Updated: Feb 10, 2020
Every microblading artist has a method of healing the brows they swear by. Almost all of them different.
There are variations that range from artists having their clients not let water touch their brows including not washing them for 2 weeks (yikes!) to artist having their clients dab their brows with a pad moistened with sterile water immediately following the procedure all the way until bedtime.
One artist will swear by Aquaphor while another swears by A & D ointment (basically the same thing) while another believes that such petroleum based products will pull pigment and suffocate the skin.
Microblading results are determined 50% by the microblading procedure and 50% by the aftercare.
With so much riding on the healing process it's important for both the client and the microblading artist to understand the hows and whys.
Unfortunately, there is a lot of confusing and opposing information on how to heal the brows.
If you do your research, you will read about so many different ways of healing that it will make your head spin and leave you confused. I know, I've done the research.
I spoke to surgeons and nurses, and read lots of medical articles on wound healing.
Here are my findings. I hope it will clear things up.
How Do Cuts and Scratches Heal?
After getting a cut, your skin may start bleeding, although when staying in the correct depth bleeding should be minimal.
This happens because the injury breaks or tears the tiny blood vessels, which are right under the skin's surface.
You might see some clear fluid on or around the brows along with some slight bleeding.
This clear fluid is called lymph fluid and is made of salt, water, and protein.
Lymph fluid takes on the role of wound protector by cleaning the wound, fighting infection and overseeing the repair process.
These fluids cause clotting which works like a plug to keep blood and other fluids from leaking out.
Nevertheless, this clear fluid is to be blotted off with a clean tissue for the first couple of hours to prevent a thick scab from forming (the goal).
A scab is a hardened and dried clot which forms a hard protective crust over the wound.
This protects the area so the skin cells underneath can have time to heal and multiply in order
to repair the wound. If the scab grows too thick we run the risk of it adhering to the pigment and having it take the pigment with it when it falls off. The less scabbing there is, the better the pigment retention will be.
Under the scab, a new layer of skin is forming. When the new skin is ready, the scabs will fall off
usually within a week or two.
If the client picks at a scab, the new skin underneath can be ripped off with the scab taking the pigment with it.
This causes the wound to take longer to heal and may leave a scar.
Dry or Wet Heal?
One medical journal states that medical professionals began to realize the benefits of moist wound healing as far back as the early 1960s. The proof that moist wounds heal faster than dry wounds came back in 1962, thanks to Dr. George D. Winter and his landmark paper, "Formation Of The Scab And The Rate Of Epithelialization Of Superficial Wounds In The Skin Of The Young Domestic Pig". His research showed that, contrary to the conventional wisdom at the time (that wounds should be allowed to dry out and form scabs to promote healing), proved that wounds, instead, heal faster if kept moist. Winter's work began the evolution of modern wound dressings that promote moist wound healing revealing that “wounds that were kept moist healed in approximately 12 to 15 days, while the same wound when exposed to the air and allowed to dry out healed in about 25 to 30 days.”
Wounds must be kept clean if proper healing is to take place. This is NOT optional.
No matter what kind of wound you have, washing it is always the first line of defense.
One more safety precaution is to NOT use tap water or any water that is not sterile on a fresh wound.
Sterile water or sterile wound wash can be found at any pharmacy. Washing with it the first day is a smart extra defense against infections.
Understandably, pigment dilution is a concern to many artists.
The answer is simply to not drench the brows but, instead to use a damp cloth.
Dr. Bruce E. Ruben MD, founder and medical director of Encompass HealthCare, located in West Bloomfield, Michigan says that lacerations, abrasions, crush injuries and burns heal faster and with less scarring when treatment involves promoting a moist wound bed.
Dr. Ruben goes on to say that "moist wound healing provides 50% faster healing than dry healing with less scarring and better results."
Moist healing is clearly the better healing method!
What about using antibiotic ointments?
Many medical articles say to use an antibiotic cream on a washed wound, but the latest research shows that any of the antibiotics present in antibiotic creams such as Neosporin and Bacitracin can cause an allergic reaction. Neomycin allergy (one of the antibiotics used in many of the antibiotic ointments)
is the most common and it appears that more and more people are reporting a sensitivity to it.
Any of the antibiotics in Neosporin can cause an allergic reaction. Neomycin allergy is the most common and it appears that more people are becoming sensitive to Neomycin.
Most allergic reactions affect only area treated with Neosporin (allergic contact dermatitis). More severe reactions with hives, difficulty breathing or swallowing, swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs, are rare and potentially dangerous, seek medical treatment immediately.
Allergic reactions can interfere with wound healing. Redness and discharge from an allergic reaction may be mistaken for signs of infection.
The first signs of an allergic reaction may be redness, skin pain, irritation, burning, swelling, itching, rash, or hives. The skin may weep or develop blisters. The onset of symptoms of neomycin allergy may be delayed up to a week from the first use.
Pharmacy Times says this about Bacitracin, similar to Aquaphor and Neosporin:
Bacitracin ranked as the ninth-most common allergen between 1998 and 2002.7,8 In 2003, the American Contact Dermatitis Association (ACDA) named bacitracin its Allergen of the Year based on increasing reports of allergy and anaphylaxis. By 2010, bacitracin ranked number 3 on the North American Contact Dermatitis Group Patch Test Results, which tests more than 4000 patients across the United States; .2% of the patients had a reaction to bacitracin. A similar study in Ontario, Canada, in 2010 (n = 102) found that 44% of patients who had previously developed ACD due to any topical agent tested positive to bacitracin; neomycin caused reactions in a comparatively low 29%, mainly because Canadians use very little neomycin. The ACDA recommends limiting the use of bacitracin.
Use of an antibacterial ointment by tattoo parlors is required or suggested by some state boards of health (ie, those of Alabama, Arkansas, Hawaii, Maine, Montana, Nevada, New Hampshire, North Carolina, Ohio, South Dakota, Texas, and Utah). Tattoo artists discourage their customers from using plain petrolatum because petroleum-based products tend to drain the color from tattoos. They also advise against using Neosporin because it is known to cause allergic reactions that cause tattoo “spotting.” Instead, tattoo artists tend to recommend bacitracin.
Dermatologists and public awareness groups have tried to publicize potential problems with bacitracin, 8% to 10% of dermatologic surgeons still use bacitracin postoperatively. Almost half of dermatologic surgeons actively advise patients not to use it because it is unnecessary, which is wise because mass marketing of bacitracin products would have patients believe otherwise.
And, yet, many artist swear by it and will tell you they've used them for years with no issues.
Sure, that's possible but it's like playing Russian Roulette, the odds are that sooner or later an issue
is bound to happen. It's overkill and an added risk.
To make matters worse, antibiotic sensitivities can be tricky to spot because it may not show up for days after the procedure, and it is often mistaken for an infection due to the redness and swelling.
As long as the wound is cleaned daily, it is not necessary to use anti-bacterial ointments, says the American Academy of Dermatology.
Do not use disinfectants over wounds.
Not using disinfectants, makes sense because disinfectants such as iodine, sodium hypochlorite and hydrogen peroxide are toxic to cells and should never be applied over a wound surface. We don't want to kill cells; we want to encourage them to live and proliferate.
Petroleum on Wound Healing
The label says petroleum jelly can help protect minor cuts, scrapes and burns, but new research suggests immediately slathering an open wound with this ointment might be a bad idea.
Scientists have studied how the skin creates its own "natural plaster" to help heal injuries.
Oil-based substances, such as petroleum jelly, appear to disrupt this important process, and might increase the risk of wound infection, they say in the Journal of Clinical Investigation.
Neosporin and most ointments contain petroleum.
The BBC Health News says that scientists have studied how the skin creates its own "natural plaster" to help heal injuries.Oil-based substances, such as petroleum jelly, appear to disrupt this important process, and might increase the risk of wound infection, they say in the Journal of Clinical Investigation.
Some NHS hospitals recommend it to patients with surgical wounds that have already started to heal, and it forms part of the first aid kit in some contact sports, including rugby union where it is used by the England team.
However, Prof Robert Ariens and colleagues at the University of Leeds say their observations with human and animal tissue suggest this may not be the best immediate approach to wound management.
They found that a microscopic protein film forms rapidly over a wound as part of the natural clotting process.
Medical imaging reveals the film - made up of a substance called fibrin - has tiny pores that let air reach the wound but are too small to allow bacteria and some viruses to pass through.
Prof Ariens said: "We did laboratory and animal studies which showed this film could be a barrier against microbial infection for at least 12 hours, and this gives the immune system time to get white blood cells to the wound to counteract any infection."
Adding petroleum jelly perforated the protective film.
Prof Ariens said: "If you get a scrape or a cut it is best to let it clot and to let the film form. Do clean it of course if it needs it, but the clot will make its own perfect plaster. After that, it might not be so bad to add petroleum jelly, but before then, from our findings, it appears to damage this film."
Ok, so what's the right way to heal the brows?
Here's what I do:
Immediately following the procedure I have them apply pressure using a couple of ice packs wrapped in a clean sterile gauze.
After 10-15 minutes of the ice pack, we will blot the brows dry and apply an aftercare ointment specifically designed for microblading such as the AfterInked by GirlzInk.
I have them gently wash their brows the first evening using a mild cleanser like Cetaphil or Cerave and rinsing it off by using a cotton pad moistened with sterile water.
They are to add a tiny amount of the after-care ointment I've provided for them in the after-care kit.
Repeat the next morning and evening.
The day after that (day 3) they can use tap water to stay with the same process.
And that's it.
The trick to using ointments is to apply a tiny amount, no bigger than a grain of rice, so as to keep the wound from drying and cracking without suffocating it.
The wound is unprotected and in a sensitive state. When the wound and the surrounding skin dry up it can create further irritation to the wound.
Oxygen is another necessary ingredient needed to properly heal a wound so that if too much product is applied to the wound it can suffocate it and impair healing.
This is why it is important to apply such a small amount of aftercare that you cannot see it on the brows once it is applied. An amount comparable to a grain of rice.
If the client has very dry skin, aftercare ointment may be applied 3 or 4 times a day.
Always a tiny amount.
It is better to apply more often than to apply a lot of product.
The goal is to find the right balance for your particular skin.
If your skin is oily, you don't have to do much more than keep it clean.
If your skin is dry, adding some moisture will aid the healing.
What About The Possibility Of Infection?
When following the proper protocol, infections are very rare but is always a possibility, therefore, it’s important to know the signs and what to do should it ever occur.
What is considered normal after the procedure?
Some slight redness or swelling around the eyebrows
Some tenderness of your eyebrows that may last a couple of days
Scabbing of the eyebrows that may last up to 7 days
Peeling and flaking of the skin
Signs & Symptoms you may have an infection
Odor coming from the eyebrows
A colored discharge. May be a greenish/brownish color
Tenderness when touching beyond the first couple of days following the procedure
Redness and swelling on and around the procedure site beyond the first couple of days
These symptoms may be early signs of an infection starting.
Consider these tips if you detect an early infection:
If you are noticing the early signs of infection, then you might consider using an antibiotic cream on the brows.
Clean the brows 3 times a day.
Consider using an antibiotic ointment like Bacitracin which will treat the most common skin pathogens such as staph and strep.
Avoid covering up the microbladed brow with creams and gels such as vaseline or other emollients which can trap in heat and keep an infection in the wound (remember bacteria dies in the presence of oxygen)
Consider using a cold pack on your eyebrows to reduce swelling and heat, this can also help alleviate some of the pain/tenderness
Keep the area clean! Avoid using makeup or other topical agents (besides the antibiotic) on your skin/wound
Using these tips will allow your brows to heal quickly and should prevent the spread or worsening infection.
If the infection continues or gets worse, it is time to have the client call a doctor.
So, now that we know that whether we choose to wet or dry heal, the brows will have to be washed, let's talk about how much water is an acceptable amount?
The point is to keep the water superficially on the brows for as short of a time as possible and to not let the brows soak.
When washing the brows, don’t leave the soap or water on too long.
Quickly and gently wash the brows with a gentle, soap-free cleanser with no fragrance
such as Cetaphil.
Wash the brows in the direction of the hair growth. No rubbing back and forth.
Rinse with a damp cloth and pat dry. Blot with a clean tissue.
It’s best to provide your client with the proper aftercare creams so that they don’t go buying their own and end up with products that will pull the pigment from the brows or blur the strokes giving the microblading artist more work at the touch up appointment.
Swimming in a pool or going into a sauna is strictly forbidden until the brows are completely healed (4 week minimum).
What about exercise?
Sweaty brows are a no no. We don't want moisture coming from inside the body diluting the pigment and pushing it out of the body.
We understand that some people can’t go 2 weeks without working out.
The compromise is to not workout for the first 7 days, then to keep the workouts light and the heart rates down.
Here is how the healing of the brows will develop:
Day 1: The brows are fresh and perfect
Day 2-4: The brows will actually get darker over this period of time but will lighten again.
Day 5-8: The brows will flake and scab off. The area may be itchy.
Not picking or removing the scabs is imperative to retaining the pigment.
After the scabs fall off the strokes may look red and shiny.
Day 9-10: The brows will appear like they are completely gone during this time, but don't worry, most strokes will re-appear soon
Days 11-28: Brows are coming back but the brows may appear patchy and incomplete during this part of the healing process.
Most of these patches will fill in over time, but if for some reason not everything comes back the touch up will fix any issues.
Day 42 (after touch-up): Brows are back to the way they looked on the first day
The touch up is where the brows are perfected, and any adjustments can be made.
Microblading is a 2-session process. Sure, there will be those clients with perfect retention from the first session, but they will be the exceptions, most will need the touch up for whatever reasons.
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