Cosmetic Tattoos - Everything you should know before deciding to go permanent

Dr Helena Torpinski|Tattoo removal
23 July 2019


Written by Dr Helena Torpinksi.
Dr Helena is a GP and skin laser specialist. She loves helping our patients to feel great in the skin they’re in.

Cosmetic tattooing, or permanent make up, is becoming an increasingly popular way to enhance our appearance.

We understand the appeal! It can:

  • save time getting ready in the morning
  • is waterproof, tear proof, all-day-wearing-off proof
  • can save money over the long term
  • can be great for people who find applying make up difficult because of things like poor eyesight, arthritis or other physical issues

And we know most women feel more confident and healthier when they have make up on, as well as more attractive.

Cosmetic tattooing can also be used to correct lacks or imperfections in the skin, and even to hide scars and vitiligo (a drop out in skin pigment).

Despite these many benefits, there are many serious negatives that can accompany cosmetic tattooing and anyone considering permanent make up should ensure they’re fully aware of these potential outcomes and have weighed up the pros and cons thoroughly.

Tattoo Troubles

There are risks with receiving a tattoo anywhere on the body, and with cosmetic tattoos, these risks can be more obvious or worrying because they are on the face and around the eyes.

Allergic reactions to pigments in the ink is not common but can be severe. The reaction can spread over a much wider surface area of the skin that what has been tattooed so can look alarming and unsightly.

Such reactions can include granulomas (lumps of connective tissues surrounding the foreign body in the skin) forming round eyes and lips; red and angry looking rashes; keloids (raised, over-grown scars) which are red and tend to itch.

Treating these reactions can be tricky because the irritant is now in your skin not on it. Because many tattoo inks do not have labelled ingredients, doctors can not tell what the specific irritant is and it often can’t be traced.

Remedying the outcomes of allergic reactions can even require major reconstructive facial surgery.

Issues with MRIs. While also rare, tattoo ink can interact with the magnetic field of MRIs and may result in swelling and burning. It can also affect the outcome of the MRI image. While this may not be a top-of-mind concern for you, if you’re facing a serious health issue that requires an MRI later in life, it may seem a pity to impair your treatment for serious illness for the convenience of permanent make up.

Other things to remember: for two weeks after your tattoo, avoid sweaty activities such as heavy exercises, saunas and facials, avoid swimming pools too. Oily skinned people’s tattoos may distort or fade more quickly with time and colours can migrate. Using facial products which include active ingredients, such as AHA or retinols, may fade their tattoos more quickly.

Common regrets with cosmetic tattoos

Eye Brows

Eyebrow fashions change over time, as often as every 5-10 years. In the 80’s we preferred very thin, highly arched eyebrows. Today, very thick eyebrows with a more squared-off centre shape are popular. Being permanently stuck with a very out dated look is not comfortable for anyone, no matter how much you love that shape today.

The wrong colour for your complexion can really affect the overall appeal of the make up. Too dark on pale complexions can be particularly severe and unpleasant.

Tattoo colours can often change over time. We often see this with black tattoos that can start to look a bluey-green colour. No one wants odd coloured eyebrows, even if the shape is great!

Finally, as your face changes with age, what accentuates your features well can change. Also, weight change can alter face shape, which can change the appropriateness of eyebrow shape.

Eye Liner

Eye liner can easily be tattooed too thick, too long or in the wrong colour.

As with eyebrows, ink colour can fade over time, leaving you with permanent eyeliner in dark blue or green shades rather than black.

Deeply placed eye liner ink can migrate and cause a smeared appearance.

Also, some skin tones and individuals from certain cultural backgrounds can look more appropriate with strong, dark eyeliner, whereas others (usually lighter skinned people) can look much more severe or over-made up. In our youth, we may like this more dramatic effect but as we age it can be far less appealing.


Lip colour preferences change like anything in fashion, so choosing your lip colour for the rest of your life can be an easy thing to regret later on. Particularly if you’re opting for darker colours.

As we’ve already mentioned, ink can fade and change colour over time, so you may not end up with the same colour you began with.

Often women are tempted to tattoo outside the natural lip line, to give the appearance of larger lips. But as we age, our lips thin out and this permanent “expansion” of lip size ceases to look effective and can look very odd, even clownish.

Rectifying Problems

Often patients return to their cosmetic tattooist to touch up or tattoo over mistakes, incorrect or unwanted initial tattoos.

This can make things look far worse, but more seriously, it can affect how easily the tattoo may be removed at a later stage.

Patients wanting to remove their cosmetic tattoos can resort to surgical excisions, dermabrasion or laser removal, all of which may be successful but may also carry their own set of side effects and complications, including changing the skin texture, anatomical distortion, and lightening or darkening of the skin being treated.

These side effects, or indeed the unwanted cosmetic tattoo itself, may be coverable with heavy, theatrical style make up, but for most people, this level of make up is visually unappealing in day-to-day life, as well as costly and time consuming to apply.

Laser removal of cosmetic tattoos

While laser tattoo removal has advanced a lot in recent years, cosmetic tattoos present their own suite of issues when it comes to being removed, primarily  because they are located on the face, around eyes and lips, which are sensitive and have more serious potential side effects than skin elsewhere on the body.

Where ink contains iron or titanium, and is hit by a laser, it oxidises and can turn black. This is concerning when treating lips as it is not uncommon and can look horrifying.

While the new black colour can often be dealt with over time, laser removal can takes many months and patients must live with a ‘gothic’ look until treatment is effective.

Laser removal can release ink pigment into the skin and cause allergic reactions, as mentioned above. These can look unsightly for a while and in very rare circumstances require serious medical attention with permanent outcomes to the appearance of skin.

Laser technicians and dermatologists have no way of knowing the content of the ink used in the tattoo nor the individual patient’s reaction to it, so this is something that should be test-patched before lasering the whole area.

When treating eyes with lasers, intra ocular eyeshields must be used (eye covers that sit inside the eyelid, against the eye). Anaesthetic drops may be needed in the eyes, antibiotic ointment to help avoid infection from the eye shields and there is a small risk of corneal abrasion.

Patients will be puffy and swollen for several days after each treatment, which may impact their day-to-day functioning.

Are you regretting your cosmetic tattoo?

If you’ve decided that your cosmetic tattoo no longer suits you, the colours have changed or you no longer like them, the look isn’t what you wanted or it simply doesn’t “look like you” anymore, we strongly suggest you visit a laser dermatologist experienced in cosmetic tattoo removal.

A consult will help you determine if laser removal is right for you, deliver you all the information you need about risks, timelines, costs, realistic expectations.

We also strongly recommend choosing a clinic with a range of lasers to choose from, a clinic with experience and knowledge in treating different skin type and tones, so you’ll be able to rest assured that your treatment will have the least chance possible of permanently affecting your skin.

Our receptionists can book you a consult with our dermatologist, our cosmetic physician or our tattoo removal specialist nurses, to discuss the removal of your cosmetic tattoo, and get you the information you need to make your decision. Call today on (02) 9953 9522.