One regulatory fact settles the question
The FDA's position is blunt: no colour additive is approved for injection into the skin. That applies to body tattoos and permanent makeup alike. The agency treats inks injected into skin as cosmetics, but states that it has traditionally not exercised colour-additive authority over tattoo pigments, citing competing public health priorities and a previous lack of evidence of problems specific to those pigments. The practical result: no bottle of pigment on the market carries a status of "federally reviewed and approved for injection".
The EU took a different route. Since 2022, REACH — Commission Regulation (EU) 2020/2081, Annex XVII entry 75 — caps hazardous substances in tattoo and permanent makeup inks. It covers carcinogens, mutagens, reproductive toxicants, skin sensitisers, skin irritants and substances damaging to the eye, spans more than four thousand substances, and requires the label to state intended use, batch reference and ingredients.
Together, those facts move the question. Safety is not settled by a claim that a pigment is safe. It is settled by where the pigment came from, whether its documentation is available, and how instruments are handled.
Which layer of responsibility you are dealing with
The practice itself is regulated by local jurisdictions, as the FDA states directly. In the UK the structure is visible: Part VIII of the Local Government (Miscellaneous Provisions) Act 1982 requires registration of both the practitioner and the premises for tattooing and semi-permanent skin colouring, including semi-permanent make-up and micropigmentation, with local byelaws covering cleanliness, sterilisation and waste. The Tattooing of Minors Act 1969 makes tattooing anyone under 18 an offence regardless of parental consent.
For a client, the status you can check is registration. Registration is a status you can check with the issuing authority. Credential acronyms depend on the issuing body and are hard to compare.
Three procedures, three risk profiles
"Semi-permanent makeup" is not one procedure. Brows, lips and eyeliner differ in anatomy and in what has been documented.
| Procedure | Documented complications | Worth asking about |
|---|---|---|
| Brows (machine strokes, microblading, powder) | Colour shift, pigment spread, papules and granulomas; fibrosis and scarring seen especially after microblading | How depth is judged; how much is attempted in one session; how correction is planned |
| Lips | Allergic reactions that can present as lichenoid dermatitis; reactivation of herpes simplex is a listed early complication | How pigment composition and allergy history are recorded; what happens with a history of cold sores |
| Eyeliner | Eyelid skin is the thinnest on the face; beyond allergy and granuloma, there is a documented risk of meibomian gland damage plus conjunctival and corneal complications | Training in ocular anatomy; how the eye is protected; where you go if something goes wrong |
The thickness evidence is specific. A cadaver study measured adult upper eyelid skin at roughly 320 ± 49 µm near the ciliary margin and 832 ± 213 µm at the upper tarsal area (Hwang et al., 2006). A second study across 39 facial subunits found the thinnest dermis and total skin on the face at the upper medial eyelid (Chopra et al., 2015). Both measurements were taken within the face; neither supports a claim about the whole body.
These are risk categories, not operating parameters. How each step is performed is the trained practitioner's judgement, and anything involving a health condition belongs to a clinician.
Five things worth asking in the studio
1. Are the instruments single-use, and can I watch them being opened? The FDA states that unsterile equipment and needles can transmit infectious disease including HIV and hepatitis, and the CDC advises that instruments and materials intended to penetrate the skin, ink included, be used once or cleaned and sterilised before reuse.
2. Can I see the documentation for the pigment being used? In the EU, the REACH restriction requires the label to state intended use, batch reference and ingredients, so asking for the product data sheet is a reasonable request.
3. Do you have healed photographs on skin like mine? Ask for healed work rather than same-day work.
4. Is there a health questionnaire and a consent form in the process? These are not documents that registration law requires everywhere, but they decide one thing: whether the information needed for a clinical judgement was captured. Asking is a check on how seriously the studio treats that chain.
5. If healing does not go to plan, what is the pathway? You want an answer you can act on: who you contact, and what would send you to a clinician.
How far "long-lasting" can honestly go
Pigment changes over time. Fading and colour shift are both documented late-onset outcomes of cosmetic tattooing. ECHA notes that chemicals in these inks can remain in the body for life and that pigment particles can migrate to organs such as lymph nodes; colourant research adds that nanoparticles can reach the bloodstream and distribute to the kidneys, liver, spleen, lungs and brain. UV exposure accelerates pigment degradation, and reported reactions cluster in sun-exposed areas. Both points come from the same colourant study.
So there is no dependable single figure for how many years a result stays. More useful than chasing a number is agreeing when you come back for assessment and how correction would be approached.
Where ATTO sits in this
ATTO supplies the tools and pigments: PMU cartridges separated by universal-style and BMX screw connections, pigment lines matched to brows, lips, eyeliner and scalp work, plus practice material and procedure support products. Instrument and material choices can be checked against the catalogue. Clinical judgement, suitability and medical decisions belong to the practitioner and to the client's own clinician.
Browse ATTO PMU cartridges by interface and configuration See ATTO PMU pigment lines and shades
The bottom line
Safety sits on three layers: what the law fixes, what you can check in the room, and what only a clinician can answer. Putting a question on the right layer is more useful than asking anyone for a guarantee.