‘Just like… Monet’: How paramedical tattoos can be used to treat vitiligo

Key takeaways:

• Tattoo artists can blend skin chromophores to create an ink unique to skin affected by vitiligo.
• Patients must undergo a minimum of three sessions and will require touch-ups within 2 to 5 years.

ORLANDO — Tattoos are not just for decorative purposes; they can also be used to treat vitiligo, according to a presentation at the American Society for Dermatologic Surgery Annual Meeting.

“There is a huge difference between traditional and paramedical tattoos,” Renee Gao, an MD candidate at UMass Chan Medical School and tattoo artist, said during her presentation. “In traditional tattoos, we really emphasize on creating very high contrast, very high vibrancy and very long-lasting pieces. ... Comparing that with paramedical tattoos, we focus a lot more on creating those subtle blending of pigments to deemphasize these pieces.”

According to Gao, paramedical tattoos can be used for vitiligo by color matching tattoo ink with patients’ skin tones in vitiligo-affected areas. Tattoo artists can create skin-colored ink by combining inorganic pigments, which are made of mineral oxides that comprise fade-resistant black and white inks, with organic pigments which are made of azo and polycyclic compounds that create more vibrant colors.

Using these types of pigments, the artists implement a method called skin chromophore blending, which combines red, blue, yellow-orange and brown pigments to replicate a patient’s unique skin color.

“Just like how Monet revolutionized Impressionism by using different points of color, our skin color is also created from blending different skin chromophores,” Gao explained.

“It is the artist’s role to then utilize these different pigments — to put very simply, the white and black to create lightness and darkness, and yellow, red and blue to adjust for temperatures,” Gao continued.

While many patients with vitiligo may be able to take advantage of this treatment option, not all patients are eligible. A patient’s vitiligo must be stable for a year before receiving this procedure. Patients who have active vitiligo, keloid-prone skin or are at high risk for infection are unable to receive this treatment.

Patients must undergo a minimum of three treatments because it takes time for the skin to retain the pigment. According to the presentation, 50% to 70% of retainment can be expected after the third session.

Two to 5 years post-treatment, patients will require touch-ups due to a lack of pigment retention over time, color changes and the “white halo,” which can form around tattooed areas affected by vitiligo, Gao said. The touch-up period will require the same number of sessions performed during the initial treatment.

Clinicians should also caution patients of exposure to topical AHA or retinoic acids as well as chlorinated pools, as exposure to these elements can induce color changes.