India ink tattoo fade8/31/2023 The colour can fade if the pigment is placed superficially or it can appear bluish due to the Tyndall effect if it is placed too deep. This is more common on the lips, exposed skin and the acral areas. This requires a great degree of skill and often a colour mismatch leads to worsening appearance of the patch and a dissatisfied patient. In vitiligo it is essential to get a good cosmetic skin-coloured tattoo matching with the surrounding normal skin. The commonest complications are changes in colour, leading to colour mismatch. In these settings infections are less common as compared to decorative tattoos as they are carried out in sterile environments, but general complications of tattoos can still occur. Tattoos by physicians are used in certain medical conditions for camouflage, like resistant vitiligo, breast areola reconstruction following surgery, scar camouflage following burns or surgery and hair camouflage for permanent hair loss following radiation or craniofacial surgery. The most common skin reactions to tattooing reported in the literature include a transient acute inflammatory reaction due to trauma of the skin with needles and medical complications such as superficial and deep local infections, systemic infections, allergic contact dermatitis, photodermatitis, granulomatous and lichenoid reactions, and skin diseases localised on tattooed area, such as eczema, psoriasis, lichen planus and morphea. These are often seen by physicians, but are generally unknown to the public. Consequently, the number of reported adverse reactions after tattooing has increased. Sterility of the pigments and equipment is an uncertainty as many are being performed on the roadside and in makeshift salons. There are currently few requirements or regulations and no legislation for the safety of tattoos. Medical therapeutic tattooing has been used as a camouflage technique in vitiligo, for breast areola reconstruction after cancer surgery, as camouflage for permanent hair loss after craniofacial surgery, and scars following plastic and reconstructive surgery. It is also being used as a form of ‘permanent makeup’ by beauty salons. Although tattooing is an ancient practice, there has been a dramatic increase in recent times among teenagers and young adults, as a cosmetic and decorative body art form. It may be done intentionally for cosmetic purposes (decorative tattoos and permanent makeup) or therapeutic purposes (medical tattoos), or introduced accidentally (traumatic tattoos), in case of abraded skin injuries. The term tattooing is derived from “tattau”, a Tahitian word which translates essentially as “to mark” and is a process of implantation of permanent pigment granules in the skin. Hence the adage, stop and think before you ink holds very much true in the present scenario. In addition, tattoo removal can be a prolonged tedious procedure, particularly with professional tattoos, which are difficult to erase as compared to amateur tattoos. Scarring and textural changes are potential irreversible complications. Another common complication is the presence of residual pigmentation or ghost images. Among the delayed complications pigmentary changes, hypopigmentation and hyperpigmentation, paradoxical darkening of cosmetic tattoos and allergic reactions can be seen. Acute complications include pain, blistering, crusting and pinpoint hemorrhage. Laser tattoo removal using Q-switched lasers are the safest however, complications can occur. On the other hand, regrets after a tattoo are also seen and requests for tattoo removal are rising. When used as a camouflage technique, colour mismatch and patient dissatisfaction are common complications. Skin diseases localised on the tattooed area, such as eczema, psoriasis, lichen planus, and morphea can be occasionally seen. Superficial and deep local infections, systemic infections, allergic reactions, photodermatitis, granulomatous reactions and lichenoid reactions may occur. Unfortunately there are no legislations to promote safe tattooing, hence complications are quite common. There has been a exponential increase in decorative tattooing as a body art in teenagers and young adults. Tattoos can be decorative, medical or accidental. Tattooing is a process of implantation of permanent pigment granules in the skin.
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