Permanent Makeup: Procedures, Healing, Risks and Touch-Ups

Microblading, powder brows, lip blush, eyeliner, freckles and scalp micropigmentation: how each is done, how long it lasts and what can go wrong.

Permanent makeup is cosmetic tattooing. A practitioner puts pigment into the skin to imitate brow hair, lip color, eyeliner or freckles. It sits shallower than a body tattoo and usually fades within one to six years. Faded isn’t the same as gone, though. Traces of pigment can stay long after the color has faded, and removal is harder than the “semi-permanent” label suggests.

Permanent makeup also goes by cosmetic tattooing, micropigmentation or PMU. It works like any tattoo: needles carry pigment into the dermis, the skin layer under the surface. Cosmetic work is placed shallower, which is why it fades and needs touch-ups. Most practitioners use a numbing cream. Brows are usually the easiest to sit through. The lash line and lips are more sensitive.

Microblading uses a handheld tool with a row of tiny needles. It makes fine, hair-like cuts and lays pigment into them. Done well, the strokes are hard to tell from real brow hair. It suits normal to dry skin best. On oily skin, the strokes tend to blur and fade faster.

Powder brows, also sold as ombré or shaded brows, are done with a machine that places tiny dots of pigment. The look is soft and filled in, closer to brow powder than to hair. Dots hold up better on oily and mature skin, and powder brows usually last longer.

Whichever you choose, the artist should draw the shape on first. Don’t let anyone start until you’ve approved it in the mirror.

Eyeliner ranges from a lash line enhancement, with pigment between the lashes, to a full liner or a small wing. Thin and close to the lashes ages best, and pigment that spreads near the eye is hard to fix. Expect puffy eyes for a day or two, and skip mascara until it has healed.

Lip blush tints the whole lip with a sheer wash of color. A lip liner tattoo defines the edge. Right after the session the color looks much brighter than it will heal, and lips usually swell for a day or two. If you get cold sores, talk to your doctor before you book. Tattooing the lips can trigger an outbreak.

Freckle tattoos are small dots of brown or tan pigment across the nose and cheeks, where the sun would freckle you. The same technique makes a single beauty mark. A good artist varies the size and spacing so the dots don’t look stamped, and matches the shade to your skin.

Fresh freckles look darker and sharper than they’ll heal. They scab lightly and soften within a week or two. They’re among the shortest-lived cosmetic tattoos, usually fading within one to three years. Some clients have a few dots placed to trace their star sign, known as “astrofrecks”.

Scalp micropigmentation (SMP) uses thousands of tiny dots to imitate hair follicles. On a shaved head it reads as stubble. Under thinning hair it makes the hair look denser. It doesn’t grow hair, so it suits people happy to keep a short hairstyle.

Practitioners commonly quote these ranges:

• Microblading lasts one to three years, at the short end on oily skin.
• Powder brows last two to three years, often longer.
• Lip blush lasts two to three years, sometimes longer.
• Eyeliner tends to last longest, often three years or more.
• Freckles last one to three years.
• Scalp micropigmentation lasts four to six years.

Sun, oily skin, exfoliating acids, retinoids and peels all speed fading up. Fading isn’t always even, either. Brown brow pigments can drift toward orange or pink, and dark pigments can turn grey-blue.

Most cosmetic tattoos look darker and a bit swollen for the first few days, then flake lightly over a week or two. Brows often seem to vanish around week two before the color comes back. Judge the result at four to six weeks.

Follow your practitioner’s aftercare. Keep the area clean, don’t pick the flakes, and keep makeup off it until it’s healed. Stay out of pools, saunas and direct sun for the first couple of weeks. After that, sunscreen slows fading. More on protecting a tattoo from the sun.

See a doctor if redness spreads, the area gets hotter or more painful after the first few days, you see pus, or you get a fever. After eyeliner, have any eye pain or change in vision checked straight away.

Permanent makeup carries the same risks as any tattoo: infections, allergic reactions, small lumps around the pigment, keloid scars, problems during MRI scans and difficult removal. Needles should be single-use and opened in front of you.

Allergic reactions to pigment are rare¹. But they’re hard to treat, and they can appear years later. Before an MRI, tell the radiographer about any tattooed eyeliner.

Removal usually means laser, and some flesh-tone, white, brown and red cosmetic pigments can turn darker under the laser. A careful clinic tests a small spot first. Our guide to getting a tattoo removed covers the laser side.

Start with licensing. In the US, states and cities set the rules. In England, practitioners have to be registered or licensed with their local council. Training varies a lot, so a certificate tells you less than healed work does. Look for:

• Healed work a year or more out, where the strokes stayed crisp and the color held.
• Work on skin like yours, in tone, oiliness and age.
• A consultation where the shape is drawn on and the shade is matched to your skin.

Tell them if you’re pregnant, form keloids, get cold sores, or take blood thinners or acne medication such as isotretinoin. Some of these mean waiting or checking with a doctor first. There’s no standard price, so ask for a quote at the consultation, and whether it covers the perfecting session.

Plan for a perfecting session about 6 to 8 weeks after the first appointment. It fills gaps and fine-tunes the shape or shade. After that come color boosts, usually every one to two years for brows, lips and freckles. Book one while some color is still there, so the artist can correct any shift in tone.

Before you book, meet two or three practitioners and compare their healed work side by side.