There will be an epithelial crust that forms in the days following the procedure. It will be more noticeable in the lip liner procedures. This crust is a combination of dried pigment and plasma that forms externally. It is important that the client does not pick it. Picking the crust will result in a loss of pigment. The crust will fall off naturally within a few days. For the first few days following the procedure, the area will feel similar to that of a sunburn. A topical ointment can help soothe the area. Instruct your client to apply antibiotic ointment twice daily. Send client home with our Rehab One-Week Solution. This will soothe the area, keeping it moist and helping it heal properly. Rehab will help with retention as well. 


Lip Liner & Full Lip Color: 

• Dryness in the treated area

• Fever blisters or cold sores. (Treat with Valtrex or Zovirax cream or tablets) 

• Scabbing 

• Pat Ointment onto lips, do not rub. Rubbing ointment onto lips may remove pigment


  • Do not touch the treated area unless applying ointment. No scratching, rubbing, or picking ofthe treated area

  • Do not apply makeup on treated area until healed

  • Apply ointment 1 - 3 times a day on treated area until peeling comes off; normally 5 to 7 days.

  • Follow with Scalpa Rehab for one week

  • Artificial tears may be used if needed but not recommended

  • Touch up may be done after 21 days, however its best to wait 30-45 days




For all clients who have permanent cosmetic makeup procedure performed, we only use the very finest pigments available. Some procedures may need to be repeated because the original application can fade anywhere from 25% to 40% on eyebrows and eyeliner. Individual chemical and genetic makeup can affect the final result.


We sincerely hope that you are one of those lucky individuals who get perfect results with only one application, however this cannot be guaranteed. Please remember that the amount of pigment you retain or lose after your initial application is not a reflection of the quality of work. In case your procedure must be repeated, you will need to wait at least 21 days of the date of your original application.


The tissue is not ready to absorb new pigment although your skin looks healed. Please be patient.


Most touch-ups can be done in 30 to 45 minutes.



Often the reason you may have trouble retaining pigment in the lips is the aftercare instruction you give your client. Full lip color is most often affected by poor after care, although any tattooing around the mouth is subject to loss of color if not treated properly during the healing process. The lip tissue is different in nature and is subjected to the salts and acids from food and drink, as well as bacteria found in one’s saliva. All three tend to have a bleaching effect on pigment in unhealed skin. A tell tale sign that your client did not comply with the afar care instructions would be a loss of color in the center of the bottom lip. This is caused by drinking coffee or sodas (acid) without the use of a good ointment or straw.

• Supply your customer with plenty of aftercare ointment as well as Rehab for them to use after the procedure. They must be “married” to this product for the two to three weeks of healing period. An old lipstick will not do, as bacteria is present and can cause an infection. 

• Use a straw before drinking anything (water, sodas, coffee, tea, etc.) 

• Do not bite into a sandwich or hamburger, instead cut them in to little pieces. Biting into bread or food causes the crust or color to adhere to it and come off. 

• Never wipe lips, always pat dry. 

• Before going to bed, your client needs to apply ointment. 

• A good lip procedure isn’t luck, but knowledge.


Although complications following a procedure are rare, it is best to familiarize yourself with the following information:


Infections are usually a result of the client’s failure to apply Rehab. Infections are very rare.  If infection occurs, instruct your client to seek advice from a physician immediately.


Allergies to pigment are extremely rare but very obvious when they do occur. The pigmented area will appear very swollen. Allergies to antibiotic ointment are more common. If the client complains of redness and itching, it is probably an allergic reaction to the antibiotic ointment. Simply instruct the client to stop using the antibiotic ointment. Usually, the signs of allergic reaction to antibiotic ointment do not occur until two to five days following the procedure, when the threat of infection has passed. A client can however, go to a physician for steroid antibiotic ointment, which provides satisfactory antibacterial action with the additional benefit of anti-inflammatory steroid.




Too often, cosmetic technicians want to apply PMU on anyone who walks through their door, even the mailman, just to make the rent payment and get another photo for their procedure portfolio. But long-term success depends on knowing when not to do a procedure. This means turning down potential clients because permanent cosmetic makeup may not be appropriate for their situation. Potential risks are followed below.


Diabetics have the tendency to both bleed and bruise easily, depending on the severity of their disease. The healing process for diabetic clients can be lengthy. Interview the potential client at length. Ask them how they react to a surface wound (i.e. a cat scratch). Avoid brittle diabetics and those that are insulin-dependent.


The most expensive insurance premiums and settlements in the medical community are paid by those involved with pregnant women. This is a condition that only lasts nine months. Wait for the child to be born, then do the procedure.


Psoriasis patients suffer from excessively dry skin characterized by peeling and flaky skin. Peeling can make the skin of psoriasis victims extremely tender, making a procedure very difficult to complete. In addition, more bleeding may occur and the final procedure may slough off, requiring additional touch-up procedures.


More common in darker skin toned clients, hyperpigmentation is a result of a past injury to the skin which permanently blemished parts of the surface. Sufferers of hyperpigmentation will often experience further damage to the surface of their skin as a result of additional trauma to the skin inherent to cosmetic tattoo procedures.


A scar is a result of past injury to the dermal layer of skin. Tattooing is applied to the upper dermal layer of the skin and therefore a tattoo is considered a scar of color. Scars vary in shape, size, texture and appearance. Camouflage procedures for the purpose of covering scars are considered experimental in nature. Always perform color testing on any scar before attempting to camouflage the entire area. Allow test patches to heal for 3 weeks to one month.


Keloid scars look like thick ropes under the skin and may be extremely tender to the touch whereas other scars are usually flat on the surface of the skin and may feel numb.


Clients suffering from any type of visible skin allergy or affliction should be required to see a dermatologist before receiving any type of intradermal pigmentation. Request a physician’s written approval before performing a procedure.


Any client who suffers from allergies of any kind must receive a patch test. This test should be performed 3 weeks to one month prior to the procedure. Those who experience allergic reactions from earring posts and must wear 14 karat gold posts may be allergic to nickel. Most tattoo needles are constructed from a nickel alloy and may cause a great deal of swelling and irritation to these clients. Those who are allergic to Novocaine or any type of Caine derivative may experience a reaction from topical ointments if they are applied. Other allergic reactions may be caused by latex gloves or powders used to lubricate gloves.


A viral infection commonly referred to as fever blisters which erupt at the base of the lips. Those who suffer from Herpes Simplex need to consult their doctor prior and follow pre and post care instruction. 


There are a wide range of birthmarks and many are risky for cosmetic tattooists. There are many preferable options for removal or camouflage of birthmarks. To avoid liability and more importantly, to achieve the optimum result in birthmark removal, seek advice from a dermatologist specializing in cosmetic work.


An integral part of the consultation is establishing the client’s motives for getting the procedure and their emotional state. A client’s unstable frame of mind could lead to problems far more complicated than any medical problem. When a client is unsure of a permanent procedure, do not do the procedure. They may discover that they’ve made a mistake, and pointing to it will be your tattoo needle.

These potentially dangerous clients come in all shapes and sizes and often give little clues to their uncertainty. If your client enters with a persuasive friend recommending your work, make sure that the client and not her friend is formulating the decision. If a client continually talks about how nervous they are, you may want to reschedule for a later date, maybe a year. One possibility which usually works with the dubious potential client is known as ‘’The Trial Period”. This is a two week span which the dubious client is instructed to diligently apply and never take off the permanent procedure. For instance, if Leery Louise has approached you for a set of red full lips and you sense her ambivalence, direct Louise to apply a long lasting lip color to her lips and wear it constantly throughout the day. You may want to have some long lasting lip color on hand for clients much like Leery Louise. Lip pencils, though drier in texture, often last up to twelve hours. Make sure your client applies it as often as possible, not allowing the color to fade. Have her look at her face first thing every morning. You, as the technician may want to call her and check on her progress.

“Hello Laura. How are you enjoying the feel of your semi-permanent lip color?” “Do you like the color itself? Or do you think you may want to go darker or lighter?” “Have you spoken with your friends or close relatives about the procedure? What do they think?”

You should be able to gain a perspective on Laura’s feelings towards a permanent full lip line. Another helpful tactic for protecting yourself may be to have a more extensive Consent/Release form, which you save in the back of your file cabinet for people similar to Leery Louise.

 Health & Safety Guidelines 


It is recommended that when working on any paying patron that you be fully insured for the procedures you are performing. Please check with your state for all important information pertaining to licensing and insurance. 

Scalpa Academy is an International Company training both licensed and non-licensed individuals, anywhere from home use to nurses. Because of the large variance in the students we educate, and the fact that laws and governing boards vary from country to country, state to state, and city to city, it is the sole responsibility of the student to research their governing boards and laws within their state and country if you are planning to perform any of the procedures we offer as a business. 

American Med Spa Association provides more information and insight regarding laws and licensing in the US. 

Click here to read more! 


Precaution & Protocols

We at the Scalpa Training Academy encourage all students to take extra precaution when performing any procedure where bloodborne pathogens may be present.

In the United States, the government agency responsible for worker safety is the Occupational Safety and Health Administration otherwise known as OSHA. 

We require that all students seeking certification through Scalpa to complete a Bloodborne Pathogen Training Course to meet and satisfy the training requirement under the federal OSHA Bloodborne Pathogens standard which prescribes safeguards to protect workers against the health hazards from exposure to blood and other potentially infectious materials and to reduce their risk from this exposure. Example health hazards include but are not limited to Hepatitis B, Hepatitis C, HIV, Malaria, Brucellosis, Syphilis, West Nile Virus, etc.   

Scalpa also requires that students must be certified in Infection Control and Prevention. One of the most common places for infections to occur is healthcare systems and they are also very prevalent within many aesthetic facilities. Because we are going to be penetrating the skin, it is extremely important to take every necessary step to ensure you and your client are safe from infection. Infections can live in the area, on materials, in your business, on your self and workers, and on the client, it is important to know how to control and prevent such infections from spreading. 

Scalpa recommends online training and certification through Aesthetics Accreditation International. This is a low-cost accredited course and is valid internationally. Click the links below for more information

Use discount code SCALPA30 at checkout for 30% OFF

**BBP certification is valid for 1 year and MUST be renewed to be valid. 

**Infection Control and Prevention certification is valid for 2 years and MUST be renewed to be valid. 

Please submit a copy of your certificates during your final submissions. 

Any procedure where there is the possibility to blood exposure, you want to take every precaution available to you for both the client and your own safety.

Who Needs to Comply with OSHA Bloodborne Pathogens? 

Anyone who could be "reasonably anticipated" to exposure to blood or OPIM (other potentially infectious materials) as a result of performing their job duties need to comply with OSHA Bloodborne Pathogens. 

This includes: 

Healthcare Workers 

Emergency Responders 

School and Day Care Staff 

Cleaning and Janitorial Staff 

Tattoo and Permanent Makeup Artists 

Cosmetologists & Aestheticians 

Scalpa Academy also encourages professional interaction with clients from the beginning to the end of their interaction with you as a practitioner. This includes but is not limited to: 

• Proper Consultation 

• Intake Forms 

• Client/Patient Files

• Procedure Table Set Up 

• Patient/Client Follow Up 


Suggested Courses For Health & Safety:

Take extra measures in your practice by learning proper health and safety precautions that may be necessary within your practice. Aesthetics Accreditation International offers a variety of medical courses to keep both you and your client safe. 




Touch-up applications are provided for the purpose of perfecting procedures. If you are finding yourself doing multiple touch-ups on cosmetic procedures, you may need to analyze the reasons for it. If you are experiencing a lack of pigment acceptance, review the following:


You must ensure the skin in the affected area receiving pigment implantation is stretched to its full elasticity. Lack of skin stretching will result in loss of pigment, pastel versions of color shades, or lack of pigment acceptance during the procedure.


Only when you reach the dermal layer of skin will the pigment stay. Do not be afraid to penetrate too deeply.


Many beginning intradermal cosmetic technicians find themselves rushing the process. Allow the machine time to implant pigment. This does not mean to completely stop the movement of your machine altogether. 


If you are finding a lack of pigment acceptance during the procedure, you should closely examine your needle. Sometimes there will be a hook or bend in the tip of the needle. You can check this with a magnifying glass or an eye loupe. Implanting with a bent or otherwise damaged needle results in skin damage or ripping, pigment not implanting properly, and excessive pain.

Disclaimer of Medical and Legal Liability: Scalpa training courses are intended to provide the general knowledge to perform procedures but is not intended to be a substitute for medical advice, diagnosis or treatment. Reliance on the information in this training course for procedural purposes is to be used at your own risk. If you have questions or concerns, contact a medical professional prior to treatment. Scalpa is not held responsible or liable for risks involved with this procedure. 


Scalpa strongly advises each member or student to research their local legislation. It is your sole responsibility to check and clarify all rules and regulations pertaining to your country, state, city and county if you are planning on performing our training program procedures as a professional. Because Scalpa is offered worldwide, we cannot guarantee this information. Please check with your local health department, governing boards and FDA regulations regarding performance of any Scalpa course procedure. Scalpa is not held responsible or liable for legal encounters regarding licensing, regulations, or other legal aspects pertaining to procedural operation.