Current problems in dermatology最新文献

Cosmetic tattoos are in the same family as medical tattoos and conventional cosmetic care and fall within the overall concept of body modification. Each discipline has its own segment of users and its own techniques and professional providers. However, they all serve the higher aim of shaping the skin and the body and improving image and self-esteem.

Permanent makeup (PMU) is a descendant of tattoo ink products and used with the intention of giving the face more advantageous contours. PMU makes it possible to condense eyelashes and eyebrows with fine lines or to visually correct them with cleverly placed contour lines. Even the correction of most subtle irregularities on the skin is possible through skillful pigmentation. Microblading describes a special technique in which the skin is carved with a certain "needle blade." The ink is then applied on the fresh wound and massaged into the cuts in order to depose the pigments in the skin. The field of medical tattooing belongs to PMU as well. Hence, PMU can be regarded as versatile as classic tattooing. Investigating online advertisements, the frequent use of the terms biological-organic or mineral pigments is notable. In opposition to the claim of being permanent, the cosmetical tattoo is often considered temporal. Web-based statements claim the use of special pigments for PMU, 100% free of heavy metals and therefore not aging to reddish, bluish, or greenish altered marks after healing. Statements are made to convey safety to consumers. Facts are mixed with fiction. This review will deal with the general structure of tattoo colorants and explain the differences and parallels to PMU ink. Certain raw material groups will be clarified further, and possible risks linked to certain material groups shall be listed and explained as well.

The definition of the task in the medical aesthetics field and good practice requires social, professional, and institutional agreements. A few aspects that are expected to be present in the professional and commercial practice of aesthetic and oncological medical tattoos may define this path. To achieve this goal, we aim to make it essential that what has been stated above becomes a profession and thus our crusade becomes effective. While all technical aspects are not intended to be addressed, we will focus on those associated with good practice, those based on adequate ethics in the practice exercise.

Lip tattooing for cosmetic or medical purposes is a difficult operation with indications and contraindications. Lips have a refined microanatomy and many functions ranging from aesthetics and mimics supporting facial expressions to entirely biological functions such as supporting oral functions and servicing sound expression as part of linguistic performance. The anatomy of the lip is explained and illustrated. In lip tattooing, the outlining and enhancement of contour particularly towards the philtrum is important along with keeping symmetry and shape right and as intended. The coloring of the vermilion and dosing of tattoo pigment is another challenge. The article reviews the technical and artistic aspects of lip tattooing down to detail and step by step procedures starting with client selection, strategy planning, and informed consent. Pitfalls and complications are described. When applied as a corrective operation as part of reconstructive plastic surgery, a close cooperation with medical specialists is needed. Lip tattooing appears underrated regarding medical usefulness. The review can be used as a tutorial in the training of newcomers in the field, having a cosmetic or a medical purpose, same technique.

Cutaneous scars are permanent and the result of physiological wound healing with formation of disorganized collagen instead of the normally structured connective tissue network (or "textile") of the dermis. A scar restores the physical and tensile integrity of skin; skin is a vital protective layer on the body. Scars are of many types and with a broad spectrum of individual variations of color, texture, thickness, furrowing, tension, and contraction. Scars can be red and hypertrophic and, moreover, aggressive and manifested as keloids. White scars can be changed in color into a normal tone and look by the application of medical tattooing. This can help many scar victims regain their quality of life. High level of skill is required by the tattoo artist, who shall be experienced. Tattooing may restore skin color, but it cannot restore textural and structural changes, which may need correction using other methods before the tattoo is ready to correction of color by tattooing. The medical tattooist needs to cooperate with other specialists and develop a consistent strategy of the treatments to be applied including the sequence of treatments with tattooing added at the end for final color correction back towards normal. The medical tattooist from start shall take responsibility and select the clients who are likely to benefit from tattooing and exclude clients, who shall not be offered this treatment.

This chapter reviews our present knowledge about equipment used for cosmetic (decorative) and medical tattooing and its function with respect to installation of tattoo ink into the skin. In the following text, the word "tattooing" refers to body tattooing, permanent makeup (PMU), microblading, and medical micropigmentation. The major consumer risks related to unsafe tattoo and PMU equipment are reconsidered. Such health risks mainly include the danger of non-sterile needles or needle cartridges, cross contamination of equipment and lack of biocompatibility. Even though state-of-the-art tattoo equipment will support the tattooist to reduce such health risks, also today unsafe equipment still might affect consumer health due to malpractice advertising and fraudulent CE certificates by questionable manufacturers and suppliers not being transparent to parlors and artists. For artists, it is therefore of growing importance to understand how to distinguish well-made safe tattoo equipment from fraudulent unsafe products.

The European Union for Standardization called CEN (Comité Européen de Nomalization), as a result of the project named CEN/TC-435 in January 2020, released a new hygiene standard for tattooing as a non-binding recommendation on safe tattoo practice in Europe, ready for national implementation. It describes hygienic standards for facilities, instruments, tattoo ink handling, and tattoo procedures. Informed consent is included. It is generic and covers all sorts of tattooing. Medical tattooing is performed in hospitals, private clinics, and in tattoo parlors. Hospitals have their own settings and hygiene standards. The article describes practical challenges of medical tattooing performed in hospital settings, with medical tattooing performed in parlors as the reference, with respect to adherence to hygiene standards of different background and nature. It is a challenge possible to overcome in practice. The specialized field of medical tattooing is also visited, and indications and precautions described.

Cosmetic and medical tattooing is miniaturized tattooing of high precision and thus requires many dedicated utensils including advanced devices for marking and anatomical delineation. Symmetry is a special demand, as is aesthetic outcome, building on perfectionated detail. The artist shall master design and strategy along with advanced technical performance helped by having and using the right tools. This article reviews and illustrates the many special utensils involved in good-practice cosmetic and medical tattooing, exemplified by selected tools used for cleansing, disinfection, pre-operative measurement and marking, and special tattoo machines, cartridges, microblades and needles. Personal protective equipment used to prevent infections among technicians and customers are also illustrated. Educational tools, such as face phantoms and eyebrow mats, are displayed. Mastering cosmetic and medical tattooing is a challenge and involves mastering the many auxiliaries along with needle configurations, machines, inks and the whole setting of the activity. This review is an illustrated practical record and a guideline to good professional practice.

The Q-switched neodymium-yttrium aluminium garnet (Nd:YAG) laser remains the gold standard method for tattoo removal including cosmetic tattoos. Modern picosecond lasers are referenced to the Nd:YAG laser and essentially do the same job. Persons with cosmetic tattoos in the face are especially eager to achieve perfect removal or correction and from start are critical to suboptimal results. Customers mostly request complete removal; sometimes the goal is fast treatment and bleaching to prepare for a cover up tattoo. Removal or correction of eyebrows is the largest group, followed by lip tattoos and eyeliners. The article gives a systematic and stepwise introduction to routine cosmetic tattoo removal by laser in an Austrian private medical practice. Rationales and selection of customers who can benefit from treatment, preparation, performance, and aftercare is reviewed. Emphasis is given to qualified power adjustment of the laser equipment and the treatment strategy, e.g. the delicate navigation between efficient removal and the risk of short-term and long-term adverse effects. Treatment relies on a partnership between provider and customer. Over the months of treatment, customers gain more insight into the possibilities of treatment, so that they get an understanding of the realistic results that can be achieved. Therefore, customers are also satisfied even with results that are not always optimal since best treatment was given a fair chance.