Most of us have features that make us unique, original or perfectly imperfect. When we look at our self, both sides of our body are slightly different and the same applies to our face. You may notice that one eyebrow is higher than the other and this may also apply to your lip line; however, we don’t always embrace the gifts of imperfection. Cosmetic Tattooing is a wonderful option for those wanting a long lasting enhancement of the eyes, brows or lips. Don’t go to a cosmetic tattooist expecting an eyebrow lift or a smooth complexion; tattooing isn’t the most appropriate procedure for correcting percieved imperfections of asymmetry, skin blemishes, stretchmarks, and under eye dark circles. These visual imperfections may cause certain individuals to feel self concious to the point they are willing to do anything to have them corrected, but please know that tattooing pigment into the skin is most definitly not the answer.

Facial asymmetries are best referred to a beauty/dermal therapist, nurse, dermatologist or medical practitioner for treatments with cosmetic injectables, laser, skin needling, and other modalities. Correcting asymmetry with tattoo pigment may result in an undesired permanent result.

There are several cosmetic tattooing procedures trending on social media that have had disasterous outcomes.
1. Camoflage undereye dark circles
2. Camoflage stretchmarks
3. Camoflage facial blemishes

Tattooing is a skin penetration procedure using needles to insert cosmetic pigments into the dermis. To create a skin coloured tattoo pigment a white pigment is combined with some other colours to create a beige or brown coloured pigment and over time due to sun exposure, life style factors and our immune system the tattoo pigment will begin to fade.

As mentioned, the skin coloured or camoflage tattoo pigments contain titanium dioxide which is a white pigment with a large molecule, much larger than any coloured tattoo pigment particles. To create a skin coloured tattoo pigment, manufacturers often formulate white titanium dioxide with several other coloured pigments. This just means that because the white pigment is a larger molecule, it will remain in the skin long after the other colours have faded out. The difficulty is that the camoflage pigment does not does not adjust colour at different times of the year like your skin does. An example is in summer, especially in Australia, it’s hard to avoid the UV rays from the sun, so during summer often our skin may vary in colour depending how much exposure it gets to UV rays. This just means our skin may be different tones at different times of the year, however, the implanted tattoo camoflage pigment will remain constantly the same colour and won’t adjust when you get a tan or lose your tan.

Choose your practitioner wisely

The scope of practice for any practitioner is defined by their education and training. Recently there has been a push to choose qualified practitioners however; there are currently NO qualified cosmetic tattooists in Australia. A nationally approved cosmetic tattooing qualification is currently being developed through SkillsIQ however it is still in the early developmental stages and there is still a lengthy process to undertake before it gets final approvall. This qualification is definitely a move in the right direction for public health and safety

The ongoing debate in the industry is over the two day training classes where anyone can learn to tattoo a face or breast of a breast cancer patient without any formal industry experience.
In the absence of being able to see a qualification, how do we choose the most appropriate cosmetic tattooist? Price is not the ideal way to find your practitioner. It’s TRUE!! We know, there is always someone who will do it cheaper and prices vary greatly between practitioners. You may assume that the practitioner charging the highest amount is the most experienced, however, the reality is anyone can be a tattooist without any formal training. Price in this industry does not reflect ability or experience. So how do you compare “apples to apples?” Comparisons for practitioner ability should be sought through research of industry experience. Ask the following questions:

What training have you undertaken?
1. Degree = Years of specialist study (What field of study?)
2. Diploma = Months of study (What field of study?)
3. Certificate = Days of training (What was the training, was it hands on or just observation?)

Many practitioners are nurses, dermal therapists or clinical aestheticians who have studied at degree level education. If you choose a practitioner that only holds a certificate they may have learnt in a one or two day workshop. Make sure you request to see a portfolio of healed results and disregard any immediately after images because most tattooing looks great immediately after, the truth is in the healed result. If your practitioner can not show you healed results then don’t be fooled by their marketing campaign. Do not use this practitioner; take the time to go to someone who can show you a vast healed portfolio.

Don’t shop on price. After all, this is a skin penetration procedure and in most cases you will wear it on your face for several years. Tattooing involves skin penetration which means there is a risk of contracting a blood-borne virus if your practitioner does not follow and maintain infection control measures during your procedure. There is currently no qualification for cosmetic tattooing. Many practitioners aren’t beauty therapists and have no knowledge of skin, wound healing or even understand the tattoo pigment composition, often learning to tattoo in a two-day class without any industry experience. Consider the difference between value and cost, though both are defined through the perceptions of the consumer.

In researching a practitioner and in the absence of a qualification, you may want to consider the following information:

Does the practitioner hold of the following nationally accredited unit of competency?

1. Design and Provide Cosmetic Tattooing
2. Maintain Infection Control Standards

If the practitioner does not at least hold the unit of competence Maintain Infection Control Standards then you need to seriously consider the risks to your health and well being.
These following questions will allow a better judgement of the value of the service:

1. Industry affiliations and/or recognition by peers and/or public?
2. Insurance held?
3. What differentiates the practitioner or elevates them above the standard?

How things can go wrong

Potential mistake 1: The client opted to ask for a price for the work without asking about experience and jumped on an opportunity with a low cost provider without consideration of outcome.

Potential mistake 2: The client did not undertake any research, such as requesting images of actual healed work to verify that the skill set of the practitioner meets with your expectations.

Potential mistake 3: The practitioner grossly overestimated their ability.

If you are asking questions of the practitioner and they are evasive and not open with their responses and if they cannot meet your requests to view healed work then you need to seriously consider your options to use that practitioner.

Things can and do go wrong. In Western Australia if you have suffered an adverse outcome, you can lodge a complaint through The Health and Disability Services Office 08 65517600

References
Hogsberg, T., loeschner, K., Lof, D., & Serup, J. (2011). Tattoo inks in general usage contain nanoparticles. British Journal of Dermatology, 165(6), 1210-1218. Doi:1111/j.1365-2133.2011.10561.x
Serup, J., Kluger, N., & Baumler, W.
(2015). Tattooed skin and health. Basel: Karger.

Christine Comans

Christine Comans is a highly respected cosmetic tattooist, trainer and educator based in Perth who specialises in medical cosmetic tattooing. Chris is a strong advocate for industry standards and is renowned for her love of learning and sharing her knowledge.

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