and results

Cosmetic corneal tattooing: evolution of the tecnique and results