Will you regret permanent makeup? Research findings on satisfaction and complications that emerge years later

High-quality research comparing the satisfaction with permanent makeup results to other methods is still limited, and most research focuses on complications. In a survey of 1,352 people who received eyebrow or eyeliner permanent makeup, 12.1% reported experiencing some form of complication[1][2]. Most complications are mild, but rarely, reactions can occur years later[2].

What does permanent makeup research investigate?

Research centers on surveys of complications and satisfaction. In a survey conducted in Japan, 1,352 people who received permanent makeup on eyebrows or eyeliner were asked about complications and satisfaction[1].

However, this survey focused only on pigment from a single manufacturer[1]. To confirm safety including allergies, research following multiple manufacturers over longer periods is needed, as the authors themselves note[1].

How redoing or removal of permanent makeup affects quality of life has also not been well studied[3]. Some point out that in many countries, anyone can perform the procedure regardless of qualification, and medical professionals end up managing complaints and complications[3].

What is the level of complication risk?

In the 1,352-person survey, 12.1% of people experienced some form of complication[2].

On the other hand, rare complications that appear years later have also been reported[2]. These include nodule-like swelling, eyelash loss, dry eye, pigment deposits on the iris, reactions during MRI, and dissatisfaction with results[2].

There are cases where conjunctivitis (inflammation inside the eyelid) appeared months after eyebrow permanent makeup[4]. With eyeliner permanent makeup, allergic inflammation, disruption of the tear film, and cases where pigment enters the white or black of the eye are known[4].

What changes with the pigment?

Allergies vary in likelihood depending on pigment color. Red, green, yellow, and blue pigments can cause allergic reactions[5]. For those with allergies to red pigment or prior reactions to tattoos, patch testing may be considered[6].

Attention must also be paid to the contents of the pigment. In a study of 41 types of ink sold in Europe, nickel exceeded standards in 24 samples, and even after regulation, many did not meet standards[7]. This is a survey of inks including tattoos and does not necessarily apply to all permanent makeup pigments[7].

Is there a relationship with MRI or systemic disease?

During MRI scans, the permanent makeup area may sting or swell[8]. With pigments containing metal, images may be distorted[8]. However, symptoms are usually temporary and mild, and are not considered a reason to avoid MRI[8]. Inform your healthcare provider about the permanent makeup before the scan.

Rarely, a disease with nodule formation in the skin (sarcoidosis) has been found after eyebrow permanent makeup[9]. In a 41-year-old woman, yellowish raised areas persisted on the eyebrow for several months, and examination also revealed swollen lymph nodes in the chest[9]. If eyebrow swelling or nodules persist for a long time, it is important to see a physician promptly.

What are the limitations of research? What can be said and what remains unknown

What can be said is that most complications are mild, though rarely, reactions appear years later[2]. Textbooks note that the risk of tattoo complications is overall low[6].

What remains unknown is the answer to how long satisfaction lasts and which techniques or pigments are safe when compared[1][3]. How quickly the color fades was also not found to have reliable figures in the papers examined this time.

Before undergoing the procedure, confirming the following points will provide peace of mind.

Pigment: Which manufacturer's pigment will be used and what color[7][5]

Constitution: Any previous contact dermatitis, allergies to red pigment, reactions to prior tattoos[6]

Follow-up consultation: Can swelling or nodules that may appear months to years later be examined[2][9]

Whether permanent makeup is appropriate for your skin or constitution and which color suits you cannot be decided by the article alone. During consultation, inform your physician of any past allergies, chronic conditions, and whether you have an MRI scan scheduled, and discuss pigment and results with your doctor.