Joharimoghadam, & Zabihiyeganeh, 2017; Naeini, Pourazizi, Abtahi‐Naeini, Saffaei, & Bagheri, 2017). One study revealed a woman suffering from chronic coughing for nearly eight months because of nodules that had formed in her lungs following an eyebrow tattooing procedure (Landers, Skokan, Law, & Storrs, 2005). Common at the sites of scars, trauma, and foreign body deposition, sarcoidosis can take more than six months to resolve and often results in permanent physical scarring (Ringger & Sluzevich, 2012). Microblading patients might be at an increased risk for these types of injuries and infections since they will likely receive the procedure several times, multiplying opportunities for exposure (Harsányi et al., 2015). These issues highlight the need for best practices concerning sterilization and hygiene requirements. Justification While microblading has been heralded by some as an emerging beauty trend or referred to as semipermanent, it is another form of permanent tattooing and should be regulated as such. Streamlining requirements for tattooing and microblading within state and local health jurisdictions will create a uniform regulatory process and improve public health. The term semipermanent, however, is misleading in several ways. No form of tattooing, including microblading, can guarantee that the pigment will fade away completely in a given time frame. Less ink is used in the microblading procedure, which can indicate a faster rate of fading and a need for more touch up procedures. Additionally, some technicians have claimed that pigment is only implanted into the surface epidermis layer, not the dermis, during microblading procedures, differentiating the process from tattooing. If this were true, ink would fade within a matter of weeks or months, not years (Society of Permanent Cosmetic Professionals, 2018). Finally, the NEHA Body Art Model Code defines tattooing as “any method of placing ink or other pigment into or under the skin or mucosa by the use of needles or any other instruments used to puncture the skin, resulting in permanent or temporary colorization of the skin or mucosa. This includes all forms of permanent cosmetics.” Microblading clearly falls under this definition, as it inserts ink under the skin using needles, results in permanent colorization, and falls under the category of permanent cosmetics. Similar infections can arise in both tattooing and microblading, yet tattooing is more strictly regulated (Khunger, Molpariya, & Khunger, 2015). Many states have tattoo regulations, but microblading is not always defined as a tattoo procedure. Rates of infection have dropped dramatically since the implementation of public health mandates related to tattooing in the mid to late 20th century that require the use of disposable needles and proper sterilization techniques (Islam et al., 2016). In comparison to tattooing, similar reactions have been documented after microblading procedures, yet the quality of sterilization differs dramatically. Inappropriate hygiene measures in tattooing and ineffective aftercare are major risk factors for tattoo related infections (Dieckmann et al., 2016). Infection rates from unlicensed body art practitioners using nonsterile equipment or ineffective sterilization methods multiply these risks (Centers for Disease Control and Prevention [CDC], 2006). Standard aftercare instructions should be supplied to clients, but untrained microblading technicians can fail to distribute instructions or supply incomplete information. Unlicensed tattooists using nonsterile equipment in unregulated facilities or settings might offer lower rates, driving up demand for their services while heightening the potential for disease transmission (Coulson, 2012).
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