Saline-based removal

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2. How does Saline Removal work?

The Principle of Osmosis

Saline-based removal of permanent makeup, including powder brows, relies on the principle of osmosis, which has chemical and biological aspects. Osmosis is a crucial physical process involving the movement of a solvent, typically water, through a semi-permeable membrane from an area of lower solute concentration to one of higher concentration. This process continues until solute concentration balances on both sides of the membrane.

In the case of saline pigmentation removal, the human skin acts as a semi-permeable membrane. The epidermis, primarily composed of keratinocytes, acts as a barrier that controls substances entering and leaving the skin. When a saline solution, a high concentration of sodium chloride (NaCl) in water, is introduced into the skin through tattooing, it disrupts the local osmotic balance. The body's natural homeostatic mechanisms respond by bringing more water to the area to dilute the high salt concentration.

The Cellular Perspective

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

Removal via Water Movement

Various biological reactions occur as water pushes these pigment particles towards the epidermis. Macrophages, a type of white blood cell, may also play a role in engulfing some of these particles, assisting in their upward movement. The formation of a scab on the skin's surface, comprising dried fluids, dead cells, and pigment particles, is essential for the body's healing process. When this scab naturally exfoliates, it carries away the pigment particles, resulting in a noticeable lightening of the tattoo or brow pigmentation.

Hence, the saline-based removal technique is a fascinating interplay of chemical, physical, and biological processes. It demonstrates how our understanding of these principles can be applied practically and aesthetically.

3. Saline vs. Laser Removal

Understanding the fundamental distinctions between saline-based and laser removal treatments is crucial in semi-permanent makeup applications, such as powder brows.

Saline-Based Removal

Interestingly, the saline-based removal process is akin to the initial Powder Brows procedure, but in reverse. In the initial procedure, a PMU (Permanent Makeup) machine injects pigment into the skin. Conversely, the same machine is now utilized to inject a saline solution, initiating the osmotic process. This process draws pigment molecules upwards, ideally through the epidermis, eventually forming a scab.

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

Laser Removal

In contrast, laser removal employs concentrated light energy delivered in ultra-short bursts, each lasting mere nanoseconds. This energy is precisely calibrated 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.

The body's immune system is pivotal in removing these fragmented particles after laser treatment. Macrophages, a critical immune system component, engulf and degrade these smaller pigment fragments. This process effectively clears the fragmented pigment from the skin, with the remnants being processed and eliminated through the lymphatic system.

Key Differences in Mechanisms

Direction of Particle Movement: Saline-based removal physically elevates all pigment particles to the skin's surface for removal, whereas laser treatment breaks down the particles in place, allowing the body's immune system to eliminate them.

Particle Handling. Saline removal lifts and removes intact pigment particles through scab formation, whereas 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, while laser removal utilizes the body's immune response to clear the fragmented particles via the lymphatic system.

Both saline-based and laser removal methods possess 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's delve into the specifics of the saline-based removal procedure.

4. The Saline-Based Removal Process

Consultation and Agreement

The process commences with a consultation where the practitioner evaluates the brows, discusses the client's expectations, and explains the procedure. This includes potential risks and aftercare instructions. Setting realistic expectations is crucial due to variations in skin types and pigment used in the initial process, which significantly impact outcomes.

Inability to Predict Precise Results

Due to the diversity in individual skin responses and pigment chemistry complexities, guaranteeing specific results is nearly impossible. Factors like skin pH, hydration, and the immune response can influence the effectiveness of the removal.

Contract Signing

Typically, a contract is signed, with the client acknowledging potential risks. It's important to note that in many regions, insurance may not cover procedures involving certain chemicals, such as those in saline-based removal solutions.

Preparing the Treatment Area

Before the procedure, the area is thoroughly sanitized to reduce infection risks. Numbing cream or local anesthesia is applied to minimize discomfort, as the skin barrier's integrity will be compromised when applying saline solution.

Application of Saline Solution

A PMU machine with a sterilized needle is used to introduce the saline solution into the skin, similar to tattooing. High-sodium chloride saline disrupts osmotic balance, drawing water from surrounding tissues to dilute the salt concentration. Circular movements with relatively large needles (e.g., 3RL) are often employed to saturate the skin.

Osmosis Process

Osmotic pressure assists in dislodging pigment particles from the dermal layer, pushing them toward the epidermis. The efficiency depends on saline solution concentration and the original pigment's depth.

Scab Formation

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

Healing Process

Following scab shedding, the area requires time to heal. Complying with aftercare instructions, such as maintaining cleanliness and sun avoidance, is essential to prevent infection and facilitate optimal healing.

Additional Sessions

Due to factors like pigment age, depth, and color, multiple sessions spaced weeks apart may be required. Each session's healing response and pigment removal extent guide the need for additional treatments.

In summary, the saline-based removal process involves complex interactions of chemical reactions, skin physiology, and cellular responses. Experienced artists emphasize that while some pigmentations may seem easy to remove with saline, showing no visible effect after treatment, others that appear challenging can significantly lighten with saline-based removal.

5. Limitations of Saline-Based removal

Size of Pigmentation Area

The effectiveness of saline-based removal diminishes as the size of the pigmented area increases. Large areas, especially those with densely saturated brows containing dark organic pigments, present significant challenges. This is primarily because the osmotic process has limited capacity to draw out high pigment concentrations across a wide area efficiently. In such cases, laser removal often becomes a more suitable alternative due to its ability to target and break down pigment over larger skin sections.

Depth of Pigment Implantation

A significant limitation arises when pigments are implanted too profoundly, particularly in cases involving black colors reaching the hypodermis. This typically involves small-sized (100-200 nm) carbon black (CI 77266) particles, especially those derived from Furnace-based carbon (Black 2). In such scenarios, saline-based removal involves challenging mobilizing these particles through the reticular dermis, papillary dermis, and eventually through the epidermis. While some practitioners have observed successful migration of these particles to the surface over multiple sessions, the process remains unpredictable. Deeply implanted and cold-toned organic carbon black particles often respond more favorably to laser treatments. Laser removal can fragment these deeply embedded pigments more effectively, allowing the body's immune system to remove them.

6. Advantages of Saline-Based removal

Listed below are the advantages of saline-based removal based on the observations of experienced artists.

Versatility in Pigment Types. Saline-based removal is effective for various pigments, regardless of their chemical composition. Unlike laser treatments, which may struggle with specific colors like camouflage, yellow, or green due to specific light absorption properties, saline-based methods work consistently 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.

They minimized the Risk of Skin Damage. Sale-based removal generally carries a lower risk of burning or scarring than laser methods. Lasers emit high-energy light that can cause thermal damage, potentially leading to scarring. While not all scars are visible, subdermal changes can affect the skin's texture, making it challenging to re-implant pigment. Saline methods are gentler, making them suitable for sensitive skin and thinner areas.

It controlled Pigment Fading. This method allows for gradual and controlled lightening of pigment. It is particularly beneficial for subtle adjustments or delicate areas where precision is crucial.

Safety near Sensitive Areas. Saline-based removal is often preferred for areas close to the eyes and mouth. Chemically, this preference arises because pigments used in these regions are typically more amenable to osmotic removal. Biologically, the skin structure in these areas facilitates effective osmosis, aiding pigment mobilization.

No Impact on Natural Brow Hair. Laser treatments can negatively affect natural brow hair, often leading to temporary or permanent hair removal. In contrast, saline-based methods typically do not impact hair growth, preserving the natural aesthetics of the brows.

Effectiveness with Titanium Dioxide (TiO2). Practitioners have encountered challenges with laser removal of titanium dioxide pigments, especially 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.

In conclusion, 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 when selecting the most appropriate removal technique for their clients.

7. Typical components of solution

The composition of saline-based removal solutions may vary among manufacturers, but several components are commonly found in these liquid mixtures.

Sodium Chloride (Salt). The primary component is salt, typically in the form of sodium chloride. Salt creates a high-concentration solution, initiating the osmotic process required to lift pigment from the skin. Creating an imbalance in solute concentration attracts water and pigment particles towards the skin's surface.

Orange Seed Extract. This natural extract aids in exfoliation and pigment fading. It contains citric acid, which gently peels the skin's upper layers, facilitating the removal of pigment particles during scabbing.

Lemon Seed Extract. Like orange seed extract, lemon extract contributes to exfoliation and fading due to its citric acid content. It promotes skin renewal and lightening of the treated area.

Aloe Vera. Aloe Vera is known for its soothing and healing properties. Saline-based solutions help 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 purity and safety.

Glycerin. Glycerin may 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, possesses 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 tighten the skin and reduce inflammation post-treatment.

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

8. Additional observations

Experienced artists have shared several additional insights presented in the following list.

Importance of Quality Products. Using high-quality saline-based removal gels from reputable manufacturers is crucial. The effectiveness of these products often depends on ingredient purity and concentration, which significantly impact the osmotic process required for effective pigment removal.

Application Technique. Unlike the light whip and pendulum movements used in powder brow pigmentation to avoid saturation, applying saline solutions involves circular motions at a medium machine speed. This technique ensures adequate saturation 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. Needle diameter, typically around 0.4 mm with a length of 1.5 - 2mm, is critical for achieving the right balance between saturation and minimal skin trauma.

Desired Bleeding. Some bleeding during the procedure is expected and desired, as it indicates effective oversaturation. This bleeding suggests the needle has reached the appropriate skin depth, vital for the solution's effective interaction with pigment particles.

Pricing Structure. The cost of saline-based removal varies, typically from USD 50-150 per session, depending on location and specific circumstances. Pricing may be adjusted, especially if artists correct their originally applied pigmentation.

Emergency Removal. Saline-based removal is used as an emergency for brow corrections within 72 hours of the initial procedure. This rapid response is effective because the pigment is in the epidermis during this early stage. The saline solution accelerates the natural exfoliation process, making it valuable for immediate corrections.

Pain during the Procedure

The procedure is not pain-free, as the implantation of salts into the skin can cause discomfort. However, many artists suggest using numbing agents sparingly to minimize interference with the procedure.

Valuable Skill

Mastering the application of saline-based removal solutions is a valuable skill for semi-permanent makeup artists. It requires understanding product chemistry, appropriate needle techniques, and an appreciation of the skin's response to treatment. This skill can be learned relatively quickly, especially for those skilled in pigmentation.

Expertise in Eyelid and Lip Removal

Removing eyelid or lip pigmentation should only be done by artists with experience providing these services. The delicate nature of these areas requires specialized knowledge and skills.

These additional insights highlight the importance of quality products, proper technique, needle selection, pricing considerations, and the value of mastering saline-based removal for semi-permanent makeup artists.

9. Conclusions

Saline-based removal relies on the principle of osmosis, utilizing a high salt concentration to draw pigment out of the skin. The process involves applying a saline solution to the skin using a PMU machine, akin to tattooing, but with saline instead of ink.

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

The Procedure

Consultation and skin evaluation.
Cleaning and optional numbing of the treatment area for comfort.
Specific application techniques using needles (e.g., 3RL for tracing and 5RL for larger areas) and appropriate needle diameters (typically around 0.4 mm) are crucial for success.
Advantages of Saline-Based Removal
Versatility for various pigment types, irrespective of their chemical composition.
Lower risk of skin damage compared to laser methods, suitable for sensitive skin. Controlled and gradual fading of pigment, ideal for subtle corrections.
Effectiveness near sensitive areas like the eyes and mouth due to the gentle nature of the process.
Preservation of natural brow hair, unlike laser treatments.

Effectiveness in removing specific pigments like Titanium Dioxide, which may not respond well to laser.

Limitations and Challenges

It is less effective on large areas of pigmentation or deeply implanted pigments, such as 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.
The process of applying may cause considerable skin damage.

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 techniques compared to pigment application, with a focus on saturation.
A certain level of visible bleeding during the procedure is average and indicates adequate saturation.
Saline-based removal is recognized as an effective emergency solution for correcting brows within 72 hours of the initial procedure.

In conclusion, saline-based removal is a valuable technique in semi-permanent makeup, offering a safe and versatile pigment correction and removal method. 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.