Consumer Safety Tips for Permanent Cosmetics

Millions of people enjoy the benefits of cosmetic tattooing done correctly and safely by well-trained and experienced artists. It’s bad enough when a careless or inexperienced artist tattoos permanent makeup that looks ugly. But there is more at risk than just looking bad:  Permanent makeup is an invasive procedure, so there is also the risk to your general health.

FACT #1: Idaho, like most states, does not require a license for permanent cosmetics, piercing, or body art tattooing. There is no state licensing board or agency regulating those facilities or technicians.  

FACT #2: Idaho, like most states, does not require an examination to be passed before someone can do permanent makeup. Anyone can tattoo makeup anywhere with any amount of training. The person’s background, experience, qualifications, or skills do not matter.  

FACT #3: Idaho, like most states, does not require Health Department inspections. A permanent makeup artist’s location, equipment, or sterilization methods are not inspected or supervised by anyone. They are not required to perform procedures in one location—they can move around to different salons, work from home, or work in their client’s homes.

FACT #4: Sterile needles are not enough to prevent disease transmission. Permanent makeup is invasive and cross-contamination can occur even if sterile needles are used. If a tattooist uses unsafe equipment or does not know, understand, or follow correct infection control guidelines, a person can contract a disease like Hepatitis. Without health department regulations and inspections, there are no assurances for public safety.  

For any cosmetic procedure, including permanent makeup, you should always do research to select the best professional for you. With no regulations for education, competency, or health safety, you are on your own. Be diligent and thoroughly investigate anyone you are considering to perform your permanent makeup procedure.

To look good and protect your health, please follow these steps and ask these questions:

1. Does the Artist Have a Medical Background? The Society of Permanent Cosmetics Professionals (SPCP) reports that most of its members have beauty or other backgrounds (cosmetologist, esthetician, nail technician, electrologist, massage therapist, or traditional tattoo artist); only 10.8% are nurses and 1.8% are physicians.* The artistry of non-medical tattooists may be excellent, but their expertise in routine infection control standards is limited. Since permanent makeup schools are not regulated, any artist without medical education and experience will practice according to how she was trained. If the training was inferior, the artist may not realize when she is cross-contaminating during a procedure. If the permanent makeup artist does not have a medical background, she should at least be certified by passing a nationally standardized examination (see below). [*2009 SPCP Industry Profile Study.]
2. Is the Artist Certified by a National Examination? Anyone completing a permanent makeup class or course receives a “certificate”—so that person with a piece of paper can say she is “certified.” But with no state licensing board for permanent cosmetics, there is no way to know that artist has been properly trained and is competent—unless she passed a standardized test from the AAM or SPCP. The American Academy of Micropigmentation (AAM) and Society of Permanent Cosmetic Professionals (SPCP) are national, non-profit professional societies for the micropigmentation industry. For membership, they require artists to have a minimum number of training hours and to abide by a code of ethics. They offer continuing education meetings and board certification credentials. For certification, both require their members to complete advanced training courses and practice a minimum number of years. To be a Diplomat or Fellow in the AAM (DAAM or FAAM), the member must pass an oral, written, and practical examination. To be a Certified Permanent Cosmetic Professional (CPCP) in the SPCP, the member must pass a nationally standardized written exam. Both examinations test the practitioner’s knowledge of anatomy, medical conditions, blood-borne pathogens, cross contamination prevention, types of equipment, sterilization methods, pigments, color theories, esthetics, pain control, and more.
3. Is the Business “Legitimate”? Opening and operating any small business requires hard work and commitment. It means the owner has made a significant financial investment for expenses such as rent,  utilities, permits, payroll, insurances, and taxes. Some people make money “on the side” by doing permanent makeup from home or in a back room of a salon. They charge less because they can afford to—by operating without the same overhead expenses. They ask for cash and do not accept credit cards or personal checks (usually to avoid paying income taxes). If a client has a problem or wants to file a complaint, those “technicians” usually disappear. So it is important to select a permanent makeup artist who is law abiding, dedicated to customer service, and committed to being in business long-term. Consider the win-win situation of paying a little more to support a permanent makeup artist who owns an established, legitimate business—if it survives and grows, it will still be there in the future when you need another appointment.
4. Inspect the Facility: Before your procedure is scheduled, visit the business and evaluate its cleanliness and environment: Is it quiet and relaxing, or noisy with loud music, conversation, or the sound of hair dryers? There should be a room used specifically for permanent makeup procedures. Ask to see it: Is the room separate and sanitary? Can you smell chemicals from hair sprays or acrylic nails contaminating the air? Move on if you’re not allowed to inspect the room; if it’s occupied, schedule a time to see it later. If the location is a doctor’s office, do not assume the tattooist will do good looking work. Most physicians advertising permanent makeup do not perform procedures themselves—they hire a nurse or technician to work for them, or they rent out a room. So you must screen a permanent makeup artist working in a doctor’s office as thoroughly as anyone else.
5. Look at Photos of the Artist’s Work: Building a portfolio takes time, so a new or inexperienced artist may not have one. Or, she may have purchased one: Permanent makeup artists can buy pre-made books, brochures, and website templates from suppliers or trainers. Those marketing materials show models who are not the artist’s clients, plus the makeup shown is often regular makeup vs. tattoo makeup. And some artists illegally copy photos from books or websites to use as their own.  To evaluate the work of a permanent makeup artist, ask to see her portfolio of “Before” and “After” pictures of real clients—including “Immediately After” and “Healed After” photos to show changes from the healing process. Look at her makeup design abilities: Do all eyebrows look alike, or are they customized to the client and flattering? Look at color choices: Are they appropriate for different ethnic groups and skin tones? Look at results: Can she create “soft and natural” or “glamorous” looks based upon a client’s preference? Are there examples of advanced techniques such as hair stroke eyebrows or scar camouflage? Any talented cosmetic tattoo artist who is experienced will not hesitate to show photos of her/his original work. If the artist has no portfolio, or makes excuses to not show it, that is a red flag to move on.
6. How Much Experience Does the Artist Have? You may not want your permanent makeup done by a brand new artist, so ask how long she has been tattooing. But do NOT assume anyone doing it “many years” will do beautiful work. Since Idaho has no licensing or continuing education requirements, a long-time artist may be using outdated equipment and techniques. Also, many technicians do not tattoo makeup on a regular basis. Often permanent makeup is offered as an extra service in a beauty salon or spa, but the artist spends more time performing other beauty services (e.g. facials). The SPCP reports that only 27% of its members practice permanent cosmetics fulltime. And the national average for new procedures is only 6.3 per month.* So in addition to asking a technician how long she has been tattooing, ask how many procedures she performs each week. An artist performing several hundred procedures each year has more experience, better skills, and returning clients. [*2009 SPCP Industry Profile Study.]
7. How Much Training Does the Artist Have? Idaho has no state board requiring a license to practice permanent cosmetics. No agency requires the passing of an examination. No board regulates school accreditation, the curriculum for primary or advanced training, or continuing education. All permanent makeup schools are not alike—basic training varies from a DVD course to a few days to several weeks. Tuition ranges from $99 for a DVD to a few hundred dollars to several thousand dollars. Students—and later their clients—get what they pay for. So ask for details about the artist’s training and look at certificates. Guidelines by the AAM and SPCP recommend that a fundamental course of instruction be 100 hours minimum. Ask to see the artist’s basic training certificate to check for hours. Also ask to see certificates for advanced courses and training in Blood-Bourne Pathogen Control that follows CDC-OSHA guidelines.
8. Ask About the Equipment Used: Do not rely fully on an artist’s reassurance about using sterile needles. Even when single-use sterile needles are used, diseases can be transferred between people through body fluid and airborne particle contamination of the machine—this is called “cross-contamination.” With most tattoo devices, many steps are needed to clean and disinfect the motor mechanism and hand piece. The parts must be autoclaved to be sterilized or disposed of and replaced completely. If the artist skips a step or performs one incorrectly, cross-contamination can occur. And some machines should never be used because they allow cross-contamination even when properly cleaned. The only devices that prevent that from happening are the disposable Nouveau Contour System, I-Star System, or manual hand tools. With other types of equipment, there is no way to guarantee safety unless it has been inspected and approved by the health department. (Note: Idaho does not require health department inspections of cosmetic tattoo artists.)
9. Ask for References and Referrals: Any reputable permanent makeup artist should willingly provide references of satisfied clients. If he/she cannot or will not provide any, you should go elsewhere. Referrals are also important—ask your friends, family members, or co-workers if they have had permanent makeup applied by someone they would recommend. But don’t rely solely on referrals—follow the guidelines on this page to choose the best technician for you.
10. Consider Price LAST: Even in today’s economy, you should never make a decision about a cosmetic procedure based on price alone. With few laws regulating permanent makeup, as a consumer you are at risk. A low price can mean an artist is a beginner and needs experience, or is not busy and needs money, or is cutting corners to save time or supply costs. An experienced and skilled permanent makeup artist who practices safely, correctly, and ethically will not have the lowest prices—because she cannot remain in business otherwise. So follow the tips above and ask many questions. Remember “you get what you pay for” and a cheap price can cost you more in the end—ugly makeup, pain, or a disease. Permanent makeup is an investment in your face and body. It can last a lifetime, so it is worth paying a little more to protect your looks and your health.

All reputable permanent cosmetic professionals will not hesitate to answer your questions, show their work, or display their credentials. Protect yourself and be informed, be careful, and be safe—you are worth it!