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Permanent make-up

A close-up of someone wearing gloves and using a sterile needle to create permanent eyebrow definition on a young woman.

Permanent make-up, also known as micropigmentation, is a cosmetic procedure to create long-lasting eyeliner, lipliner or eyebrow definition.

The technique can also be used medically (called "medical micropigmentation") on an area of skin affected by a health condition. For example, it can be used to:

  • create the appearance of a nipple for women who have had a mastectomy
  • give the illusion of hair for people with hair loss
  • camouflage scars or areas of skin affected by vitiligo

What to think about before you get permanent make-up

It's important to be absolutely certain before you go ahead with permanent make-up.

How much does it cost?

In the UK, the cost of permanent make-up varies from £75 for a beauty spot to £500 for lip liner. You could pay a few hundred pounds for nipple reconstruction and a few thousand pounds for scalp coverage.

Limitations

  • It may fade a little every year (some people decide to pay extra to maintain the look)
  • There's no guarantee you'll achieve the desired effect
  • Mistakes are hard to fix – you'll need to undergo laser or chemical tattoo removal to fix any mistakes
  • Make-up styles change over time. For example, thick, well-defined eyebrows may not be fashionable in 5 years' time

Safety

Providers of permanent make-up do not have to be registered with the Care Quality Commission (CQC), which is the independent regulator for health services in England.

But the practitioner should work in a clean, safe and appropriate environment, with processes in place to deal with any complications. 

Medical micropigmentation requires specific training, so check the practitioner's training and qualifications. Also, check with your GP that having medical micropigmentation will not interfere with any planned treatment.

Read more about choosing who will do your cosmetic procedure.

Do not consider permanent make-up if you're prone to keloid scarring.

What it involves

Consultation

You should have a thorough consultation beforehand to discuss the look you would like to achieve from permanent make-up and to agree on the colour, position and shape. Find out about what process will be followed if something goes wrong during the procedure.

Take time to think about your decision.

A patch test should also be done, to make sure you're not allergic to the pigment.

On the day

A local anaesthetic cream will be applied to numb your skin. The practitioner will then draw on your skin using a surgical pen.

A sterile single-use needle will be inserted underneath the upper layers of skin to deposit pigmented granules. The pigment is usually iron oxide, which is least likely to cause allergic reactions and bleeding.

The procedure takes a number of hours to complete.

You'll usually need 2 applications spaced 4 to 6 weeks apart, and "maintenance" or "top-up" treatments after 1 to 3 years, which will cost extra.

Afterwards

Your practitioner will apply a barrier cream. You'll be advised to apply this 2 times a day if you feel the area drying out and continue to use it for up to 14 days, or until the area has fully healed.

The area may feel itchy or be quite dry while it is healing.

Initially, the colour may appear very intense. It takes about 4 weeks for the colour to fade to its permanent shade.

The surrounding area may be red and a little swollen immediately after treatment and (depending on the procedure) for a few days afterwards. There may be a few spots of blood on the first day.

You'll need to avoid direct jets from a shower or soaking in the bath, as this may remove the pigment or increase the risk of infection. You'll also need to avoid chlorinated water (such as swimming pools) and exposure to sunlight until the area has fully healed.

It can take about 2 weeks to fully heal, after which time you'll be able to follow your usual routine and use beauty products.

Risks

Possible risks of permanent make-up are:

  • disappointing results (mistakes can be hard to fix)
  • infection
  • a skin reaction, such as swelling, cracking, peeling or blistering
  • granulomas – tiny lumps that form under the skin around the pigment
  • scarring, or overgrowths of scar tissue

an allergic reaction to the pigment – but this is rare, as a patch test will usually show this beforehand

Some people get swelling or burning in the tattooed area if they have an MRI scan, but this is rare.

What to do if you have problems

You should look out for problems with healing or skin pigmentation changes.

If you have any symptoms or complications that require medical attention, it is best to go back to the practitioner who treated you. If this is not possible, you can go to a GP or contact NHS 111.

Page last reviewed: 2 September 2019
Next review due: 2 September 2022