Side effects: what can happen after permanent makeup?

Olga Koryakina , dermatocosmetologist, mesotherapist, anti-age medicine specialist, member of associations UADV, UALDVK, MAEKM, NOM (Ukraine)

Even with correctly performed permanent makeup, we can encounter negative side effects, which, of course, will not bring joy to either the client or the master. Forewarned means forearmed, so you need to be ready for anything, including such troubles as herpes. Our task is to prevent its occurrence

In one of the materials , we talked about contraindications and started discussing the topic of side effects, the first of which was swelling. So that the reflection in the mirror does not cause sharp attacks of self-pity for your beloved each time (and it doesn’t matter whether you are a patient or a master), we will analyze what other consequences of eyebrow tattooing can be and how to avoid them. If the procedure is carried out correctly, it very rarely happens that due to the fragility of the vessels, increased bleeding and the use of adrenaline or epinephrine-containing drugs that block capillary bleeding, the blood lingers under the skin for a long time, forming hematomas (as a rule, they disappear within a day). Hematomas on the mucous membranes membranes and the red border of the lips pass without a trace in 24⎼48 hours, on the skin such hematomas can linger up to 3⎼4 days. In any case, superficial hematomas do not affect the final result of the procedure. Scabs, darkening and tightness of the skin⎼ such symptoms are a normal reaction. Do not forget that after the end of the procedure, it is worth lubricating the skin of the area where permanent makeup was performed with wound healing ointment. Do not panic if the color of the crust differs from the selected shade. After 2⎼5 days, the crusts peel off, after a week a preliminary result will be visible, and after 20 days the color may change slightly. And already the final result should be expected approximately 28 days after the procedure (a full cycle of epidermis renewal).

Virus: what and how?

I want to dwell on the most common problem in more detail. As doctors say, the best treatment is prevention, and therefore, knowing the nuances and possible complications, we can save our and the patient's time and nerves.

Herpes is the most common complication after tattooing and lip contouring. Statistics say that these procedures in almost 99% of cases lead to an exacerbation of herpes of the lips, even for those who have had it only once in their lives! But only if preventive measures have not been taken. Prolonged mechanical traumatization of the red border and the introduction of a foreign dye substance are a powerful stress factor for the skin, leading to the death of a large number of epithelial and epidermal cells. It is these short-lived cells with a high level of metabolism that are a favorite place for the colonization of the herpes simplex virus (HSV), therefore, after this kind of cell damage, a very rapid activation of the persistent virus occurs. Within a few hours after the injury, the reproduction of virions reaches hundreds of thousands!

The infectious process that has begun is sometimes difficult to stop, so postherpetic skin dyschromia due to local "eating of the pigment" and uneven lip contour can become a rather unpleasant consequence of the procedure. In the case of secondary bacterial infection of the focus against the background of weakened immunity and inadequate treatment, cicatricial changes in the skin are possible.

As a rule, herpes on the lips occurs as an exacerbation of a viral infection that the client already has. The herpes simplex virus is characterized by the ability to continuously and cyclically multiply in infected epithelial cells, nerve ganglia. Therefore, any damage to these structures, especially in an immunodeficient state, leads to an exacerbation of herpes infection.

The signs of immunodeficiency are well known to everyone:

• chronic foci of infection in the nasopharynx;
• frequent colds;
• atrophic scars after acne;
• poorly healing skin lesions;
• exacerbation of herpes more than 2 times a year and others.

Considering that 98% of urban residents are infected with HSV, and the ecology and pace of urban life cause permanent damage to health, there are practically no people with non-recurrent herpes today. Therefore, at present, the recurrence of herpes 1⎼2 times a year is considered a variant of the norm, 3⎼6 times a year ⎼ a situation of moderate severity (in this case, one should already think about immunocorrection), more than 6 relapses ⎼ a severe course of the process against the background of a pronounced immunodeficiency state.

How to outwit herpes?

According to the recommendations of experts, the simplest and most reliable method of prevention is to prescribe suppressive doses of acyclic nucleosides 1–2 days before the procedure and during the next week: acyclovir, zovirax or virolex 400 mg 2 times a day or valtrex ⎼ 500 mg once in a day. Unfortunately, this therapy does not give a 100% guarantee of the absence of post-traumatic relapse: according to statistics, in 7% of cases there are resistant or insensitive strains of HSV to acyclovir. An alternative choice is famvir at a dose of 250 mg daily.

Immuno- and vaccinal prophylaxis lead to a decrease in the frequency of relapses due to the stimulation of cellular and interferon immunity, the production of virus-neutralizing antibodies. But this treatment option is quite long and does not prevent the exacerbation of herpes with specific skin lesions.

Herpes on the lips or on the face can cause a lot of aesthetic problems. Herpes lands on the edge of the upper or lower lip, sometimes on the eyelids. In order not to be upset about unaesthetic sores, it is worth trying to prevent the exacerbation of herpes. The herpes virus "wakes up" gradually. First, at the place where the sore appears, the lip or skin on the cheek swells. Then there is a burning sensation, itching. And only then small bubbles form, which, bursting, form a dark crust. Then the crust dries up and dies. So, rashes will not appear if, within 24 hours after the onset of the first symptoms, Zovirax, acyclovir or panciclovir is applied to the painful area. These drugs are sold in pharmacies without a prescription. The cream is applied 5 times a day, every 4 hours. But at the same time, the use of antiviral ointments is undesirable, since they contribute to the removal of the coloring pigment from the skin and the appearance of whitish areas. External use of creams and cosmetic balms is useless as a prophylaxis, but necessary for the manifestation of skin manifestations of herpes.

For care after the lip tattoo procedure, it is recommended to use ointments with a pronounced anti-inflammatory and wound healing effect. At the same time, the use of ointments containing antibiotics, hormones and other healing stimulants is strictly contraindicated, as they affect the quality of implantation of the coloring pigment into the skin. In the future, it must be remembered that UV rays can provoke a recurrence of herpes, as the skin of the lips dries, microcracks appear and the likelihood of herpes increases. To avoid this, it is recommended that when visiting a solarium, the beach and in general in everyday life, especially in frosty, windy, hot weather, with increased dryness in the room, regularly moisturize your lips with hygienic lipstick, preferably with SPF (sun protection factor).

And what else?

Another, no less annoying complication is cheilitis, or inflammation of the lips (red border, mucous membrane and skin). The red border, mucous membrane and skin can be involved in the pathological process in many dermatoses: erythematosis, lichen planus, psoriasis, tuberculosis, syphilis, etc. There are various classifications of cheilitis, but this is already dermatology, so I will not overload you with it. What's more interesting to you colleagues is chronic recurrent lip fissures (CRTG), which are worth looking into as they are already broken skin and therefore a potential weak point for complications.

Allocate:

• central lip cracks;
• paracentral;
• commissural.

Exogenous factors that cause cheilitis and cracked lips are chemical, biological, pharmacological and toxic substances that also determine the development, nature of complications and the outcome of this pathological process. High or low humidity, high or low air temperature, wind, dusty rooms, solar radiation, etc. contribute to the development of cheilitis and cracked lips. The microbial factor plays an important role in the occurrence of lip diseases, starting with the appearance of cracks and maceration in the corners of the mouth, more often in older people with reduced immunity, decreased tissue turgor, and loss of teeth. Angular cheilitis is a streptococcal or mycotic infection, often a manifestation of atopy. Chronic cracked lips and cheilitis are often accompanied by diseases of the internal organs, the highest frequency of lip diseases in the pathology of the gastrointestinal tract.

The material was first published in Permanent No. 4/2016