Last reviewed: August 19, 2026
Permanent makeup may sometimes be refined with a touch-up, adjusted through color correction, lightened before redesign or professionally removed. These options are not interchangeable, and none can be selected from the visible color alone. The appropriate pathway depends on healing status, skin condition, shape, density, treatment area, previous procedures, product records and a qualified professional assessment.
Professional scope: This guide provides general education for PMU professionals and clients. It does not diagnose skin conditions, prescribe a removal method or replace assessment by a qualified medical or removal professional. Licensing and permitted procedures vary by location.
Quick Answer
| Question | Short answer |
|---|---|
| Can permanent makeup be completely removed? | It may be significantly lightened or removed in some cases, but complete removal without residual color, texture change or scarring cannot be guaranteed. |
| Can a touch-up fix unwanted PMU? | A touch-up can refine some fully healed results, but it cannot erase misplaced pigment, repair scarred skin or solve every shape and color problem. |
| Is color correction the same as removal? | No. Color correction normally adds compatible pigment to change the visible color direction. Removal or lightening attempts to reduce existing pigment. |
| Should light pigment be placed over dark PMU? | Not automatically. Adding a lighter shade does not remove the darker pigment underneath and may create a denser, more difficult future correction. |
| When should more pigment not be added? | Do not immediately add pigment to unhealed, highly saturated, migrated, scarred, inflamed or unidentified previous work. |
| What should happen first? | Allow the area to reach the appropriate review stage, identify the problem type, document previous products and procedures, and obtain an assessment within the provider’s professional scope. |
| Can permanent eyeliner be corrected or removed? | Some healed eyeliner concerns may be refined, lightened or assessed for removal, but migration and misplaced pigment cannot simply be covered. Procedures close to the eye require specialized evaluation and method-specific eye protection. |
Touch-Up, Color Correction, Lightening and Removal Are Different
The word “correction” is often used for several very different procedures. Before planning another session, artists and clients should agree on what the next procedure is intended to achieve.
| Pathway | Primary purpose | Does it add pigment? | Situations to evaluate | Important limitation |
|---|---|---|---|---|
| Touch-up | Refine a healed result | Yes | Minor gaps, controlled density adjustment or a small balance refinement | Does not erase unwanted pigment or repair damaged skin |
| Color correction | Modify the visible color direction | Yes | A fully healed result with an assessed unwanted color tendency | Neutralization adds pigment; it does not remove the original colorants |
| Lightening | Reduce visible density before reassessment or redesign | Generally no additional decorative pigment | Work that is too dark, dense or restrictive for a controlled redesign | Several sessions may be required and the response cannot be predicted from appearance alone |
| Removal | Reduce as much unwanted pigment as professionally appropriate | No | Significant shape, placement or density concerns after professional evaluation | Complete removal and restoration to untreated skin cannot be guaranteed |
| Medical referral | Assess a possible skin complication or reaction | No | Worsening pain, heat, spreading redness, pus, marked swelling, open sores or persistent abnormal tissue changes | A cosmetic touch-up is not a substitute for medical evaluation |
A client may move through more than one pathway. For example, previous brow PMU may first require lightening, followed by a healed assessment and later redesign. That does not mean every case should follow the same sequence.
Can Permanent Makeup Be Removed?
Permanent makeup can sometimes be lightened substantially, and some cases respond well enough that the remaining color becomes difficult to see. However, no artist, pigment manufacturer or removal provider should promise complete removal based only on a photograph, formula category or shade name.
The U.S. Food and Drug Administration explains that tattoo removal is often a lengthy process requiring multiple treatments and that complete removal without scarring may be impossible. Permanent makeup is also placed on sensitive and highly visible areas, so treatment planning must consider more than pigment reduction alone.
The objective may be one of the following:
- Reduce density enough for a more suitable design;
- Lighten a section that extends outside the desired shape;
- Reduce an unwanted color before professional correction;
- Remove as much visible pigment as the assessed case allows;
- Stop further cosmetic work and refer the client for medical assessment.
“Can it be improved?” and “Can it be completely removed?” are different questions. A meaningful improvement does not always return the area to its untreated appearance.
Why Removal Results Vary
The response of permanent makeup cannot be predicted by describing a pigment as organic, inorganic or hybrid. Removal planning requires evaluation of the complete case.
| Factor | Why it matters |
|---|---|
| Exact product and shade | Different finished formulations and colorant combinations may respond differently. A general formula label is not enough. |
| Current visible color | Black, brown, red, orange, pink, white and mixed colors cannot be assumed to respond in the same way. |
| Pigment density | Repeated procedures, heavy saturation and multiple layers can affect the number and complexity of future sessions. |
| Placement and distribution | Depth is not reliably determined from a photograph. Uneven distribution can produce an uneven response. |
| Treatment area | Brows, lips, eyelids, scalp and camouflage work involve different anatomy, visibility and professional considerations. |
| Previous correction | Neutralizers, camouflage shades and repeated overlays can create a more complex mixture than the visible surface color suggests. |
| Previous removal | Earlier laser, solution-based or other procedures may have changed the color, density or skin response. |
| Skin condition and history | Active irritation, abnormal healing, scarring tendencies, medical history and medications may affect suitability and referral decisions. |
| Provider and method | Equipment, training, assessment, treatment parameters and aftercare all influence risk and outcome. |
For product traceability, use the 9-Point PMU Pigment Label Guide to record the exact product, shade, batch, dates, warnings and matching documentation.
When Can a Touch-Up Help?
A touch-up is an additional pigment-implantation session used to refine an existing result. It may be appropriate when the area has reached the artist’s expected healed-review stage, the skin surface is suitable for further work and the remaining issue can reasonably be improved by adding a controlled amount of pigment.
Examples that may be evaluated for a touch-up include:
- Small gaps in an otherwise acceptable healed brow design;
- Minor density imbalance after complete surface recovery;
- A lip blush result that requires a conservative color refinement after the healed color is visible;
- A section of shading that healed lighter than the surrounding area;
- A balanced shape that requires limited, planned enhancement.
A touch-up should not be scheduled only because the result looks faint during peeling or early healing. Read the PMU Healing Stages Guide before classifying early patchiness as permanent pigment loss.
The appropriate review point varies by procedure, client and professional protocol. For a focused discussion, see How Long Should You Wait Before a PMU Touch-Up?
When Should More Pigment Not Be Added Immediately?
Adding pigment is not a neutral decision. Every additional session changes the color, density and future correction options. Stop and reassess before performing another PMU session when:
- The area is still peeling, crusting, swollen, tender or otherwise within its active healing period;
- The existing color is already very dark or densely saturated;
- The pigment extends outside the shape the client wants to keep;
- There is visible migration, spreading or an unclear border;
- Several previous touch-ups have failed to improve the result;
- The skin appears shiny, raised, indented, thickened or texturally different;
- There is persistent redness, heat, pain, discharge, marked swelling or another concerning reaction;
- The original product, color, batch or correction history is unknown;
- The proposed correction requires expanding the design simply to cover the old shape;
- The artist is not trained or legally permitted to manage the identified problem.
Important: Worsening pain, spreading redness, increasing warmth, pus, fever, open sores, marked swelling, breathing difficulty or a rapidly developing reaction should not be managed with cosmetic aftercare or another pigment session. Seek appropriate medical care.
For a broader review of infection, allergic reactions, scarring and other recognized risks, read Is Permanent Makeup Safe?
Identify the Problem Before Choosing the Procedure
One of the most common planning mistakes is treating every unwanted result as a color problem. PMU concerns should first be separated into color, density, shape, placement and skin-condition categories.
| Problem category | Examples | Professional consideration |
|---|---|---|
| Color | Healed result appears warmer, cooler, greyer, redder or otherwise different from the intended direction | Assess the existing color, density, formula history and target before deciding whether correction or lightening is appropriate |
| Density | Small gaps, uneven saturation or a result that is excessively dark | Light gaps and excessive density require opposite strategies; both should not automatically receive another full pass |
| Shape | Asymmetry, an unwanted tail, an oversized brow or pigment outside the desired border | Adding pigment to the opposite side can enlarge the total design without solving the original placement problem |
| Migration or spread | Blurred edges or pigment visible outside the intended treatment zone | Do not attempt to disguise spreading by repeatedly expanding or darkening the design |
| Skin condition | Persistent inflammation, scars, raised tissue, open areas or abnormal texture | Further cosmetic implantation may be inappropriate; medical or specialist assessment may be required |
| Unknown previous work | No product records, several overlays or an uncertain removal history | Collect as much history as possible and avoid promising a predictable response |
Color Correction Is Not the Same as Removal
PMU color correction normally changes the visible color direction by adding a carefully selected compatible pigment. It does not extract the original pigment from the skin.
For example, an artist may evaluate a warm corrector for a cool-looking brow or a neutralization direction for an unwanted lip tone. The exact decision depends on the current color, density, target, treatment area, product compatibility and the artist’s trained color assessment.
Correction becomes less appropriate when:
- The existing work is already too dense;
- The shape itself is unacceptable;
- Previous corrections have created several visible color layers;
- The artist cannot identify what was previously used;
- The skin is not suitable for another implantation session;
- Additional pigment would make later lightening or redesign more difficult.
Placing a skin-tone or light pigment over dark PMU should not be described as removal. The darker pigment remains present, and the added layer may change over time or respond differently during a future removal procedure.
For an explanation of grey, blue, red and other long-term color changes, see Why PMU Pigments Change Color and How Correction Is Planned.
Professional Lightening and Removal Approaches
The availability, regulation and professional scope of PMU lightening and removal vary by location. The following overview explains broad categories; it is not a treatment protocol.
| Approach | General purpose | Assessment considerations | Limitations |
|---|---|---|---|
| Laser-based removal | Uses professional laser systems to target tattoo pigment | Pigment color, area, skin, previous procedures, health history, equipment and provider qualifications | Multiple sessions may be needed; residual color, skin-color change, infection or scarring can occur; complete removal is not guaranteed |
| Professional solution-based lightening or removal | Uses a provider-specific procedure intended to reduce visible PMU pigment | Product instructions, practitioner training, local regulations, skin condition, placement and previous history | Evidence, protocols and permitted scope vary; the procedure still disrupts skin and cannot guarantee complete removal |
| Planned fading before redesign | Allows an existing result to soften before another decision is made | Current density, color stability, client expectations and whether the shape remains acceptable | Timing alone does not guarantee that sufficient fading will occur |
| Cosmetic color correction | Changes the visible color direction by adding pigment | Existing density, undertone, compatible products, treatment area and target result | Not a removal method and may reduce future adjustment space |
The American Academy of Dermatology recommends consulting a board-certified dermatologist for laser tattoo removal because the outcome depends heavily on the person performing the procedure and on individual case factors.
Do Not Use DIY Removal Products
Do not apply unapproved acids, tattoo-removal creams, household chemicals or online DIY removal kits to permanent makeup. The FDA warns that tattoo-removal ointments, creams and do-it-yourself kits are not FDA-approved and may cause rashes, burns or scars.
This warning is especially important for eyebrows, lips and eyelids, where uncontrolled products can affect highly visible or sensitive tissue.
How the Treatment Area Changes the Decision
| PMU area | Common concern | Assessment priority |
|---|---|---|
| Brows | Grey or red color, excessive density, asymmetry, unwanted tail or oversized shape | Separate color from shape. A color corrector cannot erase pigment outside the desired border. |
| Lip blush | Uneven healing, unwanted color, border concerns or previous neutralization layers | Wait for an appropriate healed assessment and document all direct-color and neutralization products used. |
| Permanent eyeliner | Migration, unwanted thickness, asymmetry or color change | The eyelid and eye area require specialized assessment. Do not treat eyeliner removal as an ordinary brow procedure. |
| SMP | Dots appear too dark, enlarged, cool or inconsistent with surrounding density | Assess pattern, spacing, distribution, scalp condition and previous sessions before adding more impressions. |
| Skin camouflage | Shade mismatch, excessive opacity or visible contrast after healing | Consider the treated condition, underlying skin, shade history and whether further implantation is professionally appropriate. |
Permanent Eyeliner Correction: A Separate Safety Decision
Permanent eyeliner deserves its own assessment because pigment sits on thin, mobile eyelid tissue close to the eye. A result that appears uneven during swelling or flaking is not the same as healed asymmetry, and a color concern is not the same as migration. Before proposing another procedure, classify what is actually wrong.
| Eyeliner concern | What must be assessed | Why adding pigment may not solve it |
|---|---|---|
| Apparent early unevenness | Swelling, flaking, surface healing and the provider’s appropriate healed-review point | Fresh eyeliner can look temporarily irregular; an early second pass can add unnecessary trauma and density |
| Minor healed asymmetry | Whether a conservative addition can improve balance without making the total design too thick | Matching one side to misplaced pigment can enlarge both sides and create a harder future correction |
| Excessive thickness or unwanted wing | Exact placement, density, client goal and whether lightening or specialist removal assessment is more appropriate | A lighter or skin-tone pigment does not erase the unwanted line |
| Blurred edge or migration | Extent of spread, skin condition, procedure history and specialist options | Darkening or widening the liner can conceal neither the migrated border nor the additional pigment load |
| Blue, grey, green or faded color | Healed visible color, product records, density, placement, lighting and previous correction layers | A visible color shift does not identify one universal cause or prove that neutralization is suitable |
| Pain, marked swelling or eye symptoms | Prompt medical or ophthalmic evaluation rather than cosmetic correction | Another PMU or removal session cannot diagnose or treat an infection, injury or ocular complication |
Why Permanent Eyeliner Can Look Wrong
Possible contributors include unsuitable design, imprecise placement, uneven retained density, repeated passes, migration, an incomplete product history, previous correction layers and changes that become visible during healing or long-term fading. Aftercare may affect recovery, but it should not be used as a blanket explanation for every technical, color or placement problem.
Blue or grey appearance also should not automatically be attributed to “oxidation,” one pigment category or one assumed depth. The visible result can be influenced by the remaining colorant mixture, pigment concentration and distribution, overlying tissue optics, aging of the work, previous overlays, lighting and photography. A photograph alone cannot reliably establish implantation depth or the correct repair method.
When an Eyeliner Touch-Up May Be Considered
A conservative touch-up may be evaluated after the eyeliner has reached an appropriate healed-review stage when the shape is acceptable, the skin is suitable and the issue is limited to a small gap or controlled density imbalance. It may also be possible to add a small amount of pigment to improve symmetry—but only when doing so does not force the artist to make both sides progressively thicker.
A touch-up is generally not an eraser. It should not be used to chase a migrated edge, cover an unwanted wing with a light pigment, repeatedly darken an already dense line or work over tissue that appears inflamed, scarred or otherwise abnormal.
When Lightening or Removal Needs Specialist Assessment
Healed eyeliner that is significantly misplaced, migrated, excessively thick or too dense for a controlled redesign may need a specialist lightening or removal assessment. No single method is automatically the safest or most effective for every eyelid. Suitability depends on the precise location, the pigment mixture and color, previous procedures, tissue condition, equipment, provider qualifications and applicable regulation.
Laser procedures around the eye require specific expertise and appropriate ocular protection selected for the laser wavelength and treatment location. Ordinary external eyewear should not be assumed to make every eyelid procedure safe. The treatment plan and protective measures must be determined by a properly qualified provider who performs periocular laser work.
Solution-based procedures should not be marketed as a universally gentle alternative simply because they do not use a laser. They still intentionally disrupt skin, their evidence and protocols vary, and their proximity to the eye introduces additional safety considerations. Clients should ask who is legally permitted and appropriately trained to perform the procedure, what product or device will be used, how the eye will be protected, what complications are possible and what referral plan exists if a problem develops.
Eye-area warning: Seek prompt medical or eye-care assessment for eye pain, sensitivity to light, vision changes, a very red eye, an eyelid that becomes increasingly hot or painful, pus, marked or worsening swelling, fever or inability to open the eye. Do not wait for a cosmetic correction appointment when eye symptoms are present.
What to Bring to an Eyeliner Correction Consultation
- Clear photographs from before treatment, immediately after treatment and after healing;
- The dates of every eyeliner, touch-up, correction or removal session;
- The pigment brand, line, exact shade, batch and mixing record when available;
- Details of any light, camouflage or corrective pigment previously added;
- Information about past reactions, prolonged swelling, scarring or eye symptoms;
- The intended endpoint: minor refinement, reduced thickness, removal of a wing, color adjustment or maximum feasible lightening;
- A list of questions about provider credentials, eye protection, expected stages, risks and aftercare.
Do not apply acids, salt mixtures, tattoo-removal creams or household products to the eyelid, and do not pick, abrade or repeatedly exfoliate the area. Home treatment can injure tissue without predictably removing the pigment.
Do Not Judge the Final Result During Early Healing
Fresh permanent makeup can look darker, brighter, sharper or more uneven than the later healed result. Swelling, redness, surface moisture, peeling and temporary loss of visible surface color can all change how the procedure looks during recovery.
Early fading or patchiness does not prove that an immediate touch-up is necessary. Likewise, a vivid fresh color does not prove that removal will be required.
The correct review time depends on the procedure, skin response and the artist’s protocol. The surface should no longer be actively healing, and the artist should be able to distinguish temporary healing changes from the retained result.
Read Why PMU Pigment Looks Different After Healing before comparing a fresh photograph with a later result.
Information to Collect Before Correction or Removal
The more complete the history, the more informed the next professional assessment can be. Record:
- Treatment area;
- Date of the original PMU procedure;
- Date of every touch-up or correction;
- Brand and product series;
- Exact shade names or codes;
- Batch or lot numbers;
- Every mixing ratio used;
- Whether camouflage or neutralizing shades were added;
- Machine and cartridge information when available;
- Previous laser or solution-based procedures;
- Photos before PMU, immediately after, during healing and after healing;
- Previous reactions, scarring or unusual healing;
- Relevant medical history and medication information requested by the qualified provider;
- The client’s current goal: refinement, color adjustment, shape change, lightening or maximum feasible removal.
Writing only “brown,” “black” or “lip pink” is not enough. Exact product and batch records are important because a custom mixture may contain several shades and colorants.
Professional PMU Correction Decision Path
- Confirm healing status. Do not classify an actively healing result as a permanent failure.
- Screen the skin. Stop cosmetic planning when there are signs that require medical or specialist assessment.
- Identify the problem category. Is the concern primarily color, density, shape, migration, skin condition or a combination?
- Collect the history. Record products, shades, batches, procedures and previous removal attempts.
- Define the desired endpoint. Refinement, neutralization, redesign space and complete removal are different objectives.
- Assess whether adding pigment helps. Do not use a touch-up to hide a problem that requires lightening or referral.
- Assess professional scope. The artist should only perform procedures supported by training, product instructions and local regulations.
- Set realistic expectations. Explain that several stages may be needed and that complete removal or perfect correction cannot be guaranteed.
- Document the decision. Record why the selected pathway was chosen and what limitations were discussed.
Common PMU Correction and Removal Mistakes
- Scheduling another session before the area is ready for a healed assessment;
- Assuming all faded areas need more pigment;
- Covering dark PMU with a lighter pigment and calling it removal;
- Expanding a design to hide existing asymmetry;
- Choosing a neutralizer from the original target color instead of the current healed color;
- Ignoring the density already present in the skin;
- Promising that one procedure will completely remove the pigment;
- Assuming organic, inorganic or hybrid labels predict the removal response;
- Beginning correction without the original product history;
- Continuing to work on scarred, inflamed or otherwise unsuitable tissue;
- Using a brow-removal assumption for lips, eyeliner, SMP or camouflage;
- Attempting DIY removal with acids, creams or household products.
How PMU Longevity Relates to Future Correction
Longer visible retention is not automatically good or bad. The professional question is whether the result remains suitable as the client’s skin, preferences, shape and color change over time.
Retention also cannot be predicted from formula category alone. It is influenced by the exact product, shade, treatment area, implantation, technique, client characteristics, healing, UV exposure, skincare and maintenance history.
Read How Long Does Permanent Makeup Last? for a separate explanation of retention and maintenance. That guide addresses longevity; the current article addresses what to do when an existing result needs evaluation.
Frequently Asked Questions
Can permanent makeup be completely removed?
Sometimes permanent makeup can be substantially lightened or removed, but complete removal cannot be guaranteed. The outcome depends on the product, colors, density, placement, treatment area, skin, previous procedures and removal method. Residual color or skin changes may remain.
Can a touch-up fix uneven permanent makeup?
A touch-up may improve minor density differences in a fully healed result when the skin, shape and existing pigment are suitable for another session. It should not be used to hide migration, an unwanted shape, excessive density or a possible skin complication.
Can dark permanent makeup be covered with a lighter pigment?
Adding a lighter or skin-tone pigment does not remove the dark pigment underneath. It adds another layer and may create a denser or more complex future correction. Dark or misplaced work should be assessed before any covering strategy is selected.
Is PMU color correction the same as removal?
No. Color correction normally adds compatible pigment to change the visible color direction. Lightening and removal attempt to reduce existing pigment. A correction may be suitable for some healed color concerns but not for every shape, density or placement problem.
Can permanent eyebrows be removed?
Professional lightening or removal may reduce unwanted eyebrow PMU, but the response varies. The current color, shape, density, previous corrections, skin and original product history should be assessed before choosing a method.
Can lip blush be corrected?
Some fully healed lip-blush color or density concerns may be evaluated for conservative correction. Previous neutralization, scar tissue, unknown pigments, excessive saturation or an unsuitable border may require a different pathway. Early healing should not be mistaken for the final result.
Can permanent eyeliner be removed?
Permanent eyeliner may be evaluated for professional lightening or removal, but complete removal cannot be promised. The eyelid and eye area require specific expertise, and laser procedures near the eye require method- and wavelength-appropriate ocular protection. Clients should not attempt home removal or assume that a standard brow approach is suitable for eyeliner.
Can migrated permanent eyeliner be covered with more pigment?
Usually, adding more pigment does not remove or contain migration. Widening or darkening the design may make the total result denser while the blurred pigment remains visible. The healed placement, extent of spread, skin condition and professional lightening or removal options should be assessed first.
Why did permanent eyeliner turn blue, grey or green?
The visible color can reflect the remaining colorant mixture, density and distribution, tissue optics, aging, earlier overlays, lighting and photography. It should not automatically be blamed on oxidation, a single formula category or an assumed depth. Product records and an in-person healed assessment are needed before planning color correction.
How long should I wait before correcting permanent eyeliner?
There is no universal date that makes every eyeliner ready for correction. The area must first reach the appropriate healed-review stage for the procedure and provider, with no active irritation or concerning symptoms. Removal methods also use method-specific intervals, so the qualified provider should set the schedule after assessment rather than relying on a generic online timeline.
How many PMU removal sessions are needed?
There is no universal number. The required process depends on the product, colors, density, placement, treatment area, skin, previous procedures, selected method and response between sessions. A photograph alone cannot establish an exact treatment count.
Can permanent makeup removal cause scarring?
Scarring is a recognized potential risk of tattoo-removal procedures. Other possible effects can include temporary discomfort, redness, pigmentary changes or infection. Suitability, provider qualifications and aftercare should be discussed before treatment.
Should more pigment be added when PMU looks too dark?
Not automatically. Additional pigment does not reduce existing density. If the work is too dark, misplaced or already heavily saturated, lightening or specialist assessment may need to be considered before any redesign.
Can DIY tattoo-removal creams remove permanent makeup?
Do not use DIY creams, acids or household products on permanent makeup. The FDA does not approve tattoo-removal creams or do-it-yourself removal kits and warns that these products may cause rashes, burns or scars.
What should be recorded before PMU correction or removal?
Record the treatment area, procedure dates, product names, shades, batches, mixing ratios, previous corrections, previous removal procedures, healing photographs, reactions and the client’s intended endpoint. Complete traceability supports a more informed professional assessment.
Conclusion
Permanent makeup may sometimes be touched up, color-corrected, lightened or professionally removed, but these are four different pathways.
A touch-up adds pigment to refine suitable healed work. Color correction adds pigment to change the visible color direction. Lightening creates space for reassessment or redesign. Removal attempts to reduce unwanted pigment, but complete restoration to untreated skin cannot be guaranteed.
The correct decision begins with healing status, skin condition, problem classification, product history and a realistic endpoint—not with the assumption that another layer of pigment will solve every concern.
Before planning another PMU session, identify what is already in the skin, assess whether the tissue is suitable for further work, and document why touch-up, correction, lightening or referral is the appropriate next step.
References and Further Reading
- U.S. Food and Drug Administration: Tattoos and Permanent Makeup Fact Sheet
- U.S. Food and Drug Administration: Tattoo Removal—Options and Results
- U.S. Food and Drug Administration: Tattoos and Permanent Make-Up
- American Academy of Dermatology: Tattoo Removal—Lasers Outshine Other Methods
- American Academy of Ophthalmology EyeWiki: Ocular Injuries Due to Cosmetic Laser
- NHS: Eyelid Problems and Urgent Warning Signs
- Current product labels, treatment records and product-specific documentation for the permanent makeup being assessed
