Navigating Contraindications and Medications for Micropigmentation
Article by Gemma Hutchings| Date Published 8th August 2024
Navigating Contraindications for Micropigmentation.
It is essential for practitioners in the field of micropigmentation to be aware of the various contraindications associated with all procedures.
Contraindications are specific conditions or factors that can increase the risk of adverse effects or complicate the healing process. Understanding and navigating these contraindications is crucial to ensure the safety and satisfaction of clients/patients.
In this article, we will explore the common contraindications for micropigmentation. By identifying and thoroughly understanding these factors, practitioners can make informed decisions, provide appropriate guidance to clients/patients, to ensure successful outcomes.
What is a contraindication?
A contraindication is a specific situation where a particular drug, procedure, or treatment should not be used because it may cause harm to the person. Understanding contraindications helps practitioners make informed decisions and provide appropriate advice to clients/patients. There are two main types of contraindications:
Restrictive Contraindication:
This means caution should be exercised when using two drugs or procedures together. It is acceptable to proceed if the benefits outweigh the risks. For instance, a client/patient may be taking a medication such as insulin but they are ok to go ahead with micropigmentation on the understanding that they may find it more uncomfortable and the healing maybe slower.
Absolute Contraindication:
This indicates that an event or substance could cause a life-threatening situation and should be completely avoided. For example, specific medical conditions or medications can make micropigmentation unsafe. Heamophilia would be an excellent example of this.
Certain medical conditions and medications can prevent a client/patient from safely undergoing micropigmentation, or they may necessitate special precautions. Being aware of these contraindications is crucial to prevent unwanted or dangerous reactions. Here are some examples
• Allergies: Clients/patients with certain allergies may have adverse reactions to pigments or anaesthetics used during the procedure.
• High Blood Pressure: Some treatments might not be suitable for individuals with high blood pressure and could exacerbate their condition.
• Pregnancy: Procedures like micropigmentation are often contraindicated during pregnancy due to potential risks to the fetus.
• Medications: Specific medications, such as blood thinners (e.g., warfarin or aspirin), can increase the risk of bleeding.
Consultation and Assessment: Always conduct a thorough consultation to identify any potential contraindications. Ask clients/patients about their medical history, current medications, and any known allergies.
Insurance and Medical Advice: When in doubt, consult your insurance provider for guidance on specific contraindications. Keep detailed records of these consultations, including the name of the person you spoke to and the advice given. If further clarification is needed, refer the client back to their pharmacist or general practitioner (GP) for professional medical advice.
Client Education: Ensure that clients/patients are fully informed about any potential risks associated with their condition or medications. Provide clear instructions and guidance.
In order to complete a treatment in full, a number of forms must be completed every time you carry out a treatment, whether it is your client's/patient's 1st or 10th treatment. These forms protect your client/patient to ensure that you are not taking any risks when treating them, you have agreed on the terms of the treatments and covered in full, their expectations. These forms will also protect you in the event of an insurance claim against you.
We can’t emphasise enough the importance of taking a full medical history from your client and explaining the treatment to them in full.
Informed consent is the principle that you have taken medical history, discussed in full the treatment, the limitations and expectations, the healing process in full and follow-up treatments. In order to convert this to informed consent you need to leave your client/patient to make the decision to go ahead without influence. This means leaving your client/patient alone to make the decision to proceed without the influence of you or any member of your staff.
Let’s delve into each contraindication in detail to provide a comprehensive guide for both professionals and individuals considering micropigmentation.
Here is a list of medications or conditions that are considered to be a absolute contraindication and as a result a patient/client can't be treated.
Pregnancy and Breast Feeding - although there is no medical evidence that links problems in pregnancy to a micropigmentation treatment, should your client/patients experience an unrelated reaction you are at risk and would be vulnerable in regard to a claim against you. You will not be insured to treat anyone who is pregnant or breastfeeding.
Contagious Skin Conditions - Clients/patients with a contagious skin condition are not suitable to be treated.
Heamophilia - a genetic disorder causing a lack of clotting in the blood. A client/patient who has haemophilia do not necessarily bleed more intensely but can bleed for longer than those without. Do not treat these client/patient as you will not be insured.
Chemotherapy and Radiotherapy - we advise you to check you insurance policy but the general rule is 5 weeks pre or post. Read our full article on this subject here.
Antabuse - causes a severe reaction to anything containing alcohol (pigments). Treatment should not be carried out until six months clear of the last tablet taken. Resuming medication should not happen until 4-6 weeks after treatment.
Anti - Coagulants (Warfrin) - used to thin the blood following illness and surgery. You should not offer treatment to clients on this medication, however please check your insurance policy as some may allow you to go ahead with medical consent.
Roaccutane/Accutane - steroid cream/oral medicalation for acne sufferers which can thin the skin considerably. Treatment should not be carried out until six months clear of the last tablet taken. Resuming medication should not happen until six months after treatment.
Allergies to Anaesthetic - do not treat a client/patient who suffers from allergic reactions to anaesthetic, the reactions can range from mild to servere including life threatening anaphylactic shock.
Hepatitis C - a virus that spread through bodily fluids resulting in chronic disease and long-term liver problems. There is no vaccine for Hep C, and although there is an increase in the cure rate some people are never cured, and therefore for your own safety, you cannot proceed with a treatment.
Epileptic and had a seizure within the last 2 years - a chronic nervous disorder characterised where patients suffer muscular spasms and may lose consciousness. If a client has not had a seizure for 2 years you could proceed with caution. Ensure you have informed them of the possibility of the procedure triggering a fit and make sure they have signed the consent form.
Nickel allergies are a common concern, often highlighted on medical history forms. This is especially relevant when discussing the materials used in needles.
Understanding Needle Composition
Needles are typically made from stainless steel, a durable alloy composed of several elements, including nickel. Nickel is crucial for the strength and longevity of the metal.
Our FTG needles contain approximately 8-10% nickel. This amount will vary in percentage depending on the manufacturer.
Nickel Allergies and Their Impact
Nickel allergies can vary significantly in severity. Once an individual has had an allergic reaction to nickel, they may become increasingly sensitive to it over time. Nickel is commonly found in everyday items such as jewellery, coins, zippers, cosmetics, and detergents.
Symptoms of a Nickel Allergy
If someone is allergic to nickel, they may experience the following symptoms:
Rash or bumps
Itching
Redness
Blisters
Precautionary Measures
For clients or patients with a known nickel allergy, it is advisable to avoid using treatments that involve needles containing nickel. Ensuring their safety and comfort should be a priority.
ANTABUSE – causes a severe reaction to anything containing alcohol (pigments). Treatment should not be carried out until six months clear of the last tablet taken. Resuming medication should not happen until four-six weeks after treatment.
ANTI-COAGULANTS (WARFARIN) – used to thin the blood following illness and surgery. You should not offer treatment to clients on this medication.
ANTI DEPRESSANTS – medically OK to go ahead with treatment but if you have reservations of your client’s state of mind, then gently suggest deferring the appointment.
BLOOD THINNERS (ASPIRIN) – causes bleeding but client can still be treated. Additional treatments may be required, and client may bruise easily.
INSULIN – indicates that the client has diabetes. It is advisable to obtain medical consent due to slower healing and increased risk of infection.
STEROIDS & CORTISONE – Either taken orally or applied as cream. Creams can thin the skin. Allow six months free of medication before and after the treatment.
PARACETAMOL – OK to proceed.
ROACCUTANE & ACCUTANE – steroid cream for acne sufferers which thin the skin considerably. Treatment should not be carried out until six months clear of the last tablet taken. Resuming medication should not happen until six months after treatment.
THYROXIN – for thyroid disorders. Client may find the skin more sensitive, with longer healing times and potential colour changes.
ALOPECIA – an auto immune disease resulting in hair loss, of which there are numerous types of alopecia. Sufferers may be more sensitive and can causes increased loss of fluid from treated areas and may need more treatments. There should be no problems treating these clients with the exception of Lichen planopilaris and Central centrifugal cicatricial alopecia (CCCA).
ANAEMIA – a condition characterised by a deficiency of the hemoglobin content of red corpuscles. These clients will bleed more profusely and take longer to heal and may require a third visit.
ASTHMA – is characterized by inflammation of the air passages resulting in the temporary narrowing of the airways making it difficult to breath. Asthma often requires the use of an inhaler to ease breathing. Regular use of an inhaler will cause thinning of the skin and increased vascularity. These clients will bleed more easily and sometimes bruise. Their skin is often more sensitive as well.
DIABETICS – have a tendency to both bleed and bruise easily, depending on the severity of their diabetes. They may find it more uncomfortable than usual and the healing process may be lengthier. Treat with caution brittle diabetics and those that are insulin dependent because of the prolonged bleeding and bruising. Check client is happy and blood sugar levels are within normal range. You may also need to do 3 treatments and leave longer between each treatment.
HAY FEVER – if the client’s eyes are red, watering, puffy or the skin is inflamed and red it is advisable to wait until these symptoms have passed when doing an eyeliner procedure. Afternoon appointments are advisable as pollen counts can be slightly lower at this time of day.
HERPES SIMPLEX – a viral infection commonly referred to as a cold sore or fever blister – usually around the mouth. If a client has ever had a cold sore in the past, they are more likely to have an outbreak. We suggest that they ask their doctor for anti-viral tablets (although some doctors are reluctant to prescribe them). They should be taken five days before treatment and five days aftertreatment and neither remedy offer guarantee that there will not be an outbreak.
HIV – it is the technician’s choice whether to proceed with the treatment. Extra care should be taken to avoid cross infection. Proceed with caution.
HYPERPIGMENTATION – an overproduction of melanin which has permanently damaged the surface of the skin, more commonly seen in afro Caribbean, Mediterranean, Asian, Latin skin types. It is presented as darker patches of skin. You must not tattoo directly onto the patch of hyper pigmented skin and you must treat with caution other areas of the skin and use lighter colours since the treatment may trigger hyperpigmentation in this area.
KIDNEY DISEASE – written consent from a doctor is required.
LIVER DISEASE – written consent from a doctor is required.
LUPUS – DISCOID (Cutaneous) Lupus is a version of the disease that is limited to the skin. It is characterized by a rash that appears on the face, neck and scalp. You are advised not to treat these client/patients.
RETINAL DETACHMENT – is a disorder of the eye in which the retina peels away from its underlying layer of support tissue. Initial detachment may be localized but without rapid surgical treatment the entire retina may detach leading to vision loss and blindness. Written consent from the ophthalmic surgeon is required before treating these clients for an eyeliner treatment.
SCAR KELOID – occur when scar tissue grows excessively and exceeds beyond the boundaries of the original injury to invade normal tissue. They look like thick, shiny, dense, red elevated ropes in the skin and may be extremely tender to touch. Client/patients who develop keloid scars from major trauma may not necessarily develop keloid scar from micropigmentation, but the procedure should still not be carried out. If your client/patients is unsure if they suffer from keloid scars, ask them about previous histories from minor injury to give you some indication of the likelihood of a keloid occurring. This type of scarring is most common in black skin.
SCAR HYPERTROPHIC – is raised instead of being flat and does not grow. They remain within the perimeter of the original wound and flatten over time. When new they are often purple/pink becoming more pin/white as they mature. You should proceed with caution and wait 6 months before treating the scar.
SCAR ATROPHIC – these are indented or depressed and look like valleys or holes in the skin. You may treat these areas if they are more than 6 months old.
SHINGLES – is an immune system virus which is part of the herpes family, there should be a six-month gap between the end of the virus and your micropigmentation procedure.
THYROID PROBLEMS – clients with an underactive thyroid usually find their eyebrow hairs become very sparse and fine. They may experience a slightly longer healing time after treatment and possible colour change with the pigment.
TRICHOTILLOMANIA – a condition where a person feels compelled to pull out their hair. It maybe on their head of other places such as brows or lashes. These clients will be prone to picking their healing procedure. This will increase the risk of infection and cause the pigment to look patchy when healed. Discuss this in the consultation and be sure to add to consent form that this has been discussed and ensure client signs and continue with treatment.
VITILIGO – appears as white patches on the skin and is an auto immune disease-causing stress to the body. It is possible that the trauma of having an area tattooed could act as a trigger for an outbreak in other areas of the body. You should only continue with treatment if the area has been static for at least seven years.
BOTOX – it is recommended to wait at least 21 days after the Botox has been injected before commencing with the treatment. It is important to make your client aware that Botox alters the position of the brow so when it wears off the brows may appear asymmetrical. It is preferable to do your treatment prior to any Botox being administered, or when the Botox is just about due for a top up so that you can see where your client’s brows would naturally be positioned.
BROW/FOREHEAD/FACE LIFT – allow 3 months to heal before treating for eyebrows, allow 6 months before treating the scars.
INJECTABLE FILLERS – it is recommended to wait at least 21 days after the filler has been administered before doing any treatments.
TINTING BROWS – should be done one week prior to treatment or four weeks post treatment.
