by Steven Vale, M.D.

Cosmetic tattooing, better described as micropigmentation, has been around since the late 1980s. It was first used to fill-in defects in the eyebrows caused by alopecia or injuries. Recently, cosmetic eyelid tattooing, also known as permanent eye-liner, has experienced an upsurge in popularity.
It might seem at first glance to be a time-saver to have one’s eye-liner permanently tattooed onto the eyelids, but there are quite a few risks to this practice, especially if you already experience dry eye, meibomian gland dysfunction, eye allergies or various other common ocular ailments. Here’s what you need to know about permanent eye-liner and its risks.

About Permanent Eye-liner…

As the name suggests, permanent make-up consists of carefully placed tattoos designed to look like your makeup; but it won’t rub or wipe off. Today, the two most common locations for cosmetic tattoos are on the eyelids, along the lash-line, to resemble eye-liner, and along the edges of the lips, to resemble lip liner.

The method of cosmetic tattooing is basically the same as regular tattooing elsewhere on the body. It requires pigment, or ink, to be injected into the skin using a needle to create the desired effect. Because of the frequent abrasion to the eyelids and lips from everyday cleaning, every few years most people require touch-up sessions to keep their cosmetic tattoos from fading, unlike tattoos elsewhere on the body.

Cosmetic lid tattooing has become popular with women who wish to save time getting ready every morning. While this is understandable, there are a few possible risks to consider before opting in for permanent makeup, especially when it is on your eyelids and near your eyes.

Risks of Eyelid Tattooing

When getting a tattoo, as with having any surgery near your eyes, there is an increased risk of complications. The procedure ideally should be performed by a medical professional such as an ophthalmologist or physician’s assistant, or a licensed cosmetologist or esthetician who is trained in cosmetic tattooing. However, often those interested in the procedure have it done by an unlicensed professional or a tattoo artist to save money. Because these people are not medical professionals, and they use needles (with questionable sterility) in order to create tiny tracts within the skin, one of the biggest risks is infection, including HIV, hepatitis and staphylococcal bacteria. There have also been instances of severe allergic reactions to certain inks used for cosmetic tattooing, particularly when placed near the eyes. In some cases, people have developed allergies many years after having the permanent liner applied.

Even more problematic, if one experiences an allergic reaction or some other adverse reaction to eyelid tattoos, these tattoos are extremely difficult, if not impossible, to fully remove. Laser tattoo removal can be a very effective means of removing both black and some pigmented inks. However, because of the placement of eyelid tattoos near the eyes, this method of tattoo removal can be particularly challenging, if not impossible, and can lead to damage or scarring to the lid margins and thermal or mechanical obliteration of the meibomian glands, the sebaceous oil glands on the margins of the lids that secrete the oily layer of the tear film. This can result in chronic dry eye, even if the tattoo removal is successful.

One other important consideration…

Many people who obtain cosmetic eyelid tattoos end-up dissatisfied with their final results, especially with the passage of years. Unlike regular removable cosmetic products, permanent liner does not offer the option to change or update style to match the prevailing cosmetic and fashion trends, which can leave one with an outdated look that’s near impossible to remove or modify.

Care and Cleaning of the Eyelid Margins

Most patients don’t realize that caring for the eyes and eyelids is just as important as brushing one’s teeth. Bacteria, debris and even tiny dust mite-like organisms, known as Demodex, can accumulate on the surface of your eyelids and lashes, as well as in the lash follicles. These can result in a number of eye problems, including dry eye syndrome, eye allergies and inflammatory eyelid conditions such as blepharitis and meibomianitis.

If you are considering cosmetic eyelid tattooing, be sure to consult a licensed eye care professional, such as an optometrist or an ophthalmologist, before proceeding, as any pathology of the eyelid margins or dry eye requires treatment BEFORE undergoing cosmetic tattooing of the eyelids. At InterMountain Eye Associates, we are committed to treating your eyes as if they were our own.

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