Paramedical micropigmentation: paints instead of a scalpel

Nadezhda Derzhnikele , head and leading specialist of the RMS professional micropigmentation center (Riga, Latvia), winner of the international competition for permanent makeup specialists Perfect Line 2005 (Tallinn, Estonia)

In this material, we want to raise the topic of paramedical micropigmentation, which is not only relevant as a kind of novelty in the field, but also often vital for clients who have lost faith in their attractiveness. Believe me, no equipment will do what a master PM can do. Interesting?

Recently, while talking with a doctor, I learned an interesting thing: in medicine, in order to be able to draw reasonable conclusions, analyze and publish your research, which will have weight and become recognized by colleagues, you need to study and analyze from a hundred to a thousand cases (depending on from the problem). Because each of these cases can be unique, not like the others, with its own characteristics, complications and consequences. It may turn out to be an exception and change the standard ideas about the course of the development of a disease or treatment, thereby changing the statistics as a whole.

So for the eight years (out of my 12 years of practice) that I have the courage to engage in paramedical micropigmentation, every time I encounter the same feeling: no matter how many procedures I have done before, I cannot accurately predict the outcome of the procedure, the number of corrections, the rest of the pigment and other points.

Working with atypical skin (for example, fibrous or affected by dermatosis) can be compared to walking through a minefield, where each time you need to move very carefully and little by little.

Of course, I confess honestly that I am still far from a large-scale study. But still, what I will talk about is based solely on my personal experience. This is a kind of quintessence of real cases, and I will be glad if this article will help some of my colleagues who decide to do this complex and specific work - paramedical camouflage micropigmentation.

Correction of dyschromia. Photos provided by the author

Dyschromia correction

First of all, I want to note an important feature: our center closely cooperates with plastic surgery clinics, dermatologists and cosmetologists. And basically it is the doctors who send us their patients when they themselves are no longer able to help. Consultation with a doctor is a prerequisite before carrying out manipulations with atypical skin, and such cooperation with clinics is a kind of guarantee of the safe consequences of your intervention.

Often it is micropigmentation that turns out to be the most effective and even the only way to solve the problem. But it is very important, before starting work, to find out whether the patient has used all the possibilities of modern medicine and cosmetology to correct this defect. I am talking about scar resurfacing with various lasers, injections (for example, lidase or hyaluronidase preparations to soften scar tissue), surgical manipulations (scar excision or plastic surgery) and pharmacological therapy. After we start the micropigmentation procedure, it is already undesirable to affect the shaded area, as this can damage, in the worst case, modify (for example, during laser processing) the embedded pigment.

So, what dyschromias can we work with? Dyschromia (from Greek dys- + chrōma ⎼ color, coloration) is a persistent violation of the color of the skin.

Dyschromias are divided into:

• congenital, that is, present in a person from birth (for example, age spots, albinism), but I do not work with these dyschromias;
• acquired: primary - arising on unchanged skin (for example, vitiligo) ⎼ and secondary - arising as a result of the manifestation of various dermatoses.

It is possible to work with acquired dyschromia. I mainly work with hypopigmentation, when the treated area is lighter than the surrounding tissue. In this case, it is easier to match the tone of real skin using different shades of pigments. When working with hyperpigmentation, where the area is darker than the base color of the skin, it is difficult to guarantee a match with the surrounding color due to the fact that we can only use white or almost white pigments.

Basically, when working with hyperpigmentation, I just lighten the dark area a little, applying the white pigment very lightly and transparently. You all know very well the features of titanium oxide, so you need to work with it in stages, gradually adding color density in subsequent corrections. A typical example of working with hyperpigmentation is the camouflage of dark circles under the eyes or the lightening of the “anchor” scar under the breast after breast reduction surgery.

Vitiligo is not a death sentence

Vitiligo can be attributed to the primary acquired dyschromia. It is important to distinguish when it is an independent dermatosis, and when it is a consequence of a certain disease (for example, leukoma with syphilis). Of course, this is determined by the doctor. I work only with long-stabilized vitiligo of small size on any part of the body.

Important features of working with vitiligo:

• be sure to do a color test a month before the main procedure (on untanned skin);
• before filling the stain, you need to circle its contours (you can use a waterproof pencil or pen);
• work should be relatively slow, densely painting the perimeter of the work, linear or circular movements are allowed;
• device settings ⎼ as for circuits;
• for camouflage of vitiligo, you need to take into account that the color may become more red during healing, I recommend adding olive-colored pigments;
• divide large vitiligo into sectors;
• care is the same as for PM.