Skin-Deep Beauty

The waiting area of Sheila May’s Pacific Palisades office is ultramodern, with wood pillars soaring to the 15-foot ceiling. Herbal teas, Mountain Valley water and fat-free pastries are offered. An aromatherapy diffuser emits the scent of mint, pine and lavender.

This is a tattoo parlor. But May doesn’t do dragons or “Amy luvs Joey.” She applies permanent makeup--eyeliner, eyebrows and lip color designed to last forever. Donald Trump, Georgette Mosbacher and former Miss America Mary Ann Mobley have had it done. James Brown too.

Permanent makeup practitioners from L.A. to D.C. have in the past few years seen a quiet, steady rise in the number of clients, among them federal judges and flight attendants, TV newscasters and attorneys, movie stars and athletes. The procedure, which has been popular in Asia and Europe for decades and arrived in the United States about 15 years ago, involves implanting pigment in the skin. It is most often performed by people trained as dermatologists, cosmetic surgeons or tattoo artists.

If the goal is permanent eyeliner, the client reclines in a chair similar to one found in a dentist’s office while a topical anesthetic is applied. For the next hour or so, there is the “bbbrrrr” of a pen-shaped device as the pigment is injected between the eyelashes. Some clients describe a “prickly” or “annoying” sensation; others say they feel nothing.

Afterward, the affected area may be red and swollen for a day or two. Initially, the color appears darker than desired. In a few days, the skin flakes off, revealing a lighter and permanent color. Adjustments in color can be made for several months. Because fading occurs gradually over two to six years, touch-ups are needed.

“In Hollywood, looks and image are everything,” explains May, a former tattoo artist who has been doing permanent makeup since 1978 and is widely regarded as a pioneer in the field. “I’ve seen a fast, significant rise [in permanent makeup] in the last two years.

“Rock stars come to me because the perspiration from the heat and lights causes their makeup to run. There’s also a lot of big-name soap stars coming because of all the kissing scenes they do. They tell me what a relief it is not to have to reapply their lipstick after each take,” she says.

But the technique appeals to more than just performers. In Washington, D.C., it can take weeks to get an appointment with Astrid Schneider, “micro-pigmentation specialist” and owner of Permanent Line in suburban Potomac, Md. She has applied permanent makeup to about 5,000 clients in the past 11 years.

“Many of my clients are prominent women who really don’t have the time to apply and reapply makeup throughout the day,” Schneider explains. “But I would say the majority of my clients are professionals who don’t want to deal with makeup. It’s fun when you’re 16, but that can get a little old.”

Permanent makeup can also enhance the appearance of people with alopecia (hair loss), especially of the eyebrows. Vitiligo (uneven patches of skin lacking in color), burns and scars can also be treated.

May and Schneider strongly advise anybody considering permanent makeup to thoroughly check out the practitioner, since there is no training required to perform the procedure. Many permanent makeup artists have completed only mini-courses--some as short as a weekend--that hand out impressive-looking certificates and offer equipment for sale.

Word-of-mouth usually offers the best guarantee of good results.

“Look at the artist’s portfolio of ‘before’ and ‘after’ shots and verify that the person showing you the pictures is indeed the one that did the work,” Schneider says. “To do it well requires years of repeated applications. You’ve got to take into consideration the client’s skin color, texture and age.

“It’s important that the client is properly anesthetized,” she says. “If a person doesn’t know what he or she is doing and the patient moves, the pigment can be injected too deep and it will spread. I’ve seen people come to me with pigment a half inch below their eyes. A lot of my work is just correcting other peoples’ mistakes.”

May agrees. “Permanent makeup is a ‘buyer beware’ market,” she says. “It’s an unlicensed field, so there are a lot of inexperienced people out there that don’t know what they’re doing.”

Tina Alster, a dermatologist and director of the Washington Institute of Dermatologic Laser Surgery, stays very busy removing pigment from botched jobs. “Of all the tattoos I remove, cosmetic tattoos [permanent makeup] are the hardest,” Alster says. “They have the most unpredictable reaction to the laser because of certain ingredients added to some of the colors, namely titanium or iron oxide.”

In a study published in the American Academy of Dermatology, Alster found that it takes an average of 8.5 laser sessions ($250 to $500 each) to remove the pigment. “Getting a divorce is easier than getting a tattoo off,” she says.

Gena Davis, a Los Angeles writer, knows the risks of permanent makeup. In the mid-’80s she had eyeliner applied by a cosmetic surgeon. “I cried after I saw what he had done,” Davis says. “I’m a blond and he used the black-blue color of an ink pen. He didn’t follow my upper left lash line--it just kind of took off on a course of its own.”

She covered the erratic eyeliner with makeup and began looking for someone to repair the damage. Eventually, through a friend, she found May.

May applied lighter pigment over the blue-black lines, smoothed out the liner and softened the edges. Davis went on to have her lips and eyebrows done by May in 1990, and returned recently for touch-ups on all three areas.

“We all want to look beautiful in Southern California,” Davis says with a laugh. “If you’re into sports or spend a lot of time outdoors, permanent makeup gives you a little help.”

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Michael Maron, a Beverly Hills consultant to the American Society of Plastic and Reconstructive Surgeons, is leery of any tattooing that occurs outside a medical setting.

“Any place where’s there’s permanent makeup taking place should have an autoclave [a sterilization machine] and disposable needles,” he says. Prospective clients should also note the surroundings: Is the place clean? Is the technician wearing gloves? “Permanent makeup has its place if it’s done correctly,” Maron says.

John Bailey, director of the Food and Drug Administration’s Office of Cosmetics and Colors in Washington, has begun preliminary studies on permanent eyeliner.

In a study using cell cultures, a pigment used in some permanent makeup procedures was found to be cytotoxic--meaning it affects cells under certain conditions. The next step in the study will be to test the pigment on mice.

“Permanent makeup is not to be approached as a lark,” Bailey says. “Approach it cautiously. The consumer needs to arm [herself] with not only the benefits but also the risks. The consumer should talk to people who have had it done. Have it done by someone who knows what they’re doing, someone with artistic talent.

“Though I am not advocating permanent makeup, there is a place for it . . . for the elderly or anyone having difficulty applying makeup.”

Davis is delighted with her retouched eyebrows, eyes and lips. “I like to look my best but I hate the time it entails,” she says. “For my lifestyle, simple is better.”

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What It Costs At private offices, eyebrows are $700 to $800, eyeliner is $800 to $1,200 and full lip coloring is about $1,000. Expect to pay more in a physician’s office.