Black and white guide to patients

The demand for permanent makeup serving cosmetic and medical purposes has increased recently, leading to diversity in patients’ races. It wouldn’t be fair to say that working with Caucasian patients is easier, but it might be true that there is more information available on this matter. However, while performing micropigmentation procedure on darker skin, an artist may need to consider certain peculiarities of the latter that will define further approach of work.

It terms of histology the difference between black skin and white skin is the following:

  • The stratum corneum of black skin is more layered and comprises of stronger cells. It also possesses more casual lipids. The dermis of black skin is thicker and more compact compared to white skin. Darker skin is also characterized by increased electrical resistance. These factors determine its thickness compared to white skin;
  • On the epidermal level black skin contains less glutathione than white skin. Among other functions in the body, glutathione is responsible for absence of skin color. Thus, stimulation of epidermal glutathione systems slows down or inhibits the formation of melanocites;
  • Black skin has larger melanosomes than white skin, that is obviously a cause for the increased pigmentation;
  • The fibroblasts of black skin are more numerous and larger, as well as more multi-nucleated compared to white skin. Mast cell granules of darker skin are larger than those of white skin. These factors lead to black people’s proneness to keloid formation;
  • Upper epidermal layers of black skin shed more than those of white skin.


Permanent makeup procedure by Alan Spadone

The main concern is the healing process of black skin. In response to needle wounds it can develop abnormal scars, or keloids – scars which rise over the surrounding skin and tend to progress over time. Prior to any manipulations the artist should find out how likely it is for the patient to form keloids. Although African skin is generally prone to them, exceptions can be found. The easiest way to foresee if the patient is at risk is to check their piercing, as this is one of the main causes of keloid formation. Although they rarely develop on the face, it can be a sign to reconsider micropigmentation.

It is never an easy task for a permanent tattooing novice to control the depth of the pigment application, since the depth of the epidermal layer varies quite significantly in various zones, especially on the scalp. However, this process becomes even more painstaking when dealing with dark skin due to its increased thickness. Pigment placement technique therefore should be brushed up in advance to prevent pigment leaks and fading.

Last but not least, because of increased shedding, black skin is more vulnerable to allergic reactions and irritations of any kind. Some artists therefore do not consider African patients good candidates for micropigmentation. However, with proper pigments, tools and techniques, as well as following post-operational recovery recommendations, permanent tattooing can still be feasible on patients with darker skin.

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