Saline based removal

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2. How does saline removal work?

The principle of osmosis The saline-based removal of permanent makeup, including powder brows, employs the principle of osmosis from both a chemical and biological standpoint. Osmosis is a vital physical process involving the movement of a solvent, typically water, across a semi-permeable membrane from a region of lower solute concentration to one of higher concentration. This process naturally progresses until solute concentration equilibrates on both sides of the membrane.

In the context of saline pigmentation removal, human skin functions as this semi-permeable membrane. The epidermis, primarily composed of keratinocytes, acts as a barrier that regulates substances entering and exiting the skin. When a saline solution, which is a high concentration of sodium chloride (NaCl) in water, is introduced into the skin via tattooing, it disrupts the osmotic balance locally. The body's homeostatic mechanisms trigger an influx of water to the area to dilute the high salt concentration.

The cellular perspective

From a cellular perspective, this influx of water into skin cells (keratinocytes and melanocytes) is driven by the need to balance the osmotic pressure. The added water exerts physical pressure on the pigment particles embedded in the dermal layer of the skin. These pigment particles, composed of various compounds like iron oxide or titanium dioxide, are typically held in place by the body's fibroblasts and collagen networks.

Removal through movement of water

As water pushes these pigment particles towards the epidermis, biological reactions occur. Macrophages, a type of white blood cell, may also play a role in engulfing some of these particles, aiding in their upward migration. The scab formation on the skin's surface, composed of dried fluids, dead cells, and pigment particles, is essential to the body's healing process. When this scab naturally exfoliates, it carries away the pigment particles, leading to a visible lightening of the tattoo or brow pigmentation.

Thus, the saline-based removal technique is a fascinating interplay of chemical, physical, and biological processes, demonstrating how our understanding of these principles can be applied in practical and aesthetic contexts.

3. Saline vs laser removal

Understanding the fundamental differences between saline-based and laser removal treatments is crucial in semi-permanent makeup applications like powder brows.

Saline-Based Removal

Ironically, the saline-based removal process mirrors the initial Powder Brows procedure but in reverse. During the initial procedure, a PMU (Permanent Makeup) machine injects pigment into the skin. In contrast, the same machine is now used to inject a saline solution, initiating the osmotic process. This process draws pigment molecules upward, ideally through the epidermis, forming a scab.

The high salt concentration saline solution disrupts the osmotic balance at the pigment site. Water molecules naturally move to higher salt concentration areas, exerting physical pressure on the pigment particles. This movement forces the particles up through the skin layers, eventually leading to scab formation and the expulsion of the pigment as the scab exfoliates.

Laser Removal

Laser removal, on the other hand, employs concentrated light energy delivered in ultra-short bursts, each lasting mere nanoseconds. This energy is finely tuned to target the pigment particles, causing them to break down into smaller fragments. Unlike the saline method, which moves the entire pigment particle upward, the laser technique shatters these particles.

Post-laser, the body's immune system is crucial in removing these fragmented particles. Macrophages, a key immune system component, engulf and degrade these smaller pigment fragments. This process effectively clears the fragmented pigment from the skin, with the remnants eventually being processed and removed via the lymphatic system.

Key Differences in Mechanisms

Direction of Particle Movement. Saline-based removal physically lifts entire pigment particles to the skin's surface for removal. At the same time, laser treatment breaks down the particles in situ, allowing the body's immune system to remove them.

Particle Handling. The intact pigment particles are lifted and removed through scab formation in saline removal. In contrast, laser treatment fragments the particles, making them small enough for macrophages to ingest and process.
Body's Response. The saline method relies on the body's osmotic balance to expel the pigment, whereas laser removal utilizes the body's immune response to clear the fragmented particles through the lymphatic system.
Both saline-based and laser removal methods have distinct mechanisms of action. Saline-based removal physically expels pigment particles through osmosis and scab formation, while laser removal employs light energy to fragment the particles for subsequent immune system clearance.

Next, let us explore what happens during the actual procedure of saline-based removal.

4. Saline-Based Removal Process

Consultation and agreement

The process invariably begins with a consultation. Here, the practitioner assesses the brows, discusses the client's expectations, and explains the procedure, including potential risks and aftercare. This stage is crucial for setting realistic expectations, as the variability in skin types and the nature of the pigment used in the original procedure can significantly affect the outcomes.

Impossibility to predict precise results

Given the variability in individual skin responses and the complexity of pigment chemistry, it is nearly impossible to guarantee specific results. Factors such as skin pH, hydration level, and the immune response can all influence the efficacy of the removal process.

Signing a contract

Typically, a contract is signed wherein the client acknowledges the potential risks. Notably, in many regions, insurance may not cover procedures involving certain chemicals, like those in saline-based removal solutions.

Preparing the treatment Area

Before the procedure, the area is thoroughly sanitized to mitigate infection risks. The application of a numbing cream or local anesthetic minimizes discomfort. This step is critical, as the integrity of the skin barrier will be compromised during the saline solution application.

Applying the saline solution

The saline solution is introduced into the skin using a PMU machine with a sterilized needle, mirroring the tattooing process. The high sodium chloride saline creates an osmotic imbalance, drawing water from surrounding tissues to dilute the salt concentration. In most cases, it is done to saturate the skin as much as possible, with circular movements and with fairly large needles (i.e., 3RL).

Osmosis process

This osmotic pressure aids in dislodging the pigment particles from their position in the dermal layer, moving them toward the epidermis. The efficiency of this process is influenced by the concentration of the saline solution and the depth of the original pigment placement.

Scab formation

Following the treatment, a scab forms over the area, trapping the saline solution and the dislodged pigment. Allowing the scab to detach naturally is crucial, as premature removal can negatively impact pigment extraction and wound healing.

Healing process

Post-scab shedding, the area requires adequate time to heal. Adhering to aftercare instructions, such as maintaining cleanliness and avoiding sun exposure, is essential to prevent infection and facilitate optimal healing.

Additional sessions

Due to factors like the age, depth, and color of the original pigment, multiple sessions spaced weeks apart may be necessary. The healing response and the extent of pigment removal in each session guide the need for additional treatments.

Thus, the saline-based removal process is a complex interplay of chemical reactions, skin physiology, and cellular responses. Many seasoned artists stress that some pigmentations may look easy to remove with saline, and there is practically no visible effect after the treatment. In contrast, some cases that look very hard can lightened drastically with the saline.

5. Limitations of saline-based removal

Size of pigmentation area

The efficacy of saline-based removal diminishes with the increase in the size of the pigmented area. Large areas, especially those with heavily saturated brows featuring dense, dark organic pigments, pose a significant challenge. This is primarily due to the limited capacity of the osmotic process to effectively draw out large concentrations of pigment over a wide area. In such cases, laser removal often becomes a more suitable alternative due to its ability to target and break down pigment across larger skin sections.

Depth of pigment implantation

A notable limitation arises with pigments implanted too deeply, such as black colors that have reached the hypodermis. This typically involves small-sized (100-200 nm) carbon black (CI 77266) particles, particularly those derived from Furnace-based carbon (Black 2). Saline-based removal in these scenarios involves a laborious process of mobilizing these particles through the reticular dermis, papillary dermis, and then through the epidermis.

While some practitioners have observed successful migration of these particles to the surface over multiple sessions, the process is unpredictable. Deeply implanted and cold-toned organic carbon black particles often respond more favorably to laser treatments, which can more effectively fragment these deep-seated pigments for subsequent removal by the body's immune system.

6. Advantages of saline-based removal

Here is a list of advantages of saline based treatment based on the observations of seasoned artists.

Versatility in pigment types Saline-based removal is effective for a broad spectrum of pigments, irrespective of their chemical composition. Unlike laser treatments, which may struggle with certain colors like camouflage, yellow, or green due to specific light absorption properties, saline-based methods work uniformly across all pigment types. This is because the osmotic mechanism targets the physical displacement of pigment particles, driven by water molecule movement, rather than relying on color-specific light absorption.
Minimized risk of skin damage Saline-based removal generally poses a lower risk of burning or scarring than laser methods. Lasers emit high-energy light that can cause thermal damage, leading to scarring. While not all scars are visually apparent, subdermal changes can affect the skin's texture, often making it harder to re-implant pigment. Saline methods, by contrast, are gentler, making them suitable for sensitive skin and thinner areas.
Controlled pigment fading This method allows for a gradual and controlled lightening of pigment. It’s particularly beneficial for subtle adjustments or delicate areas where precision is key.
Safety near sensitive areas Saline-based removal is often preferred for areas close to the eyes and mouth. Chemically, this is because the pigments used in these regions are typically more amenable to osmotic removal. Biologically, the skin structure in these areas is conducive to effective osmosis, facilitating pigment mobilization.
No impact on the natural brow hair Laser treatments can adversely affect natural brow hair, often leading to temporary or permanent hair removal. In contrast, saline-based methods do not typically impact hair growth, which is an added advantage for maintaining natural brow aesthetics.
Effectiveness with Titanium Dioxide (TiO2) Practitioners have noted challenges with laser removal of titanium dioxide pigments, particularly when TiO2 is not micronized. Lasers can sometimes alter the color of these particles to grayish shades without effectively removing them. Saline-based removal does not depend on pigment color or light reflection, making it more effective in mobilizing and removing TiO2 particles.

Thus, saline-based pigment removal offers several advantages, including versatility across pigment types, minimized skin damage, controlled fading, safety near sensitive areas, preservation of natural hair, and effectiveness in removing titanium dioxide-based pigments. Understanding these benefits is vital for semi-permanent makeup artists in choosing the most appropriate removal technique for their clients.

7. Typical Contents

The contents of a saline-based removal solution vary when it comes to different products of different makers. However, there are some components that are typically in the liquid mixture.

Sodium Chloride (salts). The primary component is salt, usually in the form of sodium chloride. Salt creates a high-concentration solution that initiates the osmotic process necessary for lifting pigment from the skin. Creating an imbalance in solute concentration draws water and pigment particles towards the skin's surface.
Orange seed extract. This natural extract aids in exfoliation and fading of the pigment. It contains citric acid, which helps gently peel the skin's upper layers, facilitating the removal of pigment particles during the scabbing process.
Lemon seed extract. Like orange seed extract, lemon extract also contributes to exfoliation and fading, primarily due to its citric acid content. It helps in skin renewal and lightening of the treated area.
Aloe Vera. Aloe Vera is known for its soothing and healing properties. In saline-based solutions, it helps to calm the skin post-treatment, reducing inflammation and promoting faster healing of the treated area.
Sterile water. The base of the solution is often sterile water. Sterility is crucial to prevent contamination and infection during the removal process. While distilled or filtered water can be clean, sterile water ensures the highest level of purity and safety.
Glycerin. Glycerin might be included for its humectant properties. It helps maintain moisture in the skin, which can be beneficial during the healing process.
Potassium sorbate. This is a common preservative used to inhibit the growth of mold and yeast. Its inclusion ensures the longevity and safety of the solution, preventing microbial contamination.
Sodium benzoate. Another preservative, Sodium Benzoate, has anti-bacterial and anti-fungal properties. It extends the product's shelf life and maintains its safety for use on the skin.
Witch hazel. Witch Hazel is sometimes added for its astringent properties. It can help in tightening the skin and reducing inflammation post-treatment.

Each component in the saline-based removal solution plays a specific role, from initiating the osmotic process to ensuring skin safety and promoting healing.

8. Additional observations

What the experienced artists pointed out additionally.

Importance of Quality Products

It's crucial to use high-quality saline-based removal gels from reputable manufacturers. The effectiveness of these products is often tied to their ingredient purity and concentration, which can significantly impact the osmotic process required for effective pigment lifting.

Application Technique

Unlike the light whip and pendulum movements used in powder brow pigmentation, which aim to avoid saturation, applying saline solutions involves circular motions at a medium machine speed. This technique ensures adequate saturation of the solution in the skin while minimizing tissue damage.

Needle Selection

Many experienced artists prefer using a 3RL needle for precise tracing and a 5RL needle for covering larger areas. The goal is to introduce a significant amount of the solution into the skin to ensure saturation. The choice of needle diameter, often around 0.4 mm with a length of 1.5 - 2mm, is critical for achieving this balance between saturation and minimal skin trauma.

Desired Bleeding

Some bleeding during the procedure is not just normal but desired, as it indicates effective oversaturation. This bleeding suggests that the needle has reached the appropriate skin depth, which is vital for the solution to engage effectively with the pigment particles.

Pricing Structure

The cost of saline-based removal varies, typically ranging from USD 50-150 per session, depending on location and specific circumstances. For instance, artists may adjust their pricing if they are correcting the pigmentation they originally applied.

Emergency Removal

Saline-based removal has gained popularity as an emergency solution for brow corrections within 72 hours of the initial procedure. This rapid response is particularly effective due to the pigment's location in the epidermis during this early stage. While some of the initial pigment may naturally exfoliate, the saline solution accelerates this process, making it a valuable option for immediate corrections.

Pain during the procedure

The procedure is not pain-free; merely the fact that salts are implanted into the skin causes pain. When it comes to numbing, however, many artists suggest using it as little as possible to minimize any interference to the procedure.

Good skill to have

Mastering the application of saline-based removal solutions is a valuable skill for semi-permanent makeup artists. It requires an understanding of the product’s chemistry, appropriate needle techniques, and an appreciation of the skin's response to treatment, but it can be learned fairly easily, especially if one is good at pigmentation.

When it comes to removing eyelid pigmentation or lips, many seasoned artists suggest that this should only be done if the artist has experience providing those same services.

9. Conclusions

Saline-based removal leverages the principle of osmosis, drawing pigment out of the skin by creating a high salt concentration area. The process includes applying a saline solution to the skin using a PMU machine, similar to the tattooing process, but saline solution is used instead of ink.

After application, osmosis begins, pulling water and pigment particles to the skin's surface, forming a scab that eventually falls off, taking the pigment with it.

The procedure

The procedure starts with a thorough consultation and skin evaluation.
The treatment area is cleaned and sometimes numbed to minimize discomfort.
A specific application technique is used, with needle choices (such as 3RL for tracing and 5RL for larger areas) and needle diameters (typically around 0.4 mm) playing a crucial role.

Advantages of saline-based removal

Versatile for various pigment types, effective regardless of the pigment's chemical composition.
Lower risk of skin damage compared to laser methods, making it suitable for sensitive skin.
Controlled and gradual fading of pigment, particularly beneficial for subtle corrections.
Effective near sensitive areas like the eyes and mouth due to the gentle nature of the process.
Preservation of natural brow hair, unlike in laser treatments.
Effective in removing certain pigments like Titanium Dioxide, which may not respond well to laser.

Limitations and challenges

Less effective on large areas of pigmentation or deeply implanted pigments, like carbon black particles.
Multiple sessions may be required for significant lightening, depending on the original pigmentation's depth, age, and color.
Unpredictable results in some cases, especially with deeply implanted pigments.
Typical components of saline-based solutions
Typically contain salts, sterile water, natural components like Aloe Vera for healing, orange, and lemon seed extracts for exfoliation, and preservatives to inhibit microbial growth.

Professional Considerations

Importance of using high-quality saline-based removal products.
Different application strategies compared to pigment application, with a focus on saturation.
A certain level of visible bleeding during the procedure is normal and indicates effective saturation.
Saline-based removal is recognized as an effective emergency solution for correcting brows within 72 hours of the initial procedure.

Overall, saline-based removal is a valuable technique in the field of semi-permanent makeup, offering a safe and versatile method for pigment correction and removal. While it has its limitations, particularly in the case of large or deeply implanted pigments, its advantages in terms of safety and versatility make it a preferred choice for many professionals and clients alike.

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