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The Academy supplies information which does not necessarily reflect the views of the Board of Directors or of members. However, the Academy agrees that it is important that both members and the public have information available upon which to make informed decisions. We welcome questions from the public about any concerns which they may have prior to having their cosmetic invasive procedure. While cosmetic tattooing may fade over time, it is at least "long lasting" and therefore great preparation and care must be taken to achieve the desired result. When you look for a plastic surgeon, you want to know that he or she is Board Certified. Likewise, we offer the public permanent cosmetic professionals that are Board Certified or Eligible and list them on this site for your easy access.

Should Micropigmentation Professionals drop the "Permanent" out of Permanent Makeup?
Micropigmentation, semi-permanent makeup and cosmetic tattooing are terms used worldwide. The terms permanent makeup or permanent cosmetics alone may well give the false impression to clients that their makeup will last forever. Read what others say.

Glamour Magazine APRIL 2005: Permanent Makeup-Sexy or Scary by Christine Lennon

Find out what 12 million readers are learning about permanent makeup. Be prepared to answer their questions about your training and the safety of your pigments. Buy your issue at newstands today.

Permanent Makeup Pigments Found Hypoallergenic in Scientific Testing

More than Vanity: Rutland nurse practitioner Mary Ann Tooker-Perry applies tattoos to scars
The word "tattoo" might conjure up images of that blue butterfly on a girl's shoulderor of muscle-bound bikers memorializing their love for Harley-Davidsons. But the process of injecting igment under the skin also has profound cosmetic andmedical implications. In many instances, the procedure canhelp re-establish self-confidence or even spark a new lease on life. "I can't give anybody perfection," say Mary Anne Perry..." It's all about improvement." Read this entire article

Academy Member Maggie Krippner makes news in Eau Claire (Clear water), Wisconsin
Permanent Makeup Popularity WQOW TV-18 January 18, 2005

Read the official Supreme Court Opinion in this dispute over the name or words "Micro" and "Colors" and Microcolors. Also, see additional sources below. This transcript is in Adobe Acrobat format.
J Magn Reson Imaging. 2002 Feb;15(2):180-4. Related Articles, Links
Magnetic resonance imaging and permanent cosmetics (tattoos): survey of complications and adverse events.
Tope WD, Shellock FG.
Department of Dermatology, University of Minnesota Hospital and Clinic, Minneapolis, Minnesota, USA.
PURPOSE: To use a survey to determine the incidence of complications and adverse events in individuals with permanent cosmetics (e.g., tattooed eyeliner, eyebrows, lips, cheeks, etc.) who underwent magnetic resonance (MR) imaging. MATERIALS and METHODS: A questionnaire was distributed to clients of cosmetic tattoo technicians. This survey asked study subjects for demographic data, information about their tattoos, and for their experiences during MR imaging procedures. RESULTS: Data obtained from 1032 surveys were tabulated. One hundred thirty-five (13.1%) study subjects underwent MR imaging after having permanent cosmetics applied. Of these, only two individuals (1.5%) experienced problems associated with MR imaging. One subject reported a sensation of "slight tingling" and the other subject reported a sensation of "burning"; both sensations were transient in nature. CONCLUSION: Based on these findings and information in the peer-reviewed literature, it appears that MR imaging may be performed in patients with permanent cosmetics without any serious soft tissue reactions or adverse events. Therefore, the presence of permanent cosmetics should not prevent a patient from undergoing MR imaging. Copyright 2002 Wiley-Liss, Inc.
Dermatol Surg. 2002 Jan;28(1):95-6
Areolar cosmetic tattoo ink darkening: a complication of Q-switched alexandrite laser treatment.
Chang SE, Kim KJ, Choi JH, Sung KJ, Moon KC, Koh JK.

Department of Dermatology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
BACKGROUND AND OBJECTIVE: Medical tattooing of the areola is widely performed in Korea. However, cosmetic tattoos containing flesh-tone, purple-red, and yellow dyes are sometimes resistant to Q-switched laser and may even become darker. METHOD: Two Korean women in their 30s who had a mastectomy got light brown to red areolar medical tattoos but they were not satisfied with the shape and size of the tattoos. They underwent Q-switched alexandrite laser treatment with a 3 mm collimated beam at fluences of 7.5-8 J/cm2 in order to trim the irregular contour and reduce the diameter of the tattoos. RESULTS: Within 5 minutes a dark gray to black discoloration of the treated area was evident and remained dark for 6 weeks. Improvement was not noted after two further Q-switched Nd:YAG laser treatments. CONCLUSION: Medical areolar tattoos should be approached with extra caution when attempting their removal with high-energy pulsed lasers such as Q-switched alexandrite laser and a small test site should be performed prior to treatment.

Cosmetic tattoos can be hard to fix
By Shari Roan
Los Angeles Times Posted on Wednesday, January 14, 2004

Removal of permanent makeup can result in colors such as bright orange or dark green. Numerous treatments must sometimes be used to address various colors, depending on the colors the tattoo artist used to achieve the original tone.

Permanent makeup — color applied to the facial skin to resemble lip liner, eyeliner or eyebrows — is among the trickiest of tattoos to remove. Just ask the woman whose lips turned black and eyebrows yellow.

The case, reported by a team of dermatologists last year in the journal Dermatologic Surgery, was an extreme example of what can go wrong when doctors use lasers to attempt to remove certain colors of tattoos, such as the reds and browns used in permanent makeup.

Such tattoos are popular among women who want to save time applying makeup or who want to appear as if they have makeup on all the time. But, eventually, the colors can change — as can the face's contours, resulting in makeup that looks distorted. Requests for removals are common, doctors say.

One Miami woman who had tired of her red lip liner and brown eyebrow tattoos requested laser removal of the ink, recounts New York dermatologist James Spencer. After the first laser treatment, however, the woman's red lip liner turned black and her eyebrows turned bright orange. The black faded after another laser treatment, but the eyebrow color turned yellow and dark green. Several additional laser treatments over a period of weeks were required to rid the eyebrows of most of the tropical hues.

"Cosmetic tattoos can be interesting," says Spencer, vice chairman of dermatology at Mount Sinai School of Medicine in New York and one of the doctors who reported the case. "But it can be alarming to the patient if you don't explain this could happen in advance."

Different lasers and numerous treatments must sometimes be used to address various colors. Spencer said the Miami woman's eyebrows might have proved problematic because the tattoo artist had used several colors to achieve a brown tone.

Removing permanent makeup requires patience, added Dr. Harold Lancer, a Beverly Hills dermatologic surgeon.

One of Lancer's patients regretted her tattooed eyebrows almost immediately. Sally Hermann of Acton, Calif., had the ink applied in April 2002 to thicken the appearance of her eyebrows. But she experienced inflammation and itching.

A medication prescribed by her doctor failed to calm the allergic reaction and Hermann, 64, was referred to Lancer, who began the long process of trying to remove the ink.

"It was so hard," Hermann said. "It took me going to Beverly Hills every week for a while, then once a month, for a year. It cost me $3,000."

Lancer couldn't use a laser initially because doing so would turn the eyebrows purple. The inflammation was affecting the ink color, he said, and there was such a mix of inks used to make the brown eyebrows that removing some colors with a laser would temporarily leave other odd colors behind. Instead, the doctor used medication (to treat the inflammation), microdermabrasion and, eventually, laser in small doses.

"It was a matter of treating and waiting, treating and waiting," Lancer recalls. "Removals are never, ever, a quick fix."

1: J Am Acad Dermatol. 2003 Feb;48(2):271-2. Related Articles, Links
Surgical pearl: Removal of cosmetic lip-liner tattoo with the pulsed carbon dioxide laser.
Mafong EA, Kauvar AN, Geronemus RG.
Laser & Skin Surgery Center of New York, 317 E. 34th Street, Suite 11 North, New York, NY 10016, USA.

Successful Treatment of a Cosmetic Tattoo Using a Combination of Lasers
Karen Rebecca Suchin, MD*, and Steven S. Greenbaum, MD*

Background. Cosmetic tattoos are becoming more popular and are often composed of several colors. Tattoo pigments containing ferric oxide and titanium dioxide can change to a blue-black color after exposure to Q-switched lasers that can be permanent.Objective. Using a patient who presented with rouge tattoos on the cheeks as an example, we describe a useful approach to laser treatment of cosmetic tattoos.

Methods. Test areas were done with the Q-switched Nd:YAG at both 532 and 1064 nm and with the pulsed-dye laser at 595 nm.

Results. Although an immediate blue-black color change occurred after treatment with the Nd:YAG at 532 and 1064 nm, sequential treatments at 1064 nm produced a near complete clearance of the tattoos. The pulsed-dye laser was used to remove subtle pink tones.

Conclusion. Performing small test areas before complete treatment and using several laser wavelengths throughout the course of therapy are essential to the successful treatment of cosmetic tattoos.

Dermatologic Surgery
Volume 30 Issue 1 Page 105  - January 2004

Permanent makeup: beauty or the beast? by Deborah Mitchell

Want to throw away your eyeliner, lip liner and blush forever? More and more women are turning to permanent makeup, or cosmetic tattooing, for makeup that doesn't run or smear. Will you submit yourself to the needle in the name of beauty? Learn more about permanent makeup before you decide.

If anyone had told Claudia last year she'd get a tattoo at age forty-eight, she would have said they were crazy. Now she's delighted with her new look. "When people ask me, 'where's the tattoo?' I tell them they're looking at it." Then she bats her eyes. "The eyeliner and lip color are permanent. People say it looks like makeup, and I tell them they're right."

Permanent makeup returns

Cosmetic tattooing was practiced by several ancient Mediterranean cultures, as evidenced by the tattooed mummies found by archaeologists. Cosmetic tattooing experienced a rebirth in the United States in the late 1970s, and today there are a growing number of cosmetologists, tattoo artists, nurses, and aestheticians in the industry.

Not just vanity

If you think permanent makeup is solely about vanity, think again. "Cosmetic reasons is one area, but there are many more practical applications," says Charles S. Zwerling, M.D., F.A.C.S., director of the American Academy of Micropigmentation. For women who have arthritis, stroke, Parkinson's disease, multiple sclerosis, or other conditions that cause tremors, putting on makeup can be an impossible task. Permanent makeup eliminates their frustration. Women with vision problems, who are blind, or who have cataracts are also good candidates.

"Cataracts made putting on makeup impossible," says Margaret, a 60-year-old grandmother. "Now my makeup looks good all the time!"

Cosmetic tattooing also helps women who have allergies or hypersensitivity to makeup. Female athletes and other physically active women are turning to permanent cosmetics, as are business women, entertainers, models, and housewives.

For women who have lost their hair because of chemotherapy or alopecia (a condition that can cause loss of body hair), permanent eyebrows and eyeliner can restore self-esteem and eliminate the need to reapply eyebrows every day. Cosmetic tattooing also helps with vitiligo (a condition in which the skin loses pigment). Permanent makeup can blend lightened skin tones with the surrounding normal-colored skin. (Click here for remainder of story) Nancy Erfan recounts allergic reaction to Premier Pigments. My allergic reaction symptoms consisted of burning, itching, swelling, bumps or so-called ‘granulomas’, dryness, peeling, bleeding, and the constant formation of yellowish fluids around my eyes and lips that were impossible to completely remove. My lips were sensitive to the touch and my eyes hurt when I blinked. I still can’t open my mouth wide enough to floss my teeth and I have to use baby utensils in order to eat. In addition, I still have swollen lymph nodes because I have big lumps under my chin and the sides of my face. At one point, my eyes and lips were infected and I was on antibiotics.

December 8, 2004:CFSAN announces program priorities for 2005
In 2005, the FDA/CFSAN and CDC have announced that pigments used in cosmetic and traditional tattooing will be a high priority for investigation and enforcement of existing regulations.


December 8, 2004:Supreme Court Upholds Fair Use Defense in Trademark Case: Finds that some consumer confusion is compatible with fair Use

December 9, 2004:,0,1942273.story?coll=la-news-politics-supreme_court

December, 2004: Both sides take comfort from high court's ruling in closely watched trademark case

KP Permanent Make-Up v. Lasting Impressions I, 543 U.S. ___ (2004).

FACTS: Both KP Permanent Make-Up and Lasting use the term “micro color” in marketing permanent cosmetic makeup.  KP has used a single-word version of the term since 1990 or 1991.  In 1992, Lasting (Impressions/MCN Mei-Cha) registered a trademark that included the words “Micro Colors” under 15 U. S. C. §1051, and, in 1999, the registration became incontestable, §1065. When Lasting demanded that KP stop using the word “microcolor,” KP sued for declaratory relief, asserting the statutory affirmative defense of fair use, §1115(b)(4). The Ninth Circuit ruled consumer confusion is an element of fair use and appeared to place the burden of proof (to show an absence of confusion) on KP.
ISSUE: Does a party raising the defense of fair use to a claim of trademark infringement have a burden to negate any likelihood that the practice complained of will confuse customers about the origin of goods or services affected?
HOLDING: (Souter) A party raising the statutory affirmative defense of fair use to a claim of trademark infringement does not have a burden to negate any likelihood that the practice complained of will confuse consumers about the origin of the goods or services affected.
(a) Even if a mark is incontestable (under §1115(b)), a trademark holder has the burden of showing that the defendant’s actual practice is “likely to cause confusion, or to cause mistake, or to deceive” consumers about the origin of the goods or services in question, see, e.g., Two Pesos, Inc. v. Taco Cabana, Inc., 505 U. S. 763, 780.  While cases such as Baglin v. Cusenier Co., 221 U. S. 580, are consistent with taking account of the likelihood of consumer confusion as one consideration in deciding whether a use is fair, they cannot be read to make an assessment of confusion alone dispositive or provide that the defense has a burden to negate it entirely(b) Since the burden of proving likelihood of confusion rests with the plaintiff, and the fair use defendant has no free-standing need to show confusion unlikely, the Court recognizes (contrary to the Ninth Circuit’s view) that some possibility of consumer confusion is compatible with fair use. . . . The Court does not rule out the pertinence of the degree of consumer confusion under the fair use defense.

November 30, 2004: AAM Announces electronic newsletter and e-Alerts in 2005

AAM "e-alerts" provide critical information to professionals to further protect the public and the profession

Public Safety, Permanent Makeup Facts Goal of e-Micronews®: Electronic Newsletter to Debut in 2005 by the American Academy of Micropigmentation

July 6, 2004: The AAM Speaks Out on FDA Alert Regarding Allergic Reactions to Pigment in Permanent Makeup The American Academy of Micropigmentation reminds the public that in the FDA's alert, the pigments involved are limited to those manufactured by Sandi Hammons of Premier Pigments in Arlington, Texas.

July 2, 2004 Premier Ink Shades Associated with Adverse Reactions
FDA Alerts Consumers About Adverse Events Associated with "Permanent Makeup"

The Food and Drug Administration (FDA) is alerting the public to a number of reported adverse events associated with individuals who have undergone certain micropigmentation procedures, a form of tattooing, used to apply "permanent makeup" for lip liner, eyeliner, or eyebrow color. The adverse events are associated with certain ink shades of the Premier Pigment brand of permanent makeup inks, which are manufactured by the American Institute of Intradermal Cosmetics, doing business as Premier Products, in Arlington, TX. FDA is currently investigating this matter.

To date, FDA has been made aware of more than 50 adverse events and is investigating additional reports sent to the manufacturer. Reactions that have been reported include swelling, cracking, peeling, blistering, and scarring as well as formation of granulomas (chronically inflamed tissue mass associated with an infection) in the areas of the eyes and lips. In some cases, the effects reported caused serious disfigurement, resulting in difficulty in eating and talking.

Approximate Timeline:
Fall 2002: Formal Introduction and Release of Premier True Color Concentrates.
2003: FDA Consumer Complaints About Cosmetic Products 2003 Annual Report
February 13,2003: FDA publishes complaint about Premier Pigments.
June 16, 2003: FDA publishes complaint about Premier Pigment Tattoo Lipliner
September 8, 2003: FDA publishes four complaints about Premier Pigments Tattoo pigments
November 13, 2003: FDA publishes complaint about Premier Pigment DARK PECAN
November 17, 2003: FDA publishes complaint about Premier Pigments "ROSEWOOD" pigment

July 2003, Premier reports six allergic reactions to FDA and sends letter to recall five lipcolors. Introduces Premier Enhanced True Colors lipcolors with different orange. Hammons advises professionals to keep using brow colors (with problem orange) but to warn their clients they may have an allergic reaction that may be difficult to treat.

August 2003: Micronews® Article that Premier will do pigment exchange (not recall)
November 2003: Sandi Hammons tells American Academy members there have been a few allergic reactions to True Colors because of a benzimidazole orange. Premier halts pigment exchange toward end of 2003.

March 2004: Consumer has allergic reaction to Premier True Colors lipcolor and eyeliner color. She is informed by Premier Pigments that she is the third allergic reaction reported to Premier.

July 2, 2004
: FDA Consumer Alert about Adverse Events associated with Premier True Colors

September 27, 2004:Premier issues a recall of ALL Premier Pigments True Color concentrates. Voluntary "pigment exchanges" offered intermittently by Premier may not have alerted technicians to the severity of the allergic reactions. FDA Alert states "Reactions that have been reported include swelling, cracking, peeling, blistering, and scarring as well as formation of granulomas (chronically inflamed tissue mass associated with an infection) in the areas of the eyes and lips. In some cases, the effects reported caused serious disfigurement, resulting in difficulty in eating and talking." Additionally, victims have reported inability to smile normally, weight gain from taking systemic steroids, scars from laser treatments, facial atrophy from repeated injections or overtattooing with Kenalog® and possible spread of reactions from so-called "salt water" treatments.

Note: 2003--Hammons stated she used a benzimidazole orange in 250,000 bottles of Premier TRUE COLOR Concentrates. She hoped the opaque, lightfast orange pigment would be useful in her formulations.


also see: Allergic Reactions



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