Permanent

Makeup
Milady’s Aesthetician Series
Tips & Techniques
 Ch. 1 Introduction to Permanent Makeup
Key Terms:

Alopecia Hippocrates Tatua

Applied Cosmetics Hippocratic Oath Technique Sensitivity
Ayurveda Hypersensitivity Unguent
Chi Kakua Yin and Yang
Four Humours Permanent Makeup

Review Questions:

1. When did permanent makeup begin?

2. Why is makeup so important to women?
3. What does makeup tell us about women?
4. What are the career choices for permanent makeup artists?
5. Why would someone choose one permanent makeup career path over another?
6. Why is investigating insurance options important?
7. What are the four concepts that come together to create a talented permanent makeup artist?
 INTRODUCTION

From the beginning of civilization people have been looking for new and innovative
ways to improve their appearance. Both men and women have the desire to look better.

Today, the aesthetic industry in the United States alone is a MULTI-BILLION DOLLAR
business. This desire within all of us, has created a HUGE industry that continues to grow
exponentially globally.
One of the emerging services of today is Permanent Makeup, which is also referred to as:
- Dermapigmentation
- Microdermal Pigmentation
- Dermal Graphics
- Cosmetic Tattooing
- Micropigmentation (among other names).

This process is the introduction of permanent pigments into the skin as an alternative
to removable, daily applied cosmetics.
 EVOLUTION OF SKIN CARE

Today we use a much more medical and scientific approach that not only
enhances the appearance of our face, but also improves the face down to the
cellular level.

The Chinese were the first to understand medical fundamentals that are still
practiced today. Traditional Chinese medicine dates back over 5000 years to the
writing of Fu Xi. His texts, called “Trigrams”, relied on theories of Yin and Yang. Yin
and Yang represent harmony between nature and its daily phenomenon.

The Chinese methods involving Chi (Qi), the balance of nature and imbalance
of illness, are important foundations on which contemporary western medicine
was constructed.
 EVOLUTION OF SKIN CARE: continued...
In Egypt, Ancient Egyptians routinely
used animal oils, alabaster, and salts to
enhance the appearance of their skin.
Egyptian women even soaked in sour milk,
unaware that the lactic acid would
exfoliate their skin and cause it to become
softer. Egyptians are credited for creating
the distillation process, which they used to
extract oils and other essences for the use
in both ceremonial and aesthetic contexts.
The Grecian empire had
Hippocrates had named the Four
Humors (blood, phlegm, yellow bile, and
black bile), the balance of which defined
a person’s characteristics. They also
created the Hippocratic Oath, which are
still taken today by physicians and
require people in attendance to work
cohesively. Greeks also used accessories
and adornments to enhance their
physical appearance, including pigments
like Vermillion for facial coloration.
 EVOLUTION OF SKIN CARE: continued...
The Indian concept of Ayurveda
(the science of Living), became part of
the foundation of Western medicine. In
Africa, colorful decorations of the body
were offered as gifts to the Gods, which
are still celebrated today. Native
Americans wore elaborate beads and
headdresses for hierarchical and
aesthetic purposes. They also were
practiced herbal wound healing.
In Europe, during the
Dark Ages, King Henry IV
issued the “Order if the
Bathe” due to the plague
and other diseases.
During the Renaissance,
significant breakthroughs
in science/technology
made medicine more
reliable and aesthetics
more beautiful. The
Victorian Era, elaborate
gowns, head dressings,
and makeup made women
stand out.
 EVOLUTION OF SKIN CARE: continued...

However most remarkable advancements in medicine and aesthetics have

been made in the last 25 years or so. Notably, these advancements create chaos and
fragmentation in industries, such as retail product industry, the medical industry,
and the spa and skin care industry. Leaving the consumer with many choices, asking
themselves, “Where do i go and for what exactly?”...
 HISTORY & ORIGINS OF PERMANENT MAKEUP
The history of P.M has 2 convergent
histories.
One timeline begins with the history
of skin care and makeup. Beginning with
the egyptians’ use of unguent and moving
into the use of lipstick (13th century) .
For example, during the Bosnian war,
a women would give up anything from the
house that she did not absolutely need and
skimp on things for the family (like food or
soap) to buy a tube of lipstick.
The 2nd part of the history is of
tattooing. Tattooing has been around as
long as the beginning of time with
makeup. First discovered in Samoa,
tattooing infatuated men and women,
but started as a rite of passage for men.
These 2 separate art forms
eventually merged into the field of
permanent makeup.
 HISTORY OF MAKEUP

Both men and women have adorned makeup
since the dawn of civilization. Makeup has been used
to denote concepts such as wealth, beauty, and
strength etc. Beauty immediately became a hot
commodity.
Egyptians started at the beginning of time using
unguent as a moisturizer that both men and women
used for soft skin and to avert wrinkles. Egyptian
women also wore kohl, a metallic element aka
antimony sulfide, to darken the eyelids and their
lashes. Women from egypt and rome used kohl for
hundreds of years.
In Europe (Middle Ages), A pale
natural complexion became associated
with a wealthy lifestyle, and women
would nearly bleed themselves to death
to achieve this look. With the invention
of pink lipstick (13th century) a pale
face with pink lipstick became all the
rage by women who were actually able
to afford it.

The romans used chalk to lighten their

complexion, rouge developed from berries to apply
color highlights the face, and pumice to whiten teeth.
 HISTORY OF MAKEUP: continued...

In the 14th/15th century, women began To protect their skin from tanning ,
using lead to paint their face lighter, which cast a individuals wore heavy garments, caps
dangerous reputation with cosmetics. and bonnets, and used parasols.

During the plague in Europe, makeup was Men and women wore rouge. And
used to impart an image of health and well being then the heavy makeup look with deep
to others who feared falling ill. colors became identified as ladies of the
night.
In the 18th century, the french wore heavy,
clown-like makeup to give the impression of a
vivacious spirit underneath. This overdone look
soon passed and a more minimalistic period was
ushered in with the Victorian Era.

Skin lighteners made from lead and mercury

caused illness and death in some people who used
them.
 HISTORY OF MAKEUP: continued...
At the beginning of the 20th century,
began the modern era of makeup. Two big
names hit the beauty industry at this time.
Max Factor (who invented the first
pancake makeup) , and the second was
maybelline (who developed the first mascara).
Soon pressed powders and compacts
appeared, followed by blush, and twist lipstick
cases.
Victorian look prevailed until
1920-2930’s when the film industry took off!
The free-wheeling flappers of the day took a
lead role in making makeup a necessity for the
urbane jet-setting type.
Thanks to Hollywood, the
makeup industry has models galore to
market their product, and trends took
flight. Since that time, many styles,
trends, and fads, in makeup have come
and gone, sometimes coming back
around again!
We have come from the vamped
cat eye to a more moderate and
healthy look; but the use of makeup
has become universal for most
American women and men too!
 HISTORY OF TATTOOING
Although seeing a person covered with
body art today is not uncommon, the
practiced was reviled and nearly suppressed
by western decent not too long ago.
Egyptians were among the first to
practice tattooing, dating back to 4000 BC
there are figurines painted with tattoos on
the faces.
Anthropologists believe that
tattooing was being practiced in
various parts of the world at this time.
In the Australian Alps, a 5300
year old cave dweller, named “ Otzi
the Iceman,” was found with over 50
tattoos covering is body, suspected to
have been intended to relieve pain
and aches.

A mummy of a woman from Thebes from

Dynasty XI was discovered, whose tomb
later identified her as Amunet, Priestess of
Hathor (2160-1994 BC), tattoo patterns
remain clearly visible on her flesh.
 HISTORY OF TATTOOING: continued...

Polynesians, (Samoans), are a culture that began the Hawaiian people practiced kakua
art independently. They were the ones who introduced (dark nuts that dyes were made), which
the practiced to the west and have been practicing the served the purpose of distinction,
tradition known as tatua for well over 2000 years. ornamentation, and guarded health and
spiritual well being. Designs were
This tradition has been passed from father to son, applied using a bone tied to a stick,
using an au, or special tattooing comb made from boar's which then was struck with a mallet.
teeth fastened together with the use of a tortoise shell
and a handle. People were often designed to
commemorate a fallen chief or family
This was normally performed on young men used as member. Kakua usually adorned the
a rite of passage, receiving his tatua beginning from his arms, legs, face, and torso of men, as
torso going down to his knees, as a requirement to be well as the hands, fingers, and wrists of
given a leadership role within the tribe. This process was women.
risky and painful, but not enduring the full tatua was
equivalent of a scarlet letter.
 HISTORY OF TATTOOING: continued...

The Greeks and Romans also used
the practice of tattooing.
The greeks learned from the
persians. Tattooing is mentioned in
accounts by Plato, Aristophanes, Julius
Caesar, and Herodotus. Tattoos were
usually used to mark slaves and
criminals.
18th century, Captain James Cook
also introduced the practice of tattooing
into western culture. Reviled or reveled,
people were curious of the fascinating
designs that were permanently inked into
the bodies of the polynesian natives.
In 1846, Martin Hildebrandt opened
the first tattoo parlor in New York City.

The Romans adopted tattooing

from the Greeks. (4th Century) The first
christian emperor of Rome banned the
facial tattooing of slaves and criminals. In
787, Pope Hadrian prohibited all forms
of tattooing.
 HISTORY OF TATTOOING: continued...

The art of tattooing was revolutionized in the last

decade of the 19th century. Samuel O’Reilly invented the
electric tattoo machine. Military men began to popularize
this art by getting tattoos that told their rite of passage
and it started to become mainstream.

By the middle of the 20th century, tattoos were

everywhere in American popular culture. Both men and
women adorn them and where them for many of the same
reasons they did 2000 years ago, although designs have
changed. In the past tattoos were reviled and concealed;
today, they are admired and displayed proudly.
 WHAT IS PERMANENT MAKEUP?

Permanent Makeup uses permanent pigments to apply a color to the recipient, most often done on
the face, particularly around the eyes, brows, and the lips.

Permanent Makeup is not only an art form, but a science in the sense that it is a methodical activity
whereby knowledge is gained through experience. It is a trade, a skill, a science, and an art.

You must have knowledge of the skin and how it heals, color theory, hand and eye coordination,
communication skills, time skills, and much more…

Four components combine to decide the outcome of permanent makeup:

(1) The skill of the technician
(2) The type of machine or device used to perform the procedure
(3) The type of pigments used
(4) The integrity of the client’s skin
 WHAT IS PERMANENT MAKEUP: continued...

Permanent Makeup is also a technique Finally, NOT EVERYONE is a good

sensitive, meaning that the outcome depends on
the skill level of the person performing the
procedure.
Having all the necessary knowledge of skin
anatomy, color theory, and the devices used will
enable a newer technician to have higher instance
of success.
candidate for permanent makeup. Some
individuals may be taking medication that
may disqualify them or their skin may be
resistant to it for the procedure. These are
obstacles that the technician must identify.

For example, there are many different types of

machines used for this procedure and it is up to the
technician to consult with your client and choose
the best machine for the best results for them .
Your consultation with your client will determine
not only the type of machine to use, but what color
pigments to design with.
 WHO BENEFITS FROM PERMANENT MAKEUP?

Reasons that Lead Clients to Permanent Makeup

-Poor Vision -Multiple Sclerosis
-Limited Time -Burn Injuries
-Limited Dexterity -Alopecia
-Allergies to applied cosmetics -Loss of Limbs
-Active Lifestyle -Paralysis of Limbs

People who suffer from disorders such as alopecia, an experience of permanent hair loss
all over their bodies and frequently seek permanent makeup services. Permanent
Makeup may also help people who have allergies or hypersensitivity to the ingredients in
many cosmetics, a fairly common disorder.

Obviously, many other people have equally variant reasons as to why they choose to have
permanent makeup, and the procedure is increasing in popularity, therefore you will have
the luxury of specializing in a procedure that is in demand.
 BENEFITS OF PERMANENT MAKEUP

Permanent Makeup allows the recipient the benefits of looking good without the time,
cost, and hassles of application and reapplication.

Those in need of a solution to time management routines of getting ready or individuals

who suffer from diseases and disorders who need a cosmetics applied in a simpler way,
with less maintenance for them.
 CAREER OPPORTUNITIES

Permanent Makeup Technicians have career opportunities in many places and can
specialize in certains areas within the art such as:
-Facial Cosmetic Tattooing -Decorative Tattooing
-Paramedical Tattooing -Camouflage Tattooing
-Specialty of Brows, Lips, or Eyes

Where to Take your Skills?

-Medical Offices: Dermatology, Oncology, Cosmetic Plastic Surgery,
Reconstructive Plastic Surgery

-Salons and Spas: Usually offer procedures of eyes, lips, and/or brows

-Entrepreneur: Run your own business, Booth Rent, Sola Salons, Salon Republic
 LICENSE & INSURANCE

Whether you are working in a medical office, a medi-spa, a day spa, or in your own facility,
you should be certified in the state in which you work.

If you work somewhere your employer will want you to provide evidence of your
certification or licensure before beginning your employment. In some states your license
or “certification” must be displayed as a requirement to perform procedures.
Uncertified/Unlicensed technicians SHOULD NOT be working until all legal criteria has
been met.

It is very important for permanent makeup technicians to have insurance, especially for
the malpractice policy, which is an insurance policy that covers your actions while
treating a client. This policy PROTECTS you as a technician.

If your employer covers your insurance policy as an employee it is important to know

EXACTLY what the policy covers and to what extent.
 LIABILITY ISSUES FOR THE TECHNICIAN

Liabilities are obviously part of the job if you are a permanent makeup technician. Clients
can sue you for just about anything, from a poor result to actual physical harm such as eye
damage.
The best way to avoid confrontation, liability, and litigation is to be proactive in your job.

This includes:

(1) Turning away clients who you believe are not suited for treatment
(2) Discussing in depth the risks and complications of permanent makeup
(3) Having a dialogue about the desired and final results

As we explore the contraindications and complications of permanent makeup take note

to evaluate tactics to avoid potential liability.
Ch. 2 Anatomy and Physiology
Key Terms:
Adipose Cells Anastomose Antagonist Anterior Aponeurosis
Avascular Basal Layer Capillaries Ceramides Cholesterol
Cranial Nerve V Cranial Nerve VII Dermal-Epidermal Junction Dermis
Desmosomes Elastin Epidermis Fatty Acids Frenulum
Glycosaminoglycans Hypodermis Innervates Integumentary System Keratinization
Keratinocyte Lamellar Granules Lateral Lipids Mandible
Masseter Maxilla Musculature Musculocutaneous
Perforators Nasolabial Lines Obliquely Ophthalmic Organelles
Orifice Palpebral Papillae Periocular Pons
Rete Pegs Reticular Reticular Dermis Sebaceous Glands Skin Turgor
Sphincter Stratum Corneum Subcutaneous Supraorbital Transverse
Urea Venules

Review Questions on Next Slide

Ch. 2 Anatomy and Physiology
Review Questions:
7. What are some of the major vessels in the face?
1. What is permanent makeup?
8. What are the major functions/location of the
cranial Nerve V & VII?
2. Why might someone consider permanent
makeup? 9. What are some of the muscles in the forehead
and their functions?
3. What are the 5 sublayers of the epidermis?
10. What are some of the major vessels in the
4. What are the sublayers of the dermis? perioral region?

5. What is hypodermis? 11. What are some of the major vessels in the
perioral region?

12. What is the importance of the face structure

for permanent makeup?
 ANATOMY OF THE SKIN

The skin and its appendages-nails, hair, nerve endings, sweat, and oil glands- compromise the
integumentary system, sometimes referred to as “integument”.

The skin is far more complex and variant than what meets the eye, it changes in thickness and in sensitivity
based on the areas of the body.

Overall, the skin is what possesses most of the nerve endings that transmit vital information about our
environment to the brain.

The sensations we feel by nerve connections (located mainly in the 2nd layer of the skin called the dermis)
are, in turn, sent to our brains for processing and translation.

Facts About Skin

-The fact that matter changes as it ages is a natural order of life; changes in the skin inevitably
happen as years pass
-The skin is only as thick as a few sheets of paper
-Skin is not immune to the laws of gravity
-Collagen and elastin production slows dramatically: 65% between age 20 and 80 years
-The thickness of the skin decreases a staggering 6% every 10 years
 LAYERS OF THE SKIN

The skin is composed of two main layers:

The top layer is the epidermis, which is tough because of its exposure is constantly being worn down and
replaced. The outermost layer contains no blood vessels or nerves and is vital in preventing loss of moisture from
the body.
The deeper layer of skin, the dermis, and the subcutaneous fat beneath it (a.k.a the hypodermis) lend
strength and elasticity to the skin.

Epidermis:
● The epidermis is avascular (without blood vessels), impermeable to water, physically tough, and relatively dry
at the surface to impede the growth of microorganisms.

● The skin is thickest on the palms of the hand and soles of the feet, and thinnest on the eyelids, a point
noteworthy to people who will be performing permanent makeup procedures.

● Epidermal cells are born and die and are replaced by new one, in short, the epidermis is our self-replicating
defense against everything outside of us.
 LAYERS OF THE SKIN: continued...

The epidermis is further divided into 5 sublayers.

These sublayers are characterized by stages of hardening, maturation, and eventual death in the migration of their
major cell type, the keratinocyte (any cell in the skin, skin, or nails that produce keratin.)

Each month, these cells start migrating from the bottom layer of the epidermis, called the basal layers, traveling
upward until they arrive at the Stratum Corneum, the outermost layer.

● The stratum corneum is the outermost or “superficial layer” of the dermis. This is where cells completely
their journey, soon to transition to death, at which time they are eventually sloughed off.
● Below this layer is the stratum lucidum. This thin, clear band of closely packed cells is most prominent in
areas of thick skin and may be absent in other areas…
● Stratum granulosum signals transition of the cells within it. The keratin loses the nucleus and organelles,
becoming flat, before moving farther up into the stratum corneum. This layer is called the stratum
granulosum because of the granules that now appear in the cells, as the granules grow in size, the nucleus-the
power generator of the cell-disintegrates and dies.
● Stratum spinosum means spiny layer, cells in this sublayers are intertwined with tiny structures called
desmosomes.
 EPIDERMIS: continued..

Demosomes resemble hair combed with an eggbeater, which is why this part is called the
prickly-cell layer. The hairlike demosomes permit materials to move around them in the intercellular
space. Lamellar granules that are found here, greatly contribute to the skin’s moisture.. These
granules contain lipids and other components such as cholesterol, fatty acids, ceramides, and
enzymes.

- The basement of the epidermis is appropriately called the basal layer or stratum basale. It
anchors the epidermis to the dermis. This layer contains germinal cells for all sublayers of the
epidermis.
In this layer stem cells produce two types of cells.
- Basal cells remain in the basal layer, creating a solid skin foundation.
Keratinocytes begin their upward migration to the stratum corneum.
 DERMIS

Below the epidermis, the dermis resides. The dermis is In addition to its holding properties the
crisscrossed with three types of fibers that one strength and popularity dermis has another important function in
elasticity. These fibers reticular, collagen, and elastin and form a regulating the parents of the skin surface because
network that create stability for the skin. Type I collagen runs the sublayer houses glycosaminoglycans (GAGs).
throughout the dermis and is responsible for its tensile strength and GAGs are a variety of chains made of
perfect for providing skin its youthful appearance of tightness, polysaccharide, a type of complex carbohydrate.
firmness, and fullness. The combined strength of these tissues GAGs are thought capable of binding up to 1000
anchors the epidermis above to the subcutaneous tissue below. times their weight in water, this moisture-attracting
property makes GAGs one of the most important
Epidermal appendages such as sweat glands and hair follicles components in our study of the skin.
are embedded in the dermis which also serve as an period for blood
vessels. The dermis which varies, but is approximately 2 mm thick, is
further subdivided into the papillary and reticular layers. This
subdivision is based on differences in collagen texture. The papillary
dermis, the most superficial layer of the dermis, is the first skin layer
to contain capillary blood vessel, small nerves, and lymphatic vessels.
Because of the papillary dermis contains blood vessels and blood
vessels provide temperature changes when they constrict or dilate
papillary dermis is specifically responsible for thermoregulation of
the body.
 DERMIS: continued..
Reticular dermis is located beneath papillary dermis
and rest on the thick pad fat known as the subcutaneous
tissue. The real anchor of the skin can be found at this level.
Within the reticular dermis are structures called rete pegs.
These pegs extend up into the epidermis to hold the dermis
to the epidermis. The structures are responsible for holding
the epidermis and dermis together to create a skin. Capillary
networks run through rete pegs as tiny elevators bringing
nutrients to the epidermis. Widened vessels in the rete pegs
cause broken capillaries. People with transparent or very
light skin may flush or blush, causing a dilation of the
capillaries in the rete pegs.
As time passes, collagen and elastin weaken, and
the skin begins to lose tensile strength and skin turgor. In
turn, lines of depression deepen. The DEJ flattens and
begin to undergo atrophy. Meanwhile the quantity of
blood vessels decrease. This decrease in vascularity
causes the hair, nails, and other appendages to appear
gray and dull; the appendages can also become weaker
through he process of aging. Whereas hound skin is
translucent and can retain moisture easily, older skin can
no longer retain moisture as it did before, resulting in
skin that becomes drier and flakier.
As a result of dermal aging process and the degradation
of the dermal layer, the skin has impaired healing abilities
as we grow older. All of this information sounds pretty
dismal l. Even though we cannot turn back the hands of
time. We can stimulate the dermal layer to continue to
produce collagen and encourage increases in vascularity.
Some of the improvement of the dermal layer will come
with exercise, and other improvements will come with
skin treatments.
 HYPODERMIS OR SUBCUTANEOUS TISSUE

Under the reticular dermis lies the hypodermis, or

subcutaneous fat. Composed of clumps of fat-filled cells
called adipose cells, the hypodermis is the cushion layer of
the skin and helps protect internal organs from blows; it acts
as an insulator, conserving body fat.

The attachment of subcutaneous tissue to reticular

dermis is loose, allowing the skin a degree of shifting
movement over muscle and skeletal structures. The
subcutaneous tissue is crisscrossed with connective tissue to
fibers and layers interspersed with fat to hold it together.
When pockets of fat accumulate between the connective
tissue bands beyond the ability of the connective tissue to
hold it smooth, the appearance is called cellulite or orange
peel skin. Women generally have thinner skin and less rigid
connective tissue bands than men do, therefore, makes it
more apparent in women mainly in certain areas such as, hips,
thighs, and buttocks.
 ANATOMY OF THE FACE LOCATION OF MAJOR VESSELS OF FACE & NECK

The face is a complex, interrelated To perform permanent makeup services,

network of skin, nerves, vascular entities,
muscles, and bones. Together, these
components give us our unique looks and
expressions, it is our identifier. Facial
expressions create a unique facial definition
based on the musculature we use.
you MUST know where the major blood vessels
in the face and neck are located.
Blood flow affects complexion, as well as
the healing processes, which a are vital
component to a lot of the treatments that you
will be performing.

Three important anatomic systems give

the face structure, expression, and life:
vascular system, nervous system, and
muscular system.
 LOCATION OF MAJOR VESSELS OF THE FACE & NECK: continued...

Major Vessels in the Face and Neck

-Carotid Artery -Angular Artery and Vein

-Jugular Vein -Infraorbital Artery and Supraorbital Vein
-Facial Artery and Frontal Vein -Labial Artery

Blood is a complex fluid that carries electrolytes, nourishment, groom ones, and other components through the arteries to
the tissues. Generally speaking, you can think of arteries carrying pure blood and veins “impure” blood. Through the venous
system, blood carries away the carbon dioxide and other waste materials.

Blood from a vein is dark red or purple and simply drains or flows from the vessel, while blood that comes from an
artery is bright red or scarlet color and pulsates from the vessel. The difference in color is of course related to the levels of
oxygen and carbon dioxide.

The scalp and face are richly supplied with blood. The large artery that supplies the head and neck is well-known
carotid artery.

The vein that drains blood back to the heart is perhaps ever better known: the jugular. Knowledge of anatomic
landmarks is important for practicing permanent makeup.
 ARTERIES VEINS

One major artery found in the neck, the carotid artery, is Veins carry impure blood in increasingly
composed of external and internal branches. As the external carotid larger vessels back to the heart. Venous “twigs”
courses up the neck, it's size rapidly diminishes as it splits off into are called venules, small blood vessels with thin
smaller branches. At about the temple, the external carotid artery walls that receive blood from capillaries and
becomes the temporal artery. Branches of the external carotid and convey it into veins. The walls of venules are even
temporal artery that serve the face include the facial, the transverse thinner than those of capillaries. Walls of even
facial, and the anterior temporal arteries. Arteries and veins blend larger veins are so thin, if fact, they collapse when
into each other at a molecular level. empty. Certain points of a vein, along its length,
have slight constrictions indicating the existence
If we trace the path, the carotid artery courses up the neck, of the valves meant to prevent backflow of blood.
dividing into smaller and smaller branches into the smallest of a
body's blood vessels, called capillaries. The walls of capillaries
comprise only one layer of cells so thin that single molecules can
pass through them. Useful molecules such as oxygen, water, and
lipids diffuse out of capillaries into tissues, which take them up as
nutrients, while waste products such as carbon dioxide and urea
diffuse back into the venous side of the equation. Most bleeding
that is associated with permanent makeup treatments is at the very
small arteries and veins, arterioles and venules, just before they
connect to each other to make the capillary bed.
VEINS: continued...
Our subject is the face, and we pick up our venous trail
at the “roots” the venules, which anastomose, or connect with
arterial capillaries. On the forehead, these venules rapidly
enlarge into the frontal vein, which, communicating with
tributaries of the temporal vein, converge into a single truck
that runs downward at about the middle of the forehead
parallel with the vein on the opposite side. These two trunk
unite at the root of the nose by means of a transverse branch
called the nasal arch. Still at the root of the nose, the veins
diverge to join the supraorbital vein, which runs over the eye,
and at the inner angle of the eye, forms the angular veins.
In addition, the superficial temporal and the
ophthalmic arteries contribute several anastomotic
links to increase the availability of blood. The
ophthalmic artery terminates in two branches, the
frontal and nasal arteries. Other significant arterial
branches serving the middle third of the face include
the labial arteries and the infraorbital and angular
arteries. The labial arteries, superior and inferior,
perforate muscle to lie just beneath the skin at the
upper and lower angle of the mouth. The transverse
facial artery lies under the skin just beneath the
zygomatic arch and the orbital artery, if one exists, just
above the arch.

The middle third of the face is richly supplied by arterial

blood. The facial artery, originating in the neck and branching
off from the carotid artery, can be felt pulsating where it
passes over the jaw, approximately between the chin and
earlobe. From the point, the vessel courses diagonally across
the face, past the angle of the mouth, and then alongside the
nose, where it ends as the angulatory artery. Along its length,
the vessels give off musculocutaneous perforators, smaller
arteries branching off to supply muscle and skin.
 FACIAL NERVE PATTERNS
The cranial nerves are composed of 12 pairs of
nerves, one for each side of the body, that arise from the
bottom of the brain and branch out to serve the head and
upper neck area. Some of the nerves bring information
from senses to the brain, some control muscles, and other
affect glands or internal organs.
CRANIAL NERVE VII
We are naturally most interested in cranial nerves as
they affect the face. Cranial Nerve VII, or the facial nerve,
branches are important to us because they are responsible
for all the facial expressions. The facial nerve passes
through the base of the skull and enters the bone of the
way through the internal auditory canal, the bony tube that
also carries nerves involved with hearing and balance. From
the ear, the facial nerve fans out to son the face from the
outer and inner orbit of the eye. To the cheek and mouth,
and down to the lower jaw.
The facial nerve divides into smaller fibers
that control different parts of the specific facial
muscle. The facial nerve, cranial nerve VII, also
carries impulses to the tear glands, saliva glands.
And the muscle of the stapes, the “stirrup” bone in
the middle of the ear. In addition. Okay the facial
nerve transmits the sense of taste from the front
of the tongue.
When these fibers are irritated, facial
muscles can twitch. When these fibers are
damaged, you may experience facial weakness,
twitching, or paralysis; in addition, we may notice
dryness of the mouth or eyes or disturbance in
taste.
 CRANIAL NERVE V

Cranial Nerve V is called the trigeminal nerve. The sensory branches of the cranial nerve V.
The trigeminal nerve innervates the cheek, side of Which extended to the eyes, nose, lips, and both sides
the face, conjunctiva, skin of the lower lid, side of of the jaw, respond to touch, temperature. And pain in
nose, nasal vestibule, teeth, tympanic membrane, the face. If the this nerve is damaged, you may not be
and anterior two-thirds of the tongue. Cranial nerve able to feel the air temperature or pin in your cheek,
V conducts sensory information such as touch and lips, and nose, or in parts of them.
pain from the face; it is also the principal motor
nerve that controls the muscles of In sum, the two cranial nerves that primarily
mastication(chewing) and speaking. serve the face, its expression, its feeling, and our
ability to speak are the facial (cranial nerve VII) and
The fifth cranial nerve is a large mixed nerve, the trigeminal (cranial nerve V) nerves.
meaning that it has both sensory and Moro
functions. These roots emerge together from the
pons, and the sensory nerve immediately divides into
three branches-an ophthalmic to the eye. A maxillary
to the upper jaw, and a mandibular to the lower jaw.
The motor root of the trigeminal nerve is smaller
extending to innervate muscles in the lower jaw and
floor of the mouth.
MUSCLES & MOVEMENTS OF THE FACE:

They're face is full of animation. Muscles in the face work together to make certain animated expressions.
Such is the case with the cheeks and the periocular area. You will learn the location and function of each muscles
and the lines it's motion will cause.

MUSCLES OF THE FOREHEAD:

The skin of the scalp is among the thickest of the body. Hair follicles cover much of it, particularly over the
scalp, and over its entirety are found a few sebaceous glands. The scalp adheres closely to fascia and underlying
muscle, and movements of the muscles move our skin. There are no muscles underneath the scalp itself. Muscles of
the forehead fan out into fascia in the direction of the crown.

Only one muscle, the frontalis, is in the forehead area. Though it is one muscles it can behave as if it were two.
Example: you have seen expressions in which only one half of the forehead was used, (lifting one eyebrow). The
frontal is lies directly beneath the skin of our forehead, stretching from temple to temple and from eyebrow to
about the hairline. At the hotline the frontais shades off into an aponeurosis, with the thick fascia of the vertex of
the skull.

The muscles works to lift the eyebrows, as well as, draw the scalp forward, producing transverse or
horizontal wrinkles. In its lower middle, the frontalis blends into the procerus, a muscle of the nose; to each side, it
blends with the upper eye muscles, the corrugator and orbicularis oculi. The nerve powering the frontalis muscle is
 ANATOMY & PHYSIOLOGY: MUSCLES OF THE EYE

The periocular area, is the muscles around our eye area. Two muscles lying beneath our eyebrows and above
our eyes have a lot to do with our expressions. Our eyelids and eyebrows are mobile because of these muscles: the
orbicularis oculi, the levator palpebrae superioris, and the corrugator supercilii.

The orbicularis oculi starts from the nose and wraps above the orb of the eye to form the eyelid, or palpebra,
and finally fans out towards the temple. This muscle is a sphincter muscle, meaning that it contracts to close an
orifice, the eye. The muscle acts involuntarily to close the eye, as in sleeping or blinking, and we also move in
voluntarily.

When the entire muscle is worked, as when you shut yours eyes tightly, the skin of the forehead, temple, and
cheek is pulled together, causing folds to radiate from the outside or lateral angle of the eyelid. As we age, these
folds become permanent and are called crows’ feet.

The levator palpebrae superioris antagonizes, or works against, the orbicularis oculi as it raises the upper
eyelid to expose the orb of the eye. As for the corrugator, this aptly named muscle is the “frowning” muscle,
drawing the eyebrow down and toward the middle, producing those vertical wrinkles we know so well.
 MAJOR VESSELS OF THE EYE

At the earlobe, the superficial temporal artery gives off the transverse facial artery, which passes
transversely, of course, across the face, circling beneath the eye to and alongside the nose. In the area of the eye,
this artery is sometimes known as the infraorbital artery, meaning near or around the orbit of the eye. It's branches
are numerous, supplying glands in the muscles and, last but not least, the skin. A frontal branch friends are radically
upward to the four head, what a larger pry it out branch runs up and along side of the head.

As the external carotid artery steams up work beside the year, it divides into the superficial
temporal-pertaining to the temple-and internal maxillary arteries. A middle temporal artery splits off right above
the zygomatic arch (the cheekbone) and supplies the temporal musculature. This artery may spawn an orbital
branch, running along the upper border of the cheekbone and to the outer angle of the orbit of the eye. The
internal maxillary artery supplies the deep structures of the face. Finally, just above the temple, the anterior
temporal artery supplies the forehead and upper orbit of the eye.

If you trace alongside your nose from the root downward and outward, you will be roughly tracing the route
of the angular vein. The vein communicates with the ophthalmic vein from the eye and, as it courses alongside the
nose, takes on a new identity as the facial vein, a continuation of the angular vein. The facial vein descends beneath
the zygomaticus muscles and along the front border of the masseter muscle. It crosses over the lower jaw and
beneath the plates a muscle-a broad, thin plan of muscular fibers covering the front of the neck-where it unites
with the temporo-maxillary vein. This large trim I “common facial vein” finally enters in the neck and is called the
jugular.
 MAJOR GLANDS OF THE EYES
Near our eye are two glands that are
important to the functioning of the eye,
damaging these claims can cause permanent
damage to the client, as well as his or her vision.
The first of these glands are the meibomian and
tarsal glands.
The purpose of these glands is to lubricate
the islands, preventing there if he's into the
eyeball. These glands are embedded in grooves in
the inner surface of the tarsal plates, next to the
conjunctiva. The upper level contains
approximately 30 of these glands and
significantly fewer on the lower lid. The glands
appear as tiny pearls in a linear fashion.
Sweat glands and sebaceous glands
open into the eyelash follicles. The presence
of these glands can explain why applying
eyeliner on a more mature or dryer skin client
is easier. The more oil that is present, the
more difficult it is to get pigment to hold in
the skin.
The other gland worth considering is the
lacrimal glands. This gland is the primary tear
producing gland. The tears that this gland
produces are intended to keep a clean and
protect the epithelium of the eye. This gland
is approximately the size and shape of an
almond, and it resides in the superior,
anterior, temporal region of the eye socket.
 ANATOMY & PHYSIOLOGY OF THE MOUTH
Many muscles partake in the movement of the
mouth and cheek area.
The quadratus labii superioris is a broad sheet
of muscle extending from the side of the nose and
the upper lip to the zygomatic bone, or cheekbone.
The muscle elevates help from the nasolabial
lines, which passes from the nose to the upper lip,
imparting an expression of sadness.
When the whole muscle works, pushing the lip
out get her, it causes an expression of contempt of
disdain.
The action of the levator labii superioris and
levator anguli oris muscles of the upper lip is to raise
the angle of the mouth.
Their combined efforts assist in forming the
nasolabial ridge. This line can be an indication of age
based on its depth and surrounding tissue laxity.
The zygomaticus muscle attaches to the front
of the zygomatic bone and descends obliquely until it
inserts into the angle of the mouth.
This muscle draws the angle of the mouth back
and upward when we laugh. The levator labii
inferioris, controlling the lower lip, raises the lower
lip and makes it protrude.
This action causes the chin to wrinkle in a pout.
 ANATOMY & PHYSIOLOGY OF THE MOUTH: continued...
With the depressor anguli oris and
depressor labii inferioris muscles of the lower jaw
and lower lip give further expression to
movements of the lower lip.
The depressor labii inferioris draw the lower
lip down and a little out, giving an expression of
irony.
The depressor anguli oris is the antagonist to
the levator anguli oris; instead of pushing the
lower lip forward, it draws it down and back, like
when you taste something bitter.
The orbicularis oris encircle the mouth but is
not a simple sphincter muscle.
This muscle consists of many layers, or
strata, of muscular tissue surrounding the orifice
of the mouth but having opposing actions; it also
attaches and blends into neighboring facial
muscles.
The most common action of the orbicularis
oris is to close the lips; its deep fibers compress the
lips against the alveolar arch of the teeth, as when
someone is trying to feed you something you don't
want.
The superficial part of the orbicularis oris
can also protrude that closed lips forward.
 ANATOMY & PHYSIOLOGY OF THE MOUTH: continued...
The mentalist is a small bundle of
muscle fibers at the side of the frenulum of
the lower lip. A frenulum is a tissue that
connects one thing to another; a frenulum
attaches the bottom of the tongue to the
floor of the mouth. The frenulum of the lower
lip attaches it to the gums. The mentalist
muscle raises and protrudes the lower lip as it
wrinkles the skin of the chin, producing an
expression of doubt or disdain. The
quadratus labii inferioris, arising from the
mandible to insert into the lower lip, draws
that lip down and somewhat to the side,
producing an expression of irony.
The risorius begins over the masseter,
the muscle used in chewing, and passes
horizontally forward to insert into the angle
of the mouth. The muscle retracts downward
the angle of the mouth, producing an
unpleasant grinning expression. The name
buccinator muscle is formed at the outer
surfaces of the maxilla and mandible at
approximately the level of the three molar
teeth. The fibers converge into the angle of
the mouth, and the action is to compress the
cheeks so that, as we chew, the food is kept at
the mercy of our teeth. As we distend our
cheeks with air, this muscle can expel it
between the lips in a whistle or trumpet blow.
All of these facial muscles are supplied by the
facial nerve, Cranial Nerve VII.
 LOCATION OF MAJOR VESSELS IN THE MOUTH
The facial artery, or external maxillary artery,
splits off at the angle of the jaw and initially runs
beneath the lower jaw, but not for long, considering
that it's ternate name means upper jaw. About
halfway to the mouth, the external maxillary artery
curves up and over the jaw to pass up across the
cheek to the angle of the mouth, then to follow the
side of the nose. This artery terminates at the inner
canthus, or corner, of the eye where it has acquired
the name of the angular artery.
The external maxillary artery twists and
turns throughout its length, particularly at first, to
accommodate potential movements of the neck
and lower jaw. Muscular branches of the external
maxillary artery from the neck serve the masseter
and buccinator, muscle of the mouth.
The lower lip receives much of its blood supply
from the inferior labial artery, which arises near the
angle of the mouth and runs a tortuous course along
the lower part of the orbicularis oris. The muscle
that surrounds the mouth. When an inferior exists, a
corresponding superior generally can be found. The
superior labial artery, larger than its inferior
namesake and larger than the alternate superior
coronary moniker, traces the edge of the upper lip
while sending off a few branches that ascend to the
nose.
Ch. 3 Color Theory
Key Terms:
Color Wheel Opaque Colors Secondary Colors
Eumelanin Pheomelanin Tertiary Colors
Fitzpatrick Skin Typing Primary Colors Transparent Colors

Review Questions:
1. What is Fitzpatrick skin typing?
2. What are the two different types of melanin?
3. What are the primary colors?
4. What is a color wheel?
5. How is a color wheel useful?
 COLOR THEORY
Color as we perceive it begins with white.
When a ray of light is reflected through a prism,
the seven basic colors (red, orange, yellow, green,
blue, indigo, and violet) can be seen by the
unaided eye. These colors together form what we
know as a visible spectrum of light. This discovery
was first made by Sir Isaac Newton.
Every color that we perceive falls
somewhere on the spectrum. What we perceive
as the color is in fact just an of the particular color
by the material we perceive as having that color.
For example, we see a leaf as being green
absorbing the all other colors.
At the beginning of the 20th century, a
swiss artist, Johannes Itten, created what we now
call the color wheel. The color will consist of 12
colors that comprise the primary, secondary, and
tertiary colors with which we are most familiar.
This color wheel is quite scientific and it's
explanation of colors and color matching. Rather
than a trained eye, it explains the absolutes of
colors.

Materials that are black absorbs all colors,

and materials that are white reflect all colors,
which means that white is, in fact, all colors
combined.
 PRIMARY COLORS Blue, the strongest color, is said to add
depth and is associated with coolness. Red,
which is medium and strength and density, is
Primary colors are the three basic colors said to have a warrant and is asith fullness.
of the color wheel. They are considered Yellow, the color with the least strength of the
primary because they cannot be made from primary colors, is the latest and brightest and
any other color combinations, and they are the only primary color with both warm and
the colors from which all of the colors are cool tendencies.
derived. The primary colors are blue, red, and Given that the primary colors have
yellow. variant strengths, you need three times as
much yellow to equal the strength of blue,
twice as much red to equal the strength of
Color Strength Attributes blue, and twice as much yellow to match the
strength of red.
Blue High Coolness-Depth
Red Medium Warmth-Fullness
Yellow Low Warmth-Coolness
 SECONDARY COLORS

Secondary colors are made by combining the primary colors. They are balanced mixtures of
primary and secondary colors. When anyone primary color is mixed with another, a secondary color
effect is produced. Three secondary colors are produced from the mixing of one primary color with
another. These colors are orange, green, and violet.
These colors are also known as complementary colors.

SECONDARY COLORS
COLOR FORMULA
Orange Two parts red plus three parts yellow
Green Three parts yellow plus one part blue
Violet Two parts red plus one part blue
 TERTIARY COLORS

Tertiary colors are produced by mixing one primary color with one secondary color in varying
parts. Most of the colors used in permanent make up or tertiary colors. Colors that are opposite each
other on the color we are complementary colors. When mixed together, these colors will turn brown
or gray. This property is especially important for the technician who is correcting permanent make
up colors. Complementary colors that are put next to each other well brighten.Colors that are
opposite each other on the color wheel are complementary colors. When mixed together, these
colors will turn brown or gray. This property is especially important for the technician who is
correcting permanent make up colors.

TERTIARY COLORS
Amber: yellowed brown Taupe: grayed brown
Blonde: light-browned yellow Rust: oranged brown
Brick: warm-browned red Wine: deep-blued red
Brown: can have red, yellow, green, or blue undertones Ruby: true red
Khaki: dull-yellowed green Mauve: blued and browned red
Auburn: red brown Olive: yellowed green
Coffee: dark brown Turquoise: greened blue
 OPAQUE & TRANSPARENT COLOR
Some colors are transparent colors, and some
are opaque colors. Although the statement sounds
contrary to the nature of colors, consider a cup of
tea. If you were to pour a small amount into a clear
cup, it would have the consistency of water. The
more you add, the darker it becomes. According to
the this concept, tea is transparent. This example
explains the concept of volume in color theory.
Now, consider doing the same thing to a glass
of milk. If you pour a small amount into a glass, it
appears to have the same consistency as it would if
you were to pour a full glass. This example means
that milk is the color white and is opaque.
Transparent colors get darker with my volume,
whereas opaque colors do not. Most colors used
for permanent transparent.
SKIN COLOR
Skin color is related to the level of
melanin production. As permanent make
up artist, we observe the color of skin
based on an accepted methodology:
Fitzpatrick skin typing. Fitzpatrick skin
typing helps the professional predict
what skin types to respond best to
certain topical products, and clinical
treatments, as well as ultraviolet
exposure.
Skin is also complicated in it's color
by the degree and types of melanin
secreted. This physiologic factor
contributes to the concept of the skin’s
undertones.
SKIN COLOR: continued…
As we know, melanin is responsible for
the color of the skin. People with more melanin
have deeper skin colors, and those with less
melanin have less pigment us later skin colors.
Two important variations of melanin influence
our color selection for permanent makeup
procedures: pheomelanin and eumelanin.
Pheomelanin gives tones of red to yellow, while
eumelanin produces tones of brown to black.
When selecting pigments for tattooing, these
undertones cause certain colors to look better
or worse on the skin.
FITZPATRICK SKIN TYPING
Using the Fitzpatrick system, each client is
asking series of questions related to skin color, and
unaltered eye and hair color, ethnic origin, and
response to UV light. Based on a series of questions
the client is placed into one of six Fitzpatrick skin
types that extend from very fair skin too dark skin.
To arrive at these classifications several questions
are asked of each client, together with your own
examination. Add up the total scores for each of the
three sections for your skin type score. The score
will give you a better evaluation of your skin type.
For the purpose of skin color, skin tones, and
undertones, we will only exam in the basics of
Fitzpatrick skin typing. Skin color is essentially an
inherited racial and ethnic characteristic. However,
even within the same race and ethnicity, some
variability can be found. Skin color is directly
related to the types of melanin secreted:
pheomelanin and eumelanin.
CAUCASIAN

When we think of Caucasian, we think white. However, white can be divided into a variety of
shades, and this variety will determine whether the client is a Fitzpatrick I or II or even III. In the
Fitzpatrick I, the ethnic considerations are English, Scottish, Irish, Norwegian, Swedish, and
Icelandic. These individuals would be present with very fair skin, freckling, green or light blue eyes,
and light hair colors. Within the classes of Fitzpatrick I, II, or III, undertones of red, pink, and yellow,
or blue can be seen. This feature involves the amount of pheomelanin that is produced.
NON-HISPANIC CAUCASIAN
This category of skin type has darker hair, mainly dark blonde and brown. This
Non-Hispanic-Caucasian category can also present several variations on the shades of darker whites
and brown skin. They will probably fall into the Fitzpatrick III and IV categories. The eye color is blue,
dark blue, or brown. This ethnic background is usually Mediterranean and Southern European, which
would include Greeks, Middle Easterners, and Italian. Categories III and IV look for undertones that
are yellow or blue. The amount of pheomelanin and eumelanin can be equal, creating a challenge for
undertone analysis, or one type may be more apparent.
HISPANIC

The Hispanic skin category has individuals with darker skin, darker hair, and darker eyes. Hispanic
people have dark brown or black hair, and their eyes are brown. They will generally fall into the Fitzpatrick
IV and V categories. Their ethnic background is Spanish, Mexican, South American, and Cuban. People in
Fitzpatrick IV and V have more melanin is their skin, causing darker pigment. The undertones of this skin
type are usually yellows, greens, or oranges.

AFRICAN AMERICAN

The skin type of the African or African American is darker. However, the skin will vary from light
brown, to very dark, to a blue black color. Their hair is always naturally black, but the eyes can be brown to
black. In the darkest color, the skin is the Fitzpatrick VI, but these individuals also can be Fitzpatrick V as
well. Their ethnic background is African. Fitzpatrick V and VI individuals are always dark and have darker
undertones: browns, blacks, or blues.
ASIAN & PACIFIC ISLANDER

These skin types are light brown to brown in color; the hair can often be light brown or sometimes a
dark red to dark brown. The eyes are brown and sometimes dark brown. These skin types have ethnic
background from Japan, China, and the islands of the South Pacific, to mention a few. These individuals are
usually Fitzpatrick IV or V. The skin types are often referred to as sallow and are often hinted with
yellow-orange to yellow-green undertones.
NATIVE AMERICAN & ALASKAN NATIVE

These skin types are light brown to brown, the hair color brown to black, and the eye color is
brown to dark brown. These people are found in different parts of the united states. These skin types
will be classified under Fitzpatrick IV and V and has stronger eumelanin.

CHOOSING SKIN COLOR

We are born with our skin color and skin tone; they do not change. However, pigment may
increase or decrease with tanning, illness, medication, excessive cigarette smoking, or alcohol
consumption. For the purpose of permanent makeup color selection, we not only analyze Fitzpatrick
skin type and undertones, but further determine whether the undertones are warm or cool. Warm
tones mean colors such as orange, yellow-orange, and red. Cool tones mean blue, pink, purple, and
green. When examining a fair cool skin tone, the first thing you may notice is a lack of pink or red
tones. Ruddy to pink skin tones flush the skin with warmth. Cool skin tones tend to look porcelain,
pale or beige, or washed out, with no golden or ruddy tones. We define these undertones as
transparent, translucent, olive, sallow, peach, or rosy.
Client skin tones are usually purple or variations of purple. Translucent skin is blue or variations of
blue in the undertone. Olive is just as you would suspect: green and variations of green tones. Sallow
is predictably yellow, peach is orange, and rosy is red.
 LIGHT & SKIN COLOR

Without light, color cannot be visible. As was mentioned, the reflection and refraction of
light determines the color that our eyes perceive. Because of the natural reoccurring variances
in different types of lighting, choosing the appropriate color, especially when trying to
determine skin tones, creates a challenge for permanent makeup artists as he or she begins to
select color for a client. The selection of color is the talent of the artist and one that cannot be
defined in a textbook.
The best light to use when investigating a client’s skin tone is natural sunlight. Given that
natural sunlight is not always available in a clinical setting, artificial daylight lamps will provide
you with the adequate lighting required. Invest in daylight color-balanced light sources to
ensure the best result. If possible, take the client near a window or even outside so you can
evaluate the skin in natural light. Furthermore, tanned skin and skin that has changed color
because of medications or smoking should carefully considered before treatment.
Occasionally, a patch test is recommended to avoid any negative long term consequences.
When conducting patch testing behind the ear, you should know that the skin behind the ear is
less exposed to daylight and sunlight effects compared with skin on the face.
Ch. 4 Consultations
Key Terms:
Active Listening Encoding Makeup History Shee
Body Dysmorphic Disorder External Noises Metacognitive Listening Strategy
Bottom-Up Strategy Health History Sheet Idea
Nonverbal Communication Client Information Sheet Internal Noises
Photographs Clinical Indication Interpersonal Communication
Skin History Sheet Communication Listening
Contraindication Empathy Listening Strategies
Top-Down Listening Strategy Verbal Communication

Review Questions:
1. What is communication? 8. What is a consultation? & why is it important to permanent makeup?
2. What are the different types of communication? 9. What role do fads and trends play in permanent makeup consultations?
3. What is the progression of verbal communication? 10. What is after care? Why explain after care before the procedure?
4. How are listening and communication different?
5. What are the 3 different listening strategies and their benefits?
6. What are the indications of permanent makeup?
7. What are the contraindications for permanent makeup?
TYPES OF COMMUNICATION
Every aspect of our bodies our senses, our
mouth, and our gestures are engaged in a
perpetual transmission of verbal and nonverbal
codes from which we send and receive
information, assign value levels, and retain
information. In similar situations, other people
opposite us will assign different levels of
importance to the same pieces of information. In
aesthetics, the degree to which we can or cannot
communicate can have far-reaching implications.
These implications extend to the client's
well-being, your livelihood, and the overall
success of the business that employs you. Failing
to read signals, hear important details, and act in
accordance will certainly have a bearing on any
procedures outcome.
Communication is the use of symbols to
relay information. Some of these symbols
involve words, some involve expressions, some
use gestures, and some use a combination of all
these methods. Contrary to what some people
may believe, communication does not
necessarily involve receiving information.
ANIMAL COMMUNICATION
Humans are not the only ones who
communicate. Almost all animals use sounds to
communicate with one another. Although
much less understood, animals also use
nonverbal communication cues as well.
Cross-species communication is rare but not
uncommon. For example, humans and their
pets are capable of communicating basic needs
and emotions.
TELECOMMUNICATION
We tend to think of
technology or machinery when
we think of
telecommunications. Rather,
this is the sending of
information over large areas of
space, as in the case with mass
media or even smoking signals.
Any form of
communication that is sent to a
multiplicity of persons who are
separated by distance that
would make ordinary
interpersonal communication
ineffective is considered
telecommunication.
INTERPERSONAL COMMUNICATION
Interpersonal communication,
also called dyadic communication,
involves communication usually
involves communication between
one person and another. This type of
communication usually involves
listening, exchanging dialog,
summarizing, paraphrasing, and
gesturing.
A greater instance of reception
takes place in this form of
communication than it does in the
other types. However, the
information may not be what the
sender intended. Interpersonal
communication uses both verbal and
nonverbal methodologies.
VERBAL COMMUNICATION
When a potential sender
has a thought, or an idea, the
verbal communication has its
birth. For the receiver to
understand the message, it
needs to be encoded. Encoding is
a cognitive process by which the
sender organizes ideas into
symbols.
People who are adept at
verbal communication will take
steps to ensure that the intended
recipient understands the
message. To accomplish this
tasks, words, actions, and tone
are c with the recipient are
considered and chosen with the
recipient in mind. The message is
decoded and received.
VERBAL COMMUNICATION: continued…
Verbal communication also involves the use of
inflection and volume to send a message. A person
talking in loud tones conveys a different meaning
than if the message was said in a low, monotone
fashion. No matter how well or accurately a
message is encoded, internal noises and external
noises complicate matters. Both senders and
receivers experience internal noise. How they
perceive the topic will affect how the noise-the
environmental factors of traffic, competing
conversation, ,or even hearing loss- can also
interfere.
NONVERBAL COMMUNICATION:
Nonverbal communication is the process of sending
a message without a verbal cue. Although nonverbal
communication is usually perceived as no, it can mean
yes. The most common nonverbal communication is the
use of facial expressions. Your eyes are the most powerful
nonverbal communicator. Your eyes can tell others what
you are thinking, if you believe in yourself, and if you
believe the product you recommend has value. Hand
gestures, body movements, touch, and personal space all
play a role in nonverbal communication. Silence itself can
sometimes convey information.
Hand gestures are important nonverbal
communication tools. Folded arms may reflect a closed
mind. Tapping fingers and fidgeting are negative
nonverbal communication cues. Touching others is also a
non verbal communication skill, such as squeezing or
holding someone’s arm are hand can be offered as
reassurance. Additionally, hand gestures can be used to
emphasize or expand a verbal communication.
NONVERBAL COMMUNICATION: continued… LISTENING:

Body movements can also convey a Listening is NOT just hearing what another
meaning, whether implied or not, whether person says; rather it is an active process of
intentional or not. For example, sitting with your understanding what he or she is saying, even if the
head rested on a table can read as being tired or person does not verbally say so. Listening involves the
being disrespectful. Even the way you walk, sit, translation of verbal and nonverbal cues to extrapolate
or speak says something in accordance with or a message that the speaker means to convey. Although,
against the word you use. Some people use some people may be direct about what they think or
nonverbal cues more than they use words how they feel, others have difficulty expressing
themselves. Self- image also plays a part in themselves. Our degree of active listening varies
nonverbal communication. How you feel about greatly with the importance of the information being
yourself or in what you are saying will reflect in offered.
your nonverbal cues.
Touch and personal space are important.
Being close to people you do not know can be an
uncomfortable experience. Give people their
space and respect their need to be distant from
you when you talk. Touch can imply affection,
safety, or aggression depending on the degree of
pressure or approach applied.
LISTENING: continued…
In the clinical setting, the information being
offered is of great importance to you and to the
client who gives the information. Listening and
hearing what the other person is saying are not the
same. Good listening skills are learned and are
more than just the process of hearing their words.
Learning to be a good listener requires that you
understand the concepts of active listening.
People who are active listeners use what are called
listening strategies to accomplish good
communication.
LISTENING STRATEGIES:
Listening strategies are divided into 3 types. The
first one, the top-down listening strategy, takes place
when the listener uses background knowledge on the
subject or the person for the purpose of listening to main
ideas, predicting, drawing conclusions, and summarizing.
Next is bottom-up listening strategy. In this strategy,
the listener uses the language and grammar to
understand meaning. This method includes listening to
specific details, recognizing cognates, and deciphering
specific word order patterns.
The final type is metacognitive listening strategy,
which are listeners that are accomplished at using both
bottom-up and top-down strategies; they can use both
simultaneously and switch between both to garner the
messages most effective. These individuals can plan on
using the strategy that best serves the situation, monitor
comprehension, and switch to another strategy if the
goals are not being met.
LISTENING & EMPATHY:
Carefully selecting the candidates and ensuring that
Empathy is letting the talker know his or her
the particular condition can be improved or solved
feelings and intentions are understood but not judged.
by the treatment, is the clinician’s responsibility.
The idea of being empathetic is often the
Indications and contraindications can sometimes
communication that the clinician respects the client’s
overlap, causing a challenging decision for the
views and feelings. When the concepts of empathy
clinician. Therefore, the consultation process,
and listening are wielded together, you are able to
listening to the clients, and identifying their primary
help the client by being a problem solver. Listening is a
request is important.
difficult skill to master. The more you understand your
The best candidates for permanent makeup
client’s problems, as well as the effects that they have
include individuals who are seeking aesthetic
for the client, the more likely you are to develop a
improvement of the eyes and lips or clients afflicted
trusting and lasting professional relationship.
with vitiligo, some types of scars, and alopecia.
People with contraindications such as, diabetes,
INDICATIONS & CONTRAINDICATIONS
Clinical Indication means conditions that are
pregnant, and lactating women, people with
glaucoma, and people who are taking
suited for particular treatment or procedure based on
blood-thinning medications, with diseases such as
specific indicators. Conversely, a contraindication
psoriasis, eczema, have rashes, or allergies to
would be conditions for which the treatment is not
makeup.
appropriate.Not all clients or client’s problems are
appropriate for permanent makeup. Not all clients or
client problems are appropriate for permanent
makeup.
CONSULTATIONS:
The consultation is when you will meet the
client, listen to his or her complaints, investigate the
permanent makeup objectives, and decipher the
degree to which you can help, devise a plan, and make
the necessary steps to reach the objectives. This
process is your opportunity to familiarize yourself with
the client and, from your inferences customize each
client’s clinical experience to suit his or her physical,
emotional, and psychological needs.
The objective of the consultation is to gather
information both objective and subjective that will
help to ensure the care of the client will be goal
directed toward a desired result. This process is for the
benefit of the client, however, it also benefits the artist
as well. The clinician will benefit from a well-planned
and well-executed treatment.
MOTIVATION FOR PERMANENT MAKEUP:
Most of the time, the client sitting in front of
you is thoughtful, insightful, and prepared to make
the commitment for permanent makeup. However,
other situations do exist in which the client is not
emotionally prepared for the procedure, and the
clinician needs to know how to spot these potential
problem clients. These clients may have body image
problems. Body dysmorphic disorder is an
emotional disease that causes individuals to be
inappropriately concerned with appearance.
People with BDD spend at least 1 hour a day
thinking negative thoughts about their appearance.
It may be difficult for the permanent makeup
professional to spot these types of people. Clients
with BDD have a high incidence of dissatisfaction
with results, and any small complication can cause
undue stress for both the clinician and the client.
FASHIONS, FADS, & TRENDS:
Similar to hairstyles and clothing, makeup has
trends and fads. With this fact in mind, guiding your
client to decisions that will be timeless and can be
augmented as the fashion trends change is important.
Going with a dramatic look may be unwise.
CHOOSING COLORS FOR PERMANENT MAKEUP:
Color choice is individual and has everything to
do with a person’s skin color and undertones. The
actual color of the permanent tattoo will be different
once it is healed. This color change should be
discussed with the client in advance and be
considered when choosing a color. Allergies can
sometimes happen and are most likely with red
pigments. This color should be tested before a
complete treatment.
The intensity and hue of a color is important to
consider when applying permanent makeup. These
decisions will affect the final result and the client’s
satisfaction. Colors can always be intensified, but not
always reversed once it is there. Remember, a rainbow
of variables is available involving undertones, but you
should be able to ascertain the most prevalent shade.
Matching skin tones can be difficult, and the color of
the surrounding tissue will change when the skin is
exposed to the sun. For people who are seeking
camouflage, multiple appointments are necessary to
determine color before the first treatment. Now, with
improved pigments and techniques, clients can be
successfully treated without complications.
PAIN:
A thorough discussion of pain and the techniques
used to manage pain should be included in the consultation.
Talk about the methods you have available to manage pain
and expectations clients should have. BE HONEST AND DO
NOT MISLEAD THE CLIENT. The better prepared the client
is, the better client he or she will be. If the ciet required a
sedative to complete the treatment such as Valium, a
prescription from a physician is required. If clients take ny
medication, they will need transportation from the
procedure.
POSTCARE:
Swelling, redness, and possible bruising are all
potential treatment consequences that require
post-treatment care. During the consultation, the client
should be made aware of all the possibilities and the
methods to take care of these problems. Additionally,
individuals who are seeking eyeliner should have someone
drive them to and from the clinic. As the clinician, you will
want to be sure that the client will be able to follow
instructions and perform the tasks you assign.
DURABILITY:
All clients want to know the durability of the
treatment, that is, how long the color will stay
intense or last. The color of permanent makeup will
fade over the years, but the rate of which the fading
occurs involves the product that is used and the
technique of the permanent makeup technician.
As you become more proficient and
experienced you will have more of an understanding
of your individual results and potential durability. A
rule of thumb is the older, drier and thinner the skin
is, the longer the procedure will stay & the younger,
oilier, and thicker is the shorter life span of the
treatment is. Also, the darker the colors, the longer
the life as well.
TOUCH UPS:
Touch-ups are common in the permanent makeup
industry. During your consultation be sure to discuss
this part of the procedure. This area can cause
confusion, and may lead to disharmony in your
relationship if clarity is not established before
treatment. The effects of the procedure will appear
healed in about one week, but the skin can take about
45 days to fully heal for clients over 45 year of age.
People that are younger may heal quicker. A good rule
of thumb is to perform touch ups after the 8 week
period.
COST:
Cost is important, whether or not the client is
wealthy or has saved for the procedure, a discussion of
cost is a courtesy to the client. Be sure to document the
cost so that no misunderstanding ensue, and ensure
any additional costs such as touch-ups and
medications.
TAKING PHOTOGRAPHS:
Taking photographs is perhaps the most
overlooked but most important part of the
consultation and is part of the recording
process. Recalling with accuracy and clarity
exactly how the client has the client appeared
before the treatment and then after the
treatment. This can protect the technician
from potential litigation.
To ensure accuracy and consistency in
photography, a policy and procedure should
be developed that addresses specifics such s
the number of views and distances of each
type of shot. A full face view is important and
should be accompanied by close-ups of the
areas to be treated: the eyes, lips, brows.
 CONSULTATION PAPERWORK
The documents included in permanent makeup
consultations are (1) the client information sheet, (2)
the skin history sheet, (3) the health history sheet,
and (4) the makeup history sheet. The client
information sheet is the document that captures all of
the social information, email addresses, and referral
sources. It should also capture data about the client’s
interests in the office including services that are
important to the client. This info will be important for
future promotions or direct mail.
The skin history sheet is a detailed
questionnaire about the client’s skin. Questions
should address past and current skin health and
services. It is important to ask if they have had any
skin problems such as,
blisters, severe sunburns, cancers, acne problems,
etc. Also specifically any skin care treatments
associated with any skin problems.
The health history sheet lists detailed health
status. Included on this document are questions
regarding allergies, current and past illnesses,
smoking status, pregnancy status, daily medications,
past surgical events. This form should be set up in a
check-box format. This document will give you more
of an understanding as of why they are seeking
permanent makeup, including for burns, age,
degenerative diseases, and poor eyesight.
The makeup history sheet lists details about the
client's use of makeup both past and present. The
questionnaire is short, but addresses color
preferences and manufacturers as well as other
preferences. This document should ask how long
they’ve thought about receiving permanent makeup,
why they want the service, what looks best to them, if
they’ve had it done in the past. Their style, colors, and
any special instructions should be included here.
 GLAMOUR MAKEUP & THE PERMANENT MAKEUP RESULT

Using Glamour Makeup during the

consultation, is key to determine the end
results and color perfect for you client’s
desires. The face is evaluated in 2 ways:
vertically for symmetry and horizontally for
aging. A common way to spot asymmetry is
to have the client tip their head back, so that
any differences appear more noticeable.
Analyzing the face horizontally, must be
done in thirds: upper-⅓, middle-⅓, lower-⅓
These facial analysis’ should be harmonious
with one another.
Ch. 5 Tools of the Trade
Key Terms:
Anesthetic Manual Tap Rotary Pens
Contaminated Occupational Safety and Health Administration Safety Bill of Rights
Ergonomic Organic Pigments Sharps Container
Inorganic Pigments Reciprocating Oil Machines Universal Precautions

Review Questions:
1. What personal qualifications are important to those
wanting to do permanent makeup?
2. What is the importance of using disposable needles only once?
3. What is the benefit of seeking blood-borne pathogen training?
4. Do any uniform national standards exist for testing for a license?
5. What does the term technique sensitive mean?
6. What are 3 types of devices used to perform permanent makeup?
7. What are the pros and cons of a manual tap device?
8. What are the pros and cons of a reciprocating coil machine?
9. What are the pros and cons of a rotary pen?
10. Why is knowing about pigments in permanent makeup important?
11. What is iron oxide? Why is it used as a pigment?
12. What does the term inorganic mean?
13. What does the term organic mean?
14. What is an anesthetic agent?
 PERSONAL QUALIFICATION FOR PERMANENT MAKEUP
● Good Eyesight
● Excellent hand-eye coordination
● Effective customer service skills
● Understanding of Color Theory
● Participation in the aesthetic or
medical environment
● Artistic Flair
The first requirement: is essential to
permanent makeup services. Those with
poor eyesight may use corrective lenses
to compensate. But most technicians are
encouraged to use magnifying glasses to
ensure the best results.
Fine-motor skills are absolutely
necessary, the delicate nature of this
procedure, requires good hand-eye
coordination to be critical.
Color theory is of great importance
when choosing pigments for the correct
skin color/type for clients to love their end
result. Along with colory theory many
characteristics will enhance your
possibilities of success.
Those with a background in
cosmetology or aesthetics will have a
greater advantage because the have the
necessary skills, training, and capabilities
that would benefit them in permanent
makeup services.
 SAFETY & SANITATION
Separating the concepts or safe practices
and sanitation is difficult. Keeping the
environment clean and safe is the priority of
everyone in the facility. The use of needles and
the nature of the procedure demand that the
technician understand the rules of Occupational
Safety and Health Administration and Universal
Precautions.
Permanent makeup technicians may or
may not be familiar with these ideas, but
incorporating these concepts everyday for your
safety and the safety of your clients would be in
everyone's best interest.
SAFETY & PERMANENT MAKEUP
There are 2 subjects for permanent
makeup artists to be aware of are tripping over
cords and the ergonomic relationship. The
technician should always be neat and tidy with
electrical cords, be sure that they are not frayed
or in anyone's walking path.
Also, what is important is to ensure that you
have an ergonomically correct relationship with
the patient and the device that you are using. BE
COMFORTABLE. Making sure that the device
you are using is comfortable for your hand, not
too heavy, not to big/small and make sure you
are not hunched over your client during the
procedure. Proper ergonomics will help your
back in the long term.
 OSHA
OSHA is sometime a point of
contention between employers and
technicians. OSHA originally known as the
Safety Bill of Rights, was developed by the
federal government to protect workers,
initially those in hazardous work
environments such as mines or construction.
In recent years (1992) works places in the
medical field have found their way to OSHA
as well.
Given that permanent makeup
technicians work with clients all day the must
understand how to protect themselves from
bloodborne pathogens and communicable
disease and the long term effects associated
with contaminated blood or disease.
Universal Precautions are key to
keeping the clinician safe.
PREVENTING COMMUNICABLE DISEASES
The permanent makeup technicians is
working close to the face or his or her client.
Although, respiratory transmission is not the
only method of disease transmission, it is
one of which most of us are familiar. All
technicians should wear latex gloves while
performing procedures. While wearing
gloves, avoiding contact with oil or oil-based
products is vital because contact will degrade
the latex and leave you vulnerable.
Hands should be washed between
each client sessions, and when changing into
new gloves.
 INFECTIONS
Infections happen when germs enter the body.
Most of the time, the body’s defense mechanism are
able to fight off the intruders, but some of the germs
are too strong for the body to fight off. Other disease
processes are caused by viruses, which unlike
bacterial infections will not respond to antibiotics.
Disease both bacterial and viral can enter the body
through the breaks in the skin, the mucous
membranes of the eyes, the nose, mouth, and
through body fluids such as blood or semen.
The technician must understand the disease
process. To minimize the spread of bacterial and
viral infections the following suggestions are made:
-wash your hands before and after taking care
of a client
-wear gloves -wear surgical mask
-use vaseline -wear covering clothing
UNIVERSAL PRECAUTIONS
Clinician’s should always follow the rules of
Universal Precautions. Universal Precautions
states that all body fluids with which you come in
contact with are contaminated. In addition, to
personal safety, the technician should never
recap needles and understand how to dispose of
contaminated needles properly. Contaminated
needles are discarded in a sharps container
(when full must be sealed and picked up by
proper disposal company).
Taking additional classes related to
blood-borne pathogens training will be extremely
useful, and a certification will be extremely
valuable to your business.
 GLOVES SURGICAL MASKS EYEWEAR

Gloves are an important Masks are one of the Using protective eyewear
component of self-protection. aggravating additions to a is simple. Plastic glasses are
They should be worn during ALL technician’s protective wear used to protect the technician
treatments; there are 2 types because they can steam up the from spraying pigment or body
available: latex and nonlatex. eyewear. fluids, specifically blood.
Latex allergies have However, the clinician They do not need to be
become more common, be sure should still wear a surgical laser safe, and they do not need
to ask your client if they have mask. to be construction grade; they
experienced any allergies to simply need to protect the eyes
latex gloves. from sprays.
Reactions they may occur
may be hypersensitivity or rash
or even a systemic reaction may
occur.
Also when wearing these
gloves be sure to avoid contact
with oil or oil-based products.
 RULES, REGULATIONS, & LICENSURE

Learning the techniques and nuances of Others may have laws that regulate where
performing the procedure is much easier than the business can be conducted, and some have
negotiating the tangled web of red tape limitations on who can receive the procedure
associated with the multitude of local laws and (usually subjected to those only over 18).
jurisdictions that regulate permanent makeup.
The U.S Food and Drug Administration can
regulate the pigments used in tattooing and
permanent makeup, but currently they do not. No
federal statutes or agencies that regulate the
industry as a whole do exist. Regulation is mostly See page 99-102
accomplished by means of various state and for Individual State License Requirements
local laws and agencies. And
At the present time, the laws are Permanent Makeup Legislation.
inconsistent from one state to the next. In some
states, permanent makeup is regulated by the
state’s board of cosmetology, while in other
states, the practice is now regulated by the
state’s health department. In some states, they
are not regulated at all.
NATIONAL TESTING CERTIFICATION
At the current time, no
uniform national standard or
testing exists. Certain states
have their own licensure
requirements, and some
states require testing for
board certification; however
this also varies.
Certain states will
require a cosmetology
certification, and still other
will require no certification or
licensure whatsoever. At this
time, several states have
pending legislation to require
certification for cosmetic
tattooing.
TYPES OF EQUIPMENT
Permanent makeup
equipment has evolved just as the
industry has. Most recent
advancements have most
noticeably been made in the safety
of devices, with the intention being
to reduce the risk of
cross-contamination between
clients and the technician.
Newer devices enable the
the technician to dispose of
needles immediately after single
used with a push of a button.
Whichever device is chosen
or preferred, it should always meet
the safety and sanitation
requirements for the location
where the procedure is being
performed.
MANUAL TAP EQUIPMENT
Manual Tap equipment is the oldest
form for both tattooing and permanent
makeup.These devices have as little as
one or as many as 200 needles that are
attached to a wooden, plastic, or metal
handle. These needles are then dipped
into the pigment and the recipient’s skin
is pricked with the needles, repeatedly, to
intensify the coloration.
People who prefer manual tap
devices prefer them because they are
silent, lightweight, easy to hold for long
periods of time, and are inexpensive.
Drawbacks include:
-MUST sterilize in autoclave
-or MUST be disposable
This option will help cross-contamination
and wear and tear on gloves.
 RECIPROCATING COIL MACHINE
The needle is connected to a metal rod that
strikes the ski at a rapid pace of approximately 75
to 100 times a second. The needles are held in
place with rubber bands and move around in a
pigment reservoir, which means less dipping. Each
device style selects pigments that adhere the best
to their needles. Dripping should not occur if
properly loaded and handled.
Coil Advocates Like:
-Cheaper cost of operation
-Power of machine
-Components are inexpensive
-Sturdy nature of device/reliability
-Feels more balanced
-Largest array of needle configurations
These are great for performing reconstructive
services, they penetrate deep, and through
thick/tough skin.
About the Device:
Coils come with either a single or double coil,
which come in various “wraps” that have a direct
impact on the power of the unit. Double coils are
heavier but smoother than single. Most popular one
are “8” or “10”
Frames for these units need to be nonporous
and study. Steel is the metal of choice. There are 2
methods of connecting the coil: (1) through a fork
connector (2) single snap-on or screw-on connector.
Power supplies come in all sizes, and depending
on how much you want to invest you can add many
bells and whistles to your machines and many parts
are interchangeable with different manufacturers.
Coil Dislikes:
-Intense Vibration -Heavy in Hand
-Loudest of Devices -Inconvenient power supply
 ROTARY PENS DIGITAL EQUIPMENT

Rotary Pens are the most common type of Digital Devices are more expensive than
device. These operate in a similar manner as a rotary counterparts. Advocates believe they have
sewing machine, but they introduce dyes into the more power and implant more pigment into the
skin. The rotating movement enables the needle to skin, with reduced trauma because of reduce
strike the skin vertically, repeatedly, and requires sideways needle vibration as one is moving
dipping every 3-4 strokes. Rotary pens usually forward.
have a power range of low, medium, or high. Digital units have a much wider power range
Pros: Cons: and more setting choices than rotary. They also
-90day warranty -Breakdown more have the longest manufacturer warranty of any
-Easy to handle -Fewer needle configuration permanent makeup device.
-Lightweight/reliable -Slower application process Pros: Cons:
-Quieter machine -May cause skin irritation -1-3year warranty -Expensive
-Push button on/off -More power -Hard to transport
-Readout info (some) -Not battery operated
-Implant more color
-Single-use cartridge
-Can be foot pedal operated
 PIGMENTS ORGANIC PIGMENTS INORGANIC PIGMENTS

Pigments are the colors and
dyes that are the actual colors
injected into the dermis and provide
the color that constitutes permanent
makeup. The pigments are
considered organic pigments,
meaning that they occur naturally in
nature, or inorganic, meaning they
do not contain the materials
associated with life or living beings
or combination of the 2.
Whether pigments are
organic or inorganic they are still
likely to be synthetic.
Organic pigments are not
made from living organisms.
These pigments are brighter
and more intense but are less
stable and prone to fading.
They are also less opaque.
These are usually are
synthesized in laboratories.
Carbon-based oganic pigments
are combined with nitrogen,
oxygen, and hydrogen, which
are commonly found in nature
to form a great range of
chemical compounds
Inorganic Pigments are
less intense but have a longer
life in the skin than organic
pigments. These pigments
comprise the majority of the
color pallet, mostly iron oxide.
Most of permanent makeup
and all forms of tattooing are
derived from this color palette.
Pigments used in
Permanent Makeup are all
nontoxic, stable, and insoluble.
The resulting liquid pigment is
antiseptic, meaning it will not
cause infection, in of itself

More info about pigments can be found on the website of the U.S Department of Health and Human
Services and the U.S Food and Drug Administration.
Look for FDA Drug and Cosmetic
 ANESTHETIC AGENTS
Because permanent makeup is most often
performed on areas of the body that are sensitive,
the use of anesthetic agents is not uncommon.
Ice compresses is a form anesthesia that is
not always the most effective. The ice given must
be within a plastic barrier container because
saturating te skin with moisture may cause it to
absorb water and result is retention of pigment
molecules. This method is best for managing
swelling after the procedure and to provide comfort
for the client.
Topical anesthetics are the preferred method
of reducing pain and discomfort. Examples:
betacaine, lidocaine, and tetracaine.Various
blends have been developed and are available
over the counter. Technicians are not licensed
medical practitioners, and prescribing prescription
products is illegal for them. This type of anesthetic
is effective and quick acting.
Some topicals are designed to be safe for
eyeliner procedure, be sure to follow the
manufacturer's guidelines carefully to ensure the
best result. A complete client history, including
information on sensitivities and allergies, is a
must to allow for proper topical selection.
Local anesthetics administered by an
injection are an option for patients who have a
low pain threshold. These can only be performed
by a physician, dentist, or nurse. Most patients
will experience more swelling because of injection
and should be warned in advance.
Oral sedatives that can be used with
physician’s prescription, filled in advance of
procedure, will also reduce pain and anxiety. Be
sure that client ha someone with them to drive
them home after their procedure if this method is
chosen.
Ch. 6 Indications, Contraindications, and Techniques
Key Terms:
Consent Form Lining Shading
Contractures Migration Stippling
Corner Mucocutaneous Vermillion Line
Dyschromias Paramedical Permanent Makeup Vermillion Lip
Hypertrophic Scar Pointillism Vitiligo
Keloid Scars White Lip

Review Questions:
1. Why do clients choose permanent makeup treatment?
2. What are the 4 different techniques for application?
3. What technique is best for eyeliner application?
4. What do you expect to find on the horizontal analysis of the face?
5. How is harmony created on the face?
6. What types of scars are recommended for this procedure?
7. What is a kohl line?
8. What are 3 potential complications most commonly
associated with pigment placement?
9. Why do lips shrink?
10. Why should permanent makeup artist be careful to avoid
the application of dramatic eyeliner?
 YOUR WORKSPACE

KEEP YOUR WORKSPACE CLEAN,

WELL-ORGANIZED, AND WELL-LIGHTED.
Before you begin your procedure, evaluate this
area. Make sure you have everything you need, it
is easily accessible, and that you have your
inventory ready.
Next is to make sure the room is neat and
tidy as well as your workstation. Free of all drips,
spill, splatters, and splashes. Make sure the
table/bed is made comfortable and clean for you
clients. Make sure all guidelines of OSHA are
considered and remembered.
Finally, create a space that is calm and
relaxing for you client. Playing soothing music,
having stuffed animals, or similar items to hold for
comfort usually give a positive response to stress.
 BEGINNING THE TREATMENT
When starting the procedure, the first thing
you should do is make your client comfortable.
Then begin by first taking before photos as part
of the client’s record. Many insurance firms
require date-embedded or date-stamped
pictures.
Next you should obtain consent form for the
treatment. This is part of the client’s and your
protection. Make sure your consent form has all
the necessary and important information to notify
and sign for your client.
Once photographs are taken and consent
form is understood and signed you can begin by
removing the client's makeup, with a mild
cleanser, if they have any on the treatment area.
Make sure this area is thoroughly cleaned softly
to lower risks of infection. Remember that
makeup carries bacteria and you are puncturing
the skin, so an infection can occur.
Once the client is comfortable, apply a
topical anesthetic, cover area with ilm to enhance
preparation, and then mix pigment. While the
anesthetic is working, the technician can chat
with the client, reconfirm the direction of color
selection and give the client confidence that you
are customizing the right shade for them. Most
topical anesthetics take about 7-15 minutes to be
effective.
Talk to the client to create comfort, explain
the steps you are doing and why your are doing
them to ensure they are in good hands and to
build trust.
 GENERAL TECHNIQUES FOR APPLYING PERMANENT MAKEUP
Several variable should be considered when
using each technique. Stretching is something that
is used with all types of techniques. This ensures a
consistent, ore natural-looking outcome. All
techniques employed give a better result if the skin
is stretched tightly. Many technicians fear hurting
the client, but lack of stretch hurts more. Try to
stretch the skin in multiple direction so if the client
moves the skin stays taut. In some instances,
shifting lax skin to “solid ground” is necessary to
get good pigment hold.
The first technique is the pointillism method,
a.k.a dotting. This the process of creating closely
spaced dots rather than drawing a traditional line.
Upclose the marks appear as dots, but from a
distance, they take shape. Pointillism is a common
tehnique used with low-powered devices in areas
that are difficult to penetrate, such as eyelids.
The 2nd technique is stippling. Stippling is
similar to pointillism because it used dotting. The
difference is that the technician uses stippling for
shading or adding color rather than achieving lines.
This is used for eyebrows or for reconstructive
tattooing in conjunction with cosmetic surgery. The
benefit with this technique is that you can minimize
lines around edges for a softer look.
The 3rd technique is lining. Lining uses a
back and forth motion to create a line without
interruption. These lines can be straight or curved,
horizontal or vertical. Lining is most commonly
used for lip liners, eye lining, and hair-strokes for
eyebrows. The best way to apply this technique
would be to hold the device between your fingers
and pivot from your wrist for a more smooth
application.
 GENERAL TECHNIQUES FOR APPLYING PERMANENT MAKEUP: continued...

The last technique is shading, which

uses either a round needle grouping worked in
a tight circular pattern or a magnum needle
grouping and scooping or shoveling the color
in. This latter technique most closely
resembles the lining technique and should
create a consistent color fill in the area being
shaded.
Shading is a technique of “fading the
color” from dark to light using a sweeping
motion of the wrist, which creates a depth and
contour affect.
Shaded areas often need to be touched
up, and is often one on large areas requiring
color such as, areola enhancement or lip
coloration.
 EYELIDS

The eyes are often an area that ages first

and can age quickly, giving away the
appearance of sadness, droopiness, puffiness,
and hollowness.
Our eyes are so important to how people
view us, and how we view ourselves. The work
that you do is considered permanent, that is, the
work that you do will affect the recipient, and
those whom they come in contact with.
Similar to eyebrows and other facial makeup,
eyeliner will evolve with trends and styles. The
client must be reminded that avoiding thick
dramatic liner that the client may regret in later
years.
Several different approaches can be used
for lining the eye: a straight and solid line on the
upper and lower, a straight solid line n the upper,
a straight solid line on the lower, a lash line
enhancement, and a kohl enhancement.
 EYELINER TECHNIQUES
The traditional upper and lower tattoo of the
eyelid involves placing pigment on the eyelid in a
straight line. Some client prefer the eyeliner to be
wedged (wider at the outer ⅓ to ½ of the eye) and
other like it to be domed (with the widest part over
the iris). Preferences can be culturally based.
Remember that if you get the pigment too
dark or too thick it is nearly impossible to revise.
Because of this, a light application can always be
improved at a later date and can be completed
over multiple application for the best result of the
client’s desires.
Conversely, if you select a color that is too
light, it will not be visible following healing process.
The lighter the color selection the quicker you will
have fae and color adulteration. All colors change
tone as they fade, be sure to choose a neutral
based color so underlying pigments do not show
through, such as red or violet tones.
Tips to Know:
- Lower liner will appear darker than upper
liner, be sure to choose darker color for upper
- Eyes will swell during procedure, making it
difficult to create a smooth, even line
- Pointillism can be more painful and less
consistent compared to lining, for beginners
- For a more natural look, place line in between
lashes
- To create a larger eye appearance, place the
line above the upper lash area, and just
below the lower lash area
- Avoid working in wet tissue area, will not
retain color well
- Keep tight hold of eye to help keep control for
clean, smooth application
 EYELASH ENHANCEMENT KHOL LINE

The eyelashes are at the edge of the free
margin of the lid. Lash line enhancement is unlike
eyelid liner. Lash enhancement is meant to create
the appearance of thicker lashes.
Small dots of dye are placed between the
eyelashes to promote a thick, full lash. For
blondes, you may want to use a lighter taupe and a
very thin line for a more natural result.
A little-used technique is the kohl line. This
black substance is applied on the flat edge of the
eyelid right next to the eye itself. Originally, in
Saudi Arabia this was used to deflect the sun, but
over time became a fashion statement.
When kohl is applied as permanent
makeup, it is tattooed on the flat edge of the
eyelid in a very dark color. This design is dramatic
and exotic, this also makes the eye appear
smaller.
This technique usually doesn't hold color
well because it is applied in the wet area on the
lash line.

For ALL eyeliner techniques, the line or dots should start where the lashes start on the inner area and
stop on the outer area.
Working on the inner tear duct in NOT recommended because it may risk blurring, or puddling, and
migration of color is high.
 EYEBROWS

Eyebrows may be one of the most Consider these evaluations:

overlooked yet most important features of the - Vertical facial symmetry
face. The eyebrows add expression and - Horizontal facial proportions
definition to our face and eyes, while also frame - Are any characteristics higher or lower than
and lifting those areas. one another?
Before the technician can begin the - Is any area wide, narrow, long?
permanent makeup process the face shape must - What is their face shape?
be determined. The face should be in harmony
with the horizontal thirds of the face. You should
determine the brow shape, eye shape, and face
shape, then create the best brow design for all
situations.
Every face is asymmetric, which needs to
be considered when designing and applying brow
placement.
EYEBROWS
 EYEBROWS

Choose Desired/Best Shape for Brows (:

Measure Facial Proportions (:

 EYEBROW TECHNIQUES

You and your client must determine and agree to
the style, shape, and color of the brows during the
consultation. Be sure that your client is committed and
loves the design choice of the brows.
Some clients may come in with pictures of
designs that they want. You must be able to determine,
balance, and explain to them what will look best for
their individual face structure, while also given them
the characteristics that they love.
The first technique approach for this would be
lining. Individual lining constructs each hair on by one,
creating a more subtle effect. This technique also
allows for a more natural mix of colors, giving you the
ability to add highlights within the brow design.
Begin the line at the desired spot on the
perimeter of the outline and move at an upward angle
away from the nose. Stop at the corresponding point
on the opposite side of the outline. Lines should be
implanted at a 45 degree angle to the baseline from
where they are rising, this will achieve a more realistic
look.
Keeping the lines evenly spaced is key to creating
the most natural look, if the lines are created to close
together they will heal blurred and will appear more of
a powdered, filled in brow.

You must hold the skin taut to ensure a clean

application without any irregular-looking hair strokes
and even penetration..
 EYEBROW TECHNIQUES

The second technique is shading. This
application has a more darker and defined
appearance.
You begin by creating the outline of the
brow size and shape with your marking pen. You
must stretch the skin side to side in the direction
of the movement of the device. Start on the
inside, and move your way outside.
Shading strokes are placed closely together,
so when healed they look like softly applied
makeup. Shading is sometimes done with the
pointillism technique and applying tiny dots close
together around the perimeter of the brow.
The outline is always done with a marking
pencil, we do not recommend that it is tattooed
into the skin. Altering it is almost impossible and
never looks soft and natural.
If clients have already thick brows, you can
explain that their light hairs will soften the color
that is applied underneath them. You may also
recommend having their brows tinted after the
permanent makeup is healed.

With BOTH lining and shading technique be

sure to wipe away the drawn line and touch up
any unevenness created by the outline.
 LIPS

We use our lips to speak, eat, and kiss. We
as a population have grown attached to them
and we try to accentuate them by applying
color, injecting them with fillers to plump them,
and we make noises with them, we purse them,
and we pout them to express feeling or a desire.
In society, youthfulness includes full and
plump lips. As we grow older our lips begin to
shrink, it is part of our aging process.
The problem that draws people towards
permanent makeup is that regular makeup must
be applied, reapplied, and reapplied; and not the
case with permanent makeup.
Making sure that when applying this service
you are paying close attention to detail because
the lips draw a lot of attention, just like the eyes,
and they are hard to fix mistakes once it has been
tattooed.

Many people will use dermal fillers and

permanent makeup on the lips to enhance this
feature. Asymmetric, thin lips is a primary
indication that permanent makeup may be the
service for you.
 LIP TECHNIQUES
Colors, shapes, and intensity should all be
considered when determining the outcome for
the lips. Color is a preference matter, and the
client will have one. However, as a professional
you may have to steer your client away from
fads and towards a color that best fits their
appearance.
Things to Consider:
- Choosing lighter shade: gives client option
to fill in with applied makeup when desired
- Do they need to broaden or repair
asymmetric lips?
- Want pouty lips?
- Want a discreet lip?
- Want a seductive or subtle look?
- When consulting draw on lip liner with
different color and shapes to decide what
is best for your client
The lips can be colored entirely, for a flat
affect, or shaded to seem as though they are
glossy and reflecting light.
All modifications to the lip edge to
correct asymmetry need to be done with
caution. Going too far outside the vermillion
can result is a clown-like appearance. The fact
that the vermillion rim and the surrounding
skin will retain more color must also be
compensated for.
Applying color with the pencils and tattoo
needles are a very different feeling. The tattoo
needles create the finest of lines and therefore
any wobbles or angle changes are most
obvious. Pigment will go where the needle
points and can leave a halo. The tip of the
needle should never be pointed towards the
outer edge of the lip to eliminate problems of
color movement.
 SCARS, BURNS, & SKIN DISEASES
Some people have had accidents, surgeries, or
diseases that have caused them to be physically
altered in a way that causes them great distress.
Sometimes they seek out permanent makeup to
minimize both their physical and emotional damage.
This type of makeup is called paramedical
permanent makeup. (Camouflaging tattooing); this
requires additional training and is should be
considered a specialty in the permanent cosmetics
field.
Not all scars a good candidate for camouflage
tattooing. The best scars to treat are flat and lighter
than the skin surrounding it. Now, if the scar is
raised, it is called a hypertrophic scar, or if it is
darker than the surrounding skin, the corrective
results will not be desireable. Another type of
scarring is keloid scars, which are scars that
continue to grow after the wound has healed; these
scars should also not be tattooed on.
Burn scars are usually associated with a
great deal of strife for the recipient. Burns often
encompass large areas and have consequences
for movement and sensation. This burden is
especially true for those who suffered 3rd
degree burns who can develop contractures.
Contractures occur when normal elastic
skin is replaced with fibrous inelastic tissue,
which limits movement and damages nerves.
Permanent makeup will do little to repair the
textures of the skin, but it can alter the color
making it blend in with the undamaged skin.
These types of procedures MUST be done
with extreme care and PROPER training. It does
not always work, which you and the client must
have good communication of.
 SCARS, BURNS, & SKIN DISEASE: continued....

Skin disease can also occupy large areas and

ravage self-esteem. One disorder for which people
have permanent makeup done on is vitiligo. Vitiligo is
a skin disorder characterized by areas that are
completely or partially devoid of pigment.

For people with darker skin, this disease is

especially noticeable. Affected areas have no
protection from the sun and are susceptible to
burning. (Again, treated these types of areas may not
always work) The disease can spread on its own or
because of treatment. The skin can also reject the
pigment or make the colors change.

Patients with vitiligo or any scars, burns, or

skin diseases should be well informed of the risks and
consequences of the treatment. Their expectations
should be steered towards improvement over
perfection.
 TECHNIQUES

Remember that performing these procedures
takes a great deal of experience and practice. You
should have specialized training in this type of
permanent makeup and be insured for all types of
permanent makeup.
The techniques to treat scars, burns, and skin
diseases require delicacy and finesse. You must have
an eye for coloring and progression, and the key is
knowing when to stop.
For scars, only pale-colored, flat scars can be
successfully treated. Hypertrophic scarring is difficult
because of their raised nature, light will hit these scars
differently causing shadows making it hard to blend,
resulting in dissatisfaction.
Pointillism and stippling are considered the best
technique for this, but it is really preference of the
technician and what is best for that client application.
Keep control of pigment in direct areas, surrounding
skin may absorb pigment darker than treatment area
causing a dark ring around it.
Specialized technicians often times stay within
the border of the area and let time to the blending as
the color expands over time. Touch ups are often
necessary.

The most important technique element of scar

correction is color choice. You must match the skin as
best as possible.
 TECHNIQUES
Burns are tricky, the most important thing
about this application is timing. You must not Correction of dyschromias is such a
perform any color enhancements until final stages of time-consuming and most technicians refuse to do it.
recovery has completely healed, making sure the Trained professionals often times ask their clients
skin is not red and in NOT sensitive to touch, which when it began, how it progressed, and if stress/injury
may not happen for some clients. caused the situation to intensify. Many times
technicians have to steer clients away from this
Contractures are especially difficult. This procedure because it can cause the condition to
application may result in additional scarring when spread.
exposed to further trauma. If you are qualified to
take this application on, you must match the
unaffected surrounding skin to then blend the scar.
The skin must be stretched as much as possible
using smaller needles, with a slower shading
technique.

Treating skin diseases such as vitiligo requires

patience and finesse. Some advise NOT to treat this
disease, others recommend to wait until the client
experiences “burn out” which is not more possible
color pigmentation can happen.
PLASTIC SURGERY & PERMANENT MAKEUP

Today, the choice for cosmetic surgery is a

common one.People who undergo these
procedures go to great lengths to ensure the
most natural results. A natural consequence of
these procedures is scarring and wherever the
scar is, we all would prefer for it to not be visible.

Permanent Makeup is not always intended

to repair the scars of plastic surgery. In many
instance, it is used to enhance plastic surgery.
Such has eyebrows and eyeliner application can
complete the look a client desires.
 TECHNIQUES

Treatment for scars after plastic surgery is

much the same as it is for other scarring. The
goal of scar correction is improvement, not
perfection. Scar correction will mostly make the
tone even and blend the surrounding tissue. The
most important technique for scar correction is
color choice and boundary management.

Make sure clients know that pigments will

not change with seasons, therefore dramatic skin
tone changes such as tanning will make the
treated scar more prominent. Being sure that the
tattooed area is protected with a strong SPF
topical at all times to prevent the implanted color
doesn’t fade.
 COLOR CORRECTION
Knowing about the guidelines set forth by the
professional trade organizations and your state
regulatory agency, as well as your client's requests
will help ensure your success.
To correct color mishaps, you knowledge on color
theory is essential. Any underlying pigments in
permanent makeup done previously will coexist
within the skin. To change the color you must first
modify the the color such that it can be brought to
a correctable state.
This modification usually means adding a
completely different color to offset the color
irregularity. Some pigments are sold as color
correctors. If the situation is intense, the color
corrector is first tattooed into the skin, and then
the desired color is implanted afterwards.
For a less intense situation, the modifier is
added to the desired brown tone to ensure enough
corrector color to counterbalance the existing
tone.
2 Things We Never Add to Eyebrows:
Black and White
● Black will give a blue-black color and should
be avoided during eyebrow colorations
● White has the largest micron-size color
molecule, which results in the pigment
floating to the surface of the skin, when
healed, to appear as grains of milia. (The
color Ecru is usually the substitute for white
when needing to lighten the color of brows).
 COLOR MIGRATION

The most dreaded mishap that cannot be corrected
is migration, which is the result if the pigment
leaking outside the target area. Unfortunately,
there is nothing that can be done to correct
migration once it has occurred.
*Do not attempt to correct migration with flesh
tones!
Angle and technique are a big cause of
migration. To avoid migration, be respectful of
the skin, and be sensitive to the techniques
required for the area in which you are working in.
Pigment will spread whatever direction the
needle tip is pointed. Being extremely careful
when working around the edges.

Know & understand the areas that are prone to

migration and select pigments that are least prone
to leakage and purchase them ONLY from a
reputable vendor.

Areas that are prone to leakage are:

-outer corner of the eye
-or when a poor angle is used on eyeliner or
lip liner implantation.
 EYEBROWS TOO DARK

Because of location, they may be easy to

correct.Topical applications “Retin A”, glycolic acid
will exfoliate the external layers.

For best results, let the brows fade with time and
sun exposure. Immediate correction may result in
using a greenish yellow pigment, these colors will
help soften & lighten the darkness.

Tattooists have used saline for many years to

lighten a fresh tattoo that is too dark. Client’s
must be informed that skin discoloration may
occur during the healing process.

This discoloration can be concealed with a

camouflage product, if desired.
 EYELINER TOO DARK
Correcting eyeliner that is too dark can be a
delicate endeavor, just as is applying it in the
first place. In most instances, the best option
for correcting an eyeliner that is too dark is
waiting. Generally, 6-12 months will resolve
the issue.
If an attempt to lighten is important, only
pure saline should be used, and the tattoo
needs to be less than 1 year old. Again,
specialized training is required for insurance
purposes. Unfortunately, pure black eyeliner is
difficult to correct, and the beginner should
not attempt to do so.
PIGMENT FADING
Fading usually occurs when the pigment was
applied to light at the beginning, the shading
was inconsistent, or because of the clients
physiology. All pigments fade, the more the
application is exposed to UV rays the quicker it
will face. Wearing SPF topical, sunglasses, &
protective wear is highly recommended.
Other factors may be lifestyle, medications,
and personal chemistry. Whatever the cause
for fading, corrections are touch ups.
 COLOR APPEARS GRAY

Color pigments turning gray usually occurs

during paramedical permanent makeup, such
as correcting asymmetry of the areolas.

Although, this occurrence is unexplainable,

and the cause is not precisely known, it will
fade to the original pigment color within a
few weeks.

You should warn client’s before camouflage

to minimize concerns. The color may fade or
look gray, but it usually just returns to
previous existing tones or drabs down, which
is why the client must understand the
importance of multiple visits.
Ch. 7 Managing Complications, Side Effects, and Consequences
Key Terms:
Complications Granuloma Self-Aware
Corneal Abrasion Magnetic Resonance Side Effects
Erythema imaging Tannic Acid
Glycolic Acid Postauricular Treatment Consequences

Review Questions:
1. What are complications?
2. What are treatment consequences?
3. What are side effects?
4. How is communication helpful in a difficult situation?
5. What are the client’s common responses to a complication?
6. What are the common complications of permanent makeup?
7. What are the common treatment consequences of permanent makeup?
 INTRODUCTION
Every technician fears that he or she will
make a mistake and cause complications
for the client, and yet the odds of a
mistake are rare.
Complications are unexpected events that
occur following a normally applied
procedure.
Ex. a client has a permanent makeup treatment,
and an infection results.
Side Effects are actions or effects of a
treatment or drug other than permanent
makeup.
Ex. Bruising
Treatment Consequences are predictable
outcomes of the procedure that occur in a
reasonable percentage of people having
the procedure.
Ex. Redness, swelling
COMPLICATIONS
These procedures are generally safe and rarely has
complications. Some that may occur are:
-infection -scarring
-dissatisfaction -corneal abrasions
- eye injuries -cold sores
-migration
If these occurs, they can be minimized for the technician
and client through a variety of steps.
Step 1 - During Consultation:
Most of these situations can be avoided through the
client consultation, this is when the client is educated on
all the factors that may or may not occur. Also, explain to
the client what is being done, each step through the
procedure.
Step - 2 Educate Client about Home-Care
This is one step that is also extremely important!
Being sure the client understands how to take care of the
treatment area during the healing process to ensure the
best results
 COMPLICATIONS
Step 3 - Technician Response:
Responding appropriately means the
technician speaks with the client about the
problem, sees the client in the office, validates the
situation, and finds solutions.
Step 4 - Be Prepared for Client Response
Make sure the client understands the
problem and the available options to solve the
problem. The client will go through a physical as
well as an emotional healing process, it is
important to be supportive and positive during this
time.
After dealing with the client’s needs, the technician
should contact their insurance firm and provide all
the details of the incident, making sure
documentation is complete and put in client
records.
DISSATISFACTION
Dissatisfaction is a commonly occurring complication,
which happens for many reasons.
- incomplete consultative process (the client of
technician may have miscommunicated) of color
or placement.
- technician may not have been experienced enough
to perform treatment on specific region.
- client may not like what she or he actually asked
for (“fad” treatment: thick, archy, dark, square)
The most reliable guard against dissatisfaction is
experience. The more experience you will have in
handling dissatisfaction through communication and
steering client expectations.
Avoid taking on client’s you feel uncomfortable in being
able to make him or her happy. Many technicians
consider the consultation the interview process, in which
you determine you feel comfortable pleasing the client.
 INFECTIONS & SCARRING

Infections and scarring are rare occurrences and can be Most common causes for infections are:
related to specific issues: -ineffective home-care
-unsterile implements -allergic responses -allergic reactions, not properly cared for
-granulomas -keloid scars -granuloma formations
-tattoo removal -MRI complications
Remember that pigment is placed in the upper reticular One time disposable needles, are recommended for
dermal layer. If placed too deeply, the risk of fanning or safety of clients. Sterile single-use needles protect the
blurring increases. client from infection and viral diseases such as
hepatitis and HIV.
Making sure the client knows that they are responsible for
there home-care and that most healing issues result from Allergic reactions are rare and have been traced back
inadvertent deviations from home-care protocols. to the pigment used in the treatment. They usually
present as:
Do’s and Don’ts: -cracking -bleeding
Do - Proper hand washing -swelling -pain
Do - correct topical healing agents -inflammation -burning
Do - Avoid strenuous activities, sun exposure, unclean -a tattoo injury that will not heal
environments
Some technicians recommend a patch test in the
Don’ts - wiping treatment area with unsanitary items postauricular region before a full treatment. This is a
Don’ts - Cuddling pets great indicator, but there is no scientific documentation
Don’ts - handling children, money, hands, etc. exists for predicting results.
 INFECTIONS & SCARRING
Granulomas are small nodules that form in response to
the implantation of the pigment. Many exist, but to
those associated with permanent makeup applications
are known as foreign body granulomas. These capsules
may remain hard and encapsulate the area; other times
they may become infected. Technician should call a
physician for advice and treatment.
Keloid scars extend outside the area of healing and the
result in large bubbles of tissue. Keloid scars are not
hypertrophic scars, which are simply raised scars.
Individuals who are predisposed to keloid scars should
not receive permanent makeup because of injury
sustained during the treatment can result in a keloid
scar.
We know that the biggest reason for scarring is
attempted tattoo removal. Once the tattoo has been
placed, there is little you can do to remove it.
These are some options:
-saline injections -peel application
- dermabrasion -laser
-actual surgery to excise the tissue
More safe options for pigment lightening have rendered
much better results, including use of saline pacts and
specialty acid formulations that also use osmosis to pull
or lift color.
Some reports indicate that permanent makeup will
compromise the results of the MRI. The causes of
interference are unknown, but some people speculate
that metals in the pigments cause the reaction because
of the radiation to which they are exposed. To avoid
discomfort, advise your MRI technician that you
performed permanent makeup so that the necessary
precautions can be taken.
 CORNEAL ABRASIONS & EYE INJURIES MIGRATION

Corneal Abrasions are the most common and Migration occurs when the pigment travels
requires a trip to the E.R or the ophthalmologist beyond its intended placement. This event is
for treatment. They usually require that the eye more likely to occur if your placement is near
be patched for several days while it heals. Once mucous membranes, for example, the corner
healed, the eye should return to its normal of the mouth, corners of the eyes. Using poor
functioning without permanent damage. quality pigments can also cause this event to
happen.
Other eye injuries are rare and require the
attention of a physician immediately. To reduce Technicians should avoid these areas to avoid
the risk of corneal damage these are some tips the likelihood of migration.
technicians use:
- Keep eye lubricating during process
- Single use units of eye drops
- Rinsing the eye with saline wash following
procedure
- Using eyedrops as part of client home care
 COLD SORES (Herpes Simplex I)

Clients who ever had cold sores should be pretreated by a

physician with a product such as Zovarix or Valtrex before lip
or mouth tattooing. This medication will ensure that the client
does not have a break out from the service.

If this virus is present in the body, it lays dormant until it is

stimulated (usually by heat or stress). If a cold sore breaks out,
it can spread and move to the sides of the mouth, nose, and
face. If a client reports a breakout prior to the procedure, the
service should be postponed.
 Client & Technician’s Response to Complications, Side Effects, and Treatments
Pgs. 163-171

Client and technician response to complications, side effects, and treatments all commonly depend
on the technician’s ability to educate the client, communication between technician and client, as
well as understanding one another.

It is important to understand all of the consequences that go along with all complications, side
effects, and treatments. Being a supportive and calm technician is key to handling any situation that
may come about especially during client’s physical and emotional healing process. Be sure to follow
all protocols within the salon and know when to advise your client to see a physicians for necessary
treatment.

You must be self-aware when addressing any of these situations and address every situation fairly
without emotional attachment.
 LASER TATTOO REMOVAL

Permanent Makeup by definition means,

permanent mistakes and permanent decisions.
The options available to dissatisfied clients are
numerous.
These Options include, laser tattoo removal,
tannic acid, glycolic acid.

Laser tattoo removal is thought to be the most

effective option of removal. The process is very
delicate and may not be performed around the
eyes.

Only a physician is qualified to perform this

procedure. The drawback from this option is that
the laser eradicates most pigments, (except for
white) which leaves a (ghost) pale unpigmented
section of skin, with a rough outline of the shape
that was once there.

Complications usually include:infection or scarring

 TANNIC ACID GLYCOLIC ACID

Tannic acid is a yellowish brown acid obtained Glycolic acid is an alpha-hydroxy acid (AHA)
from fermented oak and is the world’s oldest originally derived from sugar cane and is effective
means of tattoo removal. for superficial tissue erosion.

Glycolic acid doesn’t penetrate deep enough to

This can either be applied topically or implanted remove all pigments. Used topically on a daily
into the skin just as the ink was applied. This bases at a home-care strength, it can accelerate
procedure isn’t as effective as laser tattoo the pigment fade.
removal but it is better for more sensitive skin.

There is no safe effectively safe option for This too should not be used around the eyes.
removing permanent makeup of the eyes, other
than a saline wash, which should be performed
during a follow up visit.
SALINE

Saline implants are more commonly being used to

flush out pigments. The saline is implanted into
the dermis in the same fashion that the ink was
placed.

Saline works via osmosis and pulls the pigment to

the surface where it is exfoliated in the scab.
Saline is not intended for large areas, but can be
effective when used on tiny misplacements,

The drawback is that the skin may be slightly red

or discolored for some time as the healing
process occurs.
Ch. 8
Key Terms:
Annual Business Plan Differentiate Trends
Branding Fads Yearly Business Objectives
Cold Calling Standard Pricing Policy

Review Questions:
1. What is the difference between licensure and certification?
2. What is the process of determining the location you will choose?
3. What are the common marketing tactics that will help you be successful?
4. Why might a permanent makeup artist consider carrying retail products?
5. Why is a code of ethics important?
 Licensure
Licensure varies from state to state, just as cosmetology or
aesthetic licenses.
This variation makes the technician vulnerable to
state-to-state regulations that may jeopardize the practice of
the business.
Permanent Makeup can fall under the body of tattooing
laws, and more often will fall under medical laws and will be
performed by nurses.
Some states will have NO licensing rules, making the
situation more difficult.
Certification
Currently there are no uniform regulations that govern
the practice of permanent makeup.However, means do
exist of becoming board certified for permanent
makeup technicians.
This certification should be displayed in a prominent
place in your treatment room.
In 1994, the American Academy of Micropigmentation
(AAM) and the Society of Permanent Cosmetic
Professionals (SPCP) established themselves as the
self-regulating arms of permanent makeup industry.
They created testing programs intended to certify the
technician and added level of credibility for the client’s
peace of mind.
Certification through them is so thorough that some
states require they certify all technicians before they
are allowed to practice legally.
 TRAINING

Technology, informations, and techniques are constantly evolving. As a student as esthetics, your homework will go on long
after you complete your education or training. The most successful technicians will always be on the lookout for NEW innovations
that will reap positive results for their client base and themselves.

Some of the best places to acquire training and continuing education can be at shows, trade industry conferences, and by
taking courses from organizations to which you belong too. More products, techniques, and technology can be found. Therefore,
you must always continue to grow and educate yourself.

Network with others in the industry, subscribe to new learning materials, take as many courses and classes as possible.
Collect as much information as possible, sift through it, keep the good, and throw away the bad. As you continue to advance your
sphere of knowledge, you will become more of an asset to yourself, which helps provide you with job and client security.
 PROFESSIONAL TRADE ORGANIZATIONS

Professional trade organizations are a

coalition of trade professionals who unite for
the purpose of education, networking, and
marketing.

Members pay an annual dues for which they

receive access to group marketing,
continuing education, and other valuable
information.

The technician is then positioned to receive many resources that will offer training on the
newest training techniques, equipment, education, and consulting tactics. Which will also
create a successful business for the technician.

The AAM and SPCP have code of ethics that will guide you, whether you are a beginner or
an advanced permanent makeup specialist.

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 TECHNOLOGY

Technology

As the industry expands, technology is keeping up the pace. The more credible the industry
becomes, the more the market drives the need for technology that will improve the outcomes of the
procedure while offering safety, comfort, and peace of mind to the clients.

At times, some clients will ask you for your opinion or information about new products and
techniques. In this instance, it is best to keep up with innovation to help guide your client to reach
the best results for there permanent makeup goals.

Technology and its results are the wave of the future; it builds business, gives the technician new
tools, provides effective marketing tactics, and improves the results for the clients.
 SERVICES

Services

Within the practice of permanent makeup, you would be well You should have a menu of services that include all the prices
advised to perform the procedures in which you have the and terms. If you have any limited time offers and discounts,
highest degree of skill, knowledge, training, and passion. this information should be noted on the menu.

In terms of business and marketing, it is important to Also highlight what your specialties are on your brochure,
differentiate yourself as an expert. Telling your client who you show all the procedures you can achieve & why your clients
are and why you are good at what you do is key. come to you.
For example if you specialize in: permanent facial cosmetics,
paramedical makeup specialist, or areola
recoloration/reconstruction.

The services you offer and the location where you will pursue
these treatments must correspond to the training and
experience you have, and the clientele you wish to attract.

For example, a specialist technician would not want to locate

themselves in the heart of the piercings and tattooing distract.
A perfect location would be plastic surgeon or dermatology
facility in an upscale spa or private practice.
 FADS AND TRENDS

Fads and trends are pervasive in our pop culture society. Fads
ebb and flow with greater speed than trends do. The basis for
something to be a fad is that it gains popularity with a
relatively small group of persons, usually a subculture.

Once a fad emerges into mainstream, it becomes a trend. A

trend is a course of prevailing tendencies over time and is the
result of a variety of indicators that suggests a general
directional flow ideology.

For example, a trend in the permanent makeup world might be

a proclivity toward a certain color eyeliner like royal blue.
Trends like these will ultimately be doomed to fall out of
fashion.
 ENVIRONMENT AND LOCATION
Current thinking holds that success of a retail business depends
on three things: location, location, location. But before you decide
on a location, you have to decide who you are and what you offer.
The environment is as much a component of your branding as are
the services, products, brochures, and other employees. The
environment should be easy to locate, appealing, and most
certainly clean.
The environment should invite and accommodate the needs of the
client. This concept should reflect in all aspects, from the decor to
the treatments themselves.
Interior design, rituals, and innovative marketing are keys to
driving loyalty with clients in the aesthetics business. It should be
gender neutral and refined.
PRODUCTS
Permanent makeup artists should be aware of the
products sold in the clinic for which he or she works and
should be able to make recommendation to clients.
If the facility is your own, retail is a must. They create an
opportunity for add-on sales and return visits.
As the owner of a facility you may want to consider
employing an esthetician to do facial.
The recommended products that would become
available would be a benefit. Such as anti inflammatory
products, cortisone, eye creams, eye pads, lip
conditioners, or sunscreens.
 CHOOSING YOUR VENDORS

Just as important as are the services you offer, the location of your Do your homework, ask questions, and make sure you choose
practice, and the products you have available is the vendor from wisely. Make sure that you can trust the integrity of the vendor
which you purchase your materials. you are purchasing from.

The vendor will be especially important from which you choose
your pigments. The most FAQ’s involve the pigments, whether
they contain iron oxides or whether any reactions have been
reported with these pigments.
Selecting a vendor from which the pigments are consistent, safe,
and increasingly important, traceable according to the batch from
which they were derived is a good idea.
-Do the meet all the manufacturing and distributing
qualifications and guidelines?
-What is the quality of their products?
-Do the create their products or where do they ship from?
-Do they insure or guarantee warranty?

Pigments can be impure, or they can be subject to separation,

therefore the more we buy reputable products, the more likely
these companies will continue to produce premium products.

Another key fact to know about the vendors is whether they are in
the business of manufacturing machines and devices for you to
use for application or whether they are simply a distributor.
 KEEPING YOUR BUSINESS MOVING
4 Different topics are covered in this section: 1. Competition, 2. Pricing, 3.
Cash Management, 4. Marketing Strategies.
This is the difference between success and failure.
For COMPETITION to translate into success, a permanent makeup
technician needs to negotiate a fine line between active interest and a
nosy neighbor.
By collecting small amounts of information, you can catch a glimpse of
what the competition is doing with pricing, menu offerings, and
compensation. Then, translating this data into useful criteria for your
business is a valuable skill when running your business.
PRICING is perhaps one of the more important strategies you will learn.
The price of an item is consumer driven, the amount of what the customer
is willing to pay.
Your first step should be understanding your client: What is their
motivation for permanent makeup, and their knowledge that they have
acquired, and why they selected you.
Every client fits into budget, average, or expert service brackets…..
Knowing the answer to those questions, along with many other with
help you decide on your pricing. Which will in turn allow you to
provide bonus offers, gifts, specials, or other benefits to your client.
Effective CASH MANAGEMENT will be your success or your failure.
You can understand the theories of how to manage your cash, but to
have discipline to manage the cash will separate the winners from the
losers.
Cash is perhaps the most important commodity available to a
business, giving them flexibility and the ability to grow.
Creating MARKETING STRATEGIES and watching them bring in
clients can be rewarding at times and equally disconcerting other
times. Business growth followed by success depends on innovative,
effective, and organized marketing.
The marketing plan you create should use as many strategies as
possible because every one of them will have a different reach,
appeal, and anticipated impact on the practice.
 UNDERSTANDING THE COMPETITION (IN DEPTH)

Your competition is everywhere, even outside your business sector. Your waiting area will be compared with the most exquisite
furnishings fit for royalty. Your customer service will be held up to virtually unattainable standards. This tendency is simply the way
the customer or client thinks and does not suggest that your permanent makeup business must settle for mediocrity.
Your permanent makeup success will be served best by an internal motivation to satisfy your own clients.

Your competition in town can be distracting, but you will want to know what they are doing:
1. What services they offer?
2. Do you share common services?
3. What prices do they offer these services compared to yours?
4. Demographic targets.
5. Promotions, discounts, beenefits?
Stay informed, but use your time efficiently by growing your own business. Do not consume yourself with others.

Additionally, look at competition across the country. This view will help you see the direction of the industry.
Stay on top of what they are doing: pricing, procedures, promotions, literature, written materials, web promotions, ect.
This search will help you stay up to date on fads and trends that are developing in the industry and adjust your business model, and
menu as you wish.
 PRICING (IN DEPTH)

Paying attention to pricing and considering different pricing models to facilitate

growth and profitability of your business is a smart strategy.

You may want to consider implementing a standard pricing policy. A standard pricing
policy is a document that lists all of the prices. The initial prices are calculated from a
mathematical formula based on cost and a specific makeup percentage.

The standard pricing policy helps the company meet its yearly business objectives. The
yearly business objectives are a part of the annual business plan, which is a complex
document that includes individual development plans for specific services. This
business plan gives focus and depth to the business growth.
 CASH MANAGEMENT (IN DEPTH)

Cash management includes accurate and regular monitoring and daily tracking of operations and business risks. Establishing
indicators and goals is key to evaluate your performance. You should create a “hot sheet” which will enable you to see the business
in a clear view.

Create a document that shows how many consultations you’ve had and how many of them converted into actual services, what
procedures are most popular, what treatments are performed at the same time, or which procedures are great add-ons for another.
Each services is converted into cash, which is important to know which services trigger another to create more income.

Finally, you’ll want to know how much cash was collected, how much cash is on hand, and what major expenses will be incurred in
the following weeks. This information is vital for any company, so must make it easy to collect and easy to use. This will give you a
good idea of the trends of your business and the type of clients you are seeing.

Set daily goals, which will help you achieve weekly goals, that will help you reach monthly goals. This in term set your business up to
completed your annual business goals. There are programs that can help make this process easier.

Documents all things relating to: How many clients do you take in one day, a week, a month? How much cash was collected? How
much is being deposited and taken out to pay expenses? Where is the money going specifically, to what expenses? What is the
remaining income?

Your cash and credit card payments should match your daily, weekly, and monthly revenue sheet.
CASH MANAGEMENT (IN DEPTH)
 MARKETING STRATEGIES

Creating MARKETING STRATEGIES and watching them bring in clients can be rewarding at times and equally disconcerting other times.
Business growth followed by success depends on innovative, effective, and organized marketing.

The marketing plan you create should use as many strategies as possible because every one of them will have a different reach, appeal, and
anticipated impact on the practice.

These strategies include, but are not limited to:

Direct mail
Email
Newspaper
In-house promotions/offers
Literature

Some of the most effective marketing campaigns combine cold calling, which are sales calls to parties unknown to the caller, and other
marketing strategies such as direct mail or magazine and advertising.
 BEST MARKETING CAMPAIGNS

The best marketing campaigns to get a small permanent makeup business

moving use a combination of tactics.

For example hand out multiple promotion cards to clients, friends, family
members, to also spread the word about the permanent makeup services,
along with having a magazine advertisement that contains the
technician’s skills and resume.

This dual approach allowed the technician to cover more territory and
perhaps put his or her name in front of people twice.
 CONCLUSION

Permanent makeup is an art, a science, and a business. As you learn your

trade, you should also become a proficient business person, as well as a
talented artist. In the end, this knowledge and skill will protect your
livelihood.

Continuing education is the key to furthering your place in the world of

permanent makeup, and this principle also applies to your business skills
as well.

Individuals who are well educated, properly licensed, legally certified, and
prepared to succeed will have the best chance of being a winner in this
highly special profession,