“She just got permanent eye liner and eyebrow augmentation—looks fab,” emailed one of my closest friends last month, about her coworker. “I am seriously considering permanent liner/eyelash augmentation. Do you have any interest in doing this with me?”

I understood the appeal … I’d never have to reapply makeup after showering at the gym, save time on my morning routine and enhance features like thinning lashes and brows. Although we had gone together for facials, brow waxings, and a variety of hair and nail treatments, and teamed up for several ridiculous diets and exercise fads over the years, this one scared me. “It’s permanent, basically, a tattoo, right?

Hold off until I review the literature …” I wrote back. And what I found out was enough to confirm my fears and more.

Permanent makeup—aka micropigmentation, dermal pigmentation, permanent cosmetics, cosmetic tattooing—has gained steady popularity in recent years. As YouTube can attest, eyebrows, eyelids, lips are the most common areas, although cheeks (blush) eye shadow and even beauty marks can be applied. Ads for the services seem to be at an all-time high, and permanent makeup is being promoted to consumers at some doctors’ offices, beauty parlors, day spas, nails salons, tattoo studios and massage parlors. The market has grown so large that a few months ago the US Navy released its regulations for sailors issuing color and other restrictions. But just like body tattoos, if you have a change of heart, permanent makeup is neither easy, nor inexpensive to remove, and as it turns out, it’s quite risky, too.

Internet forums are loaded with sad tales of remorse. One question posted by an unhappy user on Realself.com garnered 508 replies, including:

wilnjoy: I to[sic] had the bottom liner of my eyes done and one peeled off and the other is uneven and only half is done. I cried for weeks…have to use makeup everyday to make it even…

LuluCo: Some days I feel like a freak—and can’t believe how STUPID I was to ever have thought PERMANENT eyebrow make-up was a good idea!!! Mine is uneven (one side thick, one thin), one dark, one light, and the ends are pointy like Spock on Star Trek.

Ann: I just got permanent lipliner and color done………. the worst thing I have ever done. The shape is not natural and I look like a circus clown…

Most of the posters were inquiring about laser removals, a procedure that in itself carries a number of risks. Inks can become paradoxically darker, skin areas can blanch, and if the practitioner is working near lashes and brows, hair follicles can become damaged leading to permanent hair loss.

Even if you’re willing to put up with the risks of permanent makeup itself—botched jobs, color fading or “rusting,” infections, allergic reactions, and skin cancer among others—consider this carefully: cosmetic tattoos are permanent, extremely tricky to remove, and laser treatments themselves are so risky few practitioners are willing to do them.

Orly Avitzur is medical adviser at Consumer Reports and blogs at the Consumer Reports Health Blog.

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