When it is better to refuse a permanent: advice from a dermatologist

Alina Mantula , dermatovenereologist, candidate of medical sciences, head of the department at the Euroderm clinic

PM masters sometimes face such a problem as skin diseases in a client. To do or not to do permanent makeup in this case is your and the client's choice. But still, it is worth remembering that with some manifestations on the skin, the procedure can not only be accompanied by painful sensations, but can also provoke an aggravation of the disease, and in addition, worsen the appearance even more.

Recently, the procedure of permanent makeup not only has not lost its relevance, but continues to develop, constantly replenished with new techniques and techniques. They are characterized by less trauma, and the refinement of the work of the master gives the maximum naturalness to the result. Permanent makeup has gained wide popularity among women of all age groups. But the other side of the coin was an increase in the number of complications after such procedures.

As you know, permanent makeup is the process of introducing pigment into the skin. The procedure is accompanied by a violation of the integrity of the skin, which can cause a number of complications . Among the risk factors influencing the development of complications, one can single out the effect of the active components of the pigment injected into the skin during permanent makeup. The most common of them are infectious and inflammatory (bacterial, viral, fungal) and allergic processes. But, in addition to complications, there is a risk factor in which the PM master must carry out the procedure with extreme caution or even refuse to work with the client. We are talking about skin diseases.

Photo 1. Rosacea

The group of dermatological diseases with localization in the face area is numerous and heterogeneous. The most common ⎼ are inflammatory diseases with lesions of the piloseborrheic complex, including seborrheic dermatitis, acne, acneiform dermatosis, perioral dermatitis, rosacea. Often there are diseases associated with a violation of the pigment-forming function of the skin: vitiligo, melasma, melasma; autoimmune diseases: psoriasis, discoid lupus erythematosus, dermatomyositis, scleroderma. Also in recent decades, the problem of non-melanoma skin cancers and actinic keratosis, in which the face is the most common site of clinical manifestations, has been relevant.

Unfortunately, in some cases, an isomorphic reaction to permanent makeup can cause the manifestation of dermatological diseases, such as allergic dermatitis, psoriasis, lichen planus, cheilitis, eczema, and can also cause the formation of granulomas. Often, permanent makeup leads to an exacerbation/debut of diseases, often localized in the face area.

Photo 2. Discoid red Volzhanka

Rosacea: is there a risk?

Of particular interest in this regard is rosacea - a chronic disease of the skin of the face, characterized by redness, expansion of small and superficial vessels, as well as the formation of papules, pustules. Most often, rosacea occurs after 30 years, and this is exactly the age group of women among whom permanent makeup is so relevant. The leading role in the development of the disease is played by vascular disorders (often of a constitutional nature), disorders of the endocrine system and the gastrointestinal tract, psychosomatic and immune changes.

It should be said that in the secretion of the sebaceous glands in rosacea, there is an increase in the content of porphyrins, which contributes to pronounced photodamage (photoaging of the skin), the development of actinic elastosis. For many years, the presence of a mite of the demodex folliculorum genus was considered the leading cause in the development of rosacea, but now this theory has lost its primacy, but at the same time, assumptions about its indirect influence in the formation of rosacea remain relevant.

It is very important that the initial manifestations of rosacea are insignificant and can only manifest as episodic hot flashes (diathesis rosacea), persistent moderate erythema (in the form of severe reddening of the skin caused by the expansion of capillary vessels) and single telangiectasias (persistent expansion of small vessels of the skin non-inflammatory nature, manifested by spider veins or reticulum). In the future, with an unfavorable course of the disease, the clinical picture becomes pronounced, while the erythema is already persistent, multiple telangiectasias, papules, pustules, and sometimes nodular cystic elements appear. Subjectively, patients note a feeling of heat, burning and itching. It should be noted that at first only the central part of the face is affected, however, in the future, lesions can also be in the area of the auricles, neck, chin, and nose.

It is important for permanent makeup specialists to know that eyelids and conjunctiva are also affected by this disease. Clinical manifestations of ophthalmic rosacea are diverse. It can also be a lesion of the eyelids, manifested by chronic posterior blepharitis, dysfunction of the meibomian glands, sebaceous cysts, recurrent styes, chalazions. The conjunctiva may also be involved in the process, but the manifestations are nonspecific and are characterized by conjunctival telangiectasia, chronic diffuse hyperemia, granulomas, and in some cases conflicts. Corneal lesions occur in 5⎼15% of patients with rosacea, are characterized by the severity of the course and frequent complications up to loss of vision.

Often, the inflammatory elements of the rash are also localized in the perioral region, on the border of the skin and the red border of the lips. In this case, it is categorically not recommended to carry out permanent makeup in order to avoid complications of an inflammatory, as well as septic nature.

In conclusion, I would like to note that in the pursuit of beauty and perfection, it should be remembered that invasive procedures, including permanent makeup, can cause a number of complications.