How to Work with Sensitive and Vascular Skin in Permanent Makeup: Expert Guide 2026 How to Work with Sensitive and Vascular Skin in Permanent Makeup: Expert Guide 2026 Every Permanent Makeup (PMU) master, regardless of experience, has faced this nightmare in the studio at least once: you barely touch the eyebrow with the machine, make the first pass, and the skin turns reactively red. After 5 minutes, lymph (ichor) starts to ooze, mixing with the pigment and pushing it out. The anesthesia "whitens," but the client still winces in pain. As a result, the procedure drags on for 3-4 hours, the master is covered in a cold sweat, and after healing, the client sends a photo with "empty" eyebrows or, worse, bluish spots. Sensitive, mature ("parchment"), couperose, or reactive skin is the most difficult canvas to work on. The standard schemes taught in basic courses do not work here. One extra millimeter of depth or a wrongly chosen needle can lead to irreversible consequences: scars, pigment migration into blood vessels, or persistent hematomas. But difficult skin is not a death sentence. It is a challenge to your professionalism and... your equipment. Experts from the "Tatushechka" store, together with leading masters, have prepared a fundamental guide. We will break down the physics of the process, learn how to choose needles that don't tear tissue, and examine the chemistry of anesthesia capable of stopping bleeding in a minute. Section 1. Histology and Diagnosis: Know Your Enemy The main mistake of a beginner is to start working immediately without conducting a detailed examination of the skin under a lamp. "Difficult" skin varies, and the approach to it must vary too. Type A: Couperose (Vascular) Skin Signs: A fine red or purple mesh of capillaries (telangiectasia) is visible on the cheeks, nose wings, and even in the eyebrow area. The Danger: The vessels are located anomalously high, almost at the basal layer of the epidermis. Any puncture of standard depth hits a capillary. Consequences: Blood washes out the pigment during the procedure. If the needle hits a vessel directly, the pigment can spread under the skin, forming a "bruise" that cannot be removed by a laser. Type B: "Parchment" (Mature) Skin Signs: The skin is very thin, dry, and lacks subcutaneous fat. It gathers in fine folds on the eyelids, resembling crumpled paper. The Danger: Lack of elasticity (collagen). The needle meets no resistance and falls in like into water. Consequences: Instant deep penetration. Pigment goes on in patches, the color shifts to a cold (gray/blue) shade. Type C: Hypersensitivity (Reactive Skin) Signs: The skin turns red from simply rubbing it with a cotton pad during makeup removal. The client complains of pain even when shaping with tweezers. The Danger: Instant swelling. Tissues swell, altering the shape of brows or lips. The sketch "floats," and you lose symmetry. Consequences: Crooked results after the swelling goes down. Section 2. Needle Selection: Why is a 0.35 Diameter Taboo? On sensitive skin, your task is to implant the pigment as superficially and delicately as possible without traumatizing the dermis. Imagine you are drawing on a balloon and must not pop it. A thick needle (0.35 and even 0.30) works like a nail: it leaves a large entry hole, tears the edges of the wound, and provokes a powerful immune response (lymph). The Gold Standard: 0.25 mm (Nano-needles) For working with couperose and mature skin, we strongly recommend switching to the thinnest needles — 0.25 mm in diameter. Why is 0.25 better than 0.30? The puncture area of a 0.25 needle is significantly smaller. It pushes collagen fibers apart rather than tearing them. Less trauma = less lymph = more pigment stays inside. Which cartridge to choose? You cannot skimp here. Cheap Chinese needles have poor polishing (micro-burrs on the metal), which act like a grater on delicate skin. KWADRON® PMU OPTIMA Cartridges — the #1 choice for difficult skin. Configuration: 25/1 RLLT (1RL 0.25 Long Taper). Why Kwadron: Their unique stabilization system (a plastic "spider" inside) holds the needle in a death grip. It does not vibrate sideways, entering the skin as cleanly as a neurosurgeon's scalpel. LT Taper: The long and sharp taper makes the puncture unnoticeable. The skin "collapses" immediately behind the needle, sealing the pigment. Mast Pro Cartridges — an excellent alternative for a tight budget. They have a very soft membrane. This is crucial for sensitive skin because a soft membrane allows working at a lower voltage, reducing the force of the hit on the skin. Section 3. The Chemistry of Anesthesia: How to Control Vessels? Many masters think anesthesia is only needed so the client doesn't feel pain. In reality, on vascular skin, anesthesia performs another, more important function — it acts as a vasoconstrictor. Stage 1. Primary Anesthesia ("Freezing") Applied only to unbroken skin before the sketch. Its task is to numb the upper layer of the epidermis so the client doesn't flinch during the first pass (fixing the sketch). Our favorite is TKTX Black 40% Anesthetic Cream. How it works: It's a powerful cocktail of lidocaine and prilocaine. It penetrates deeply into the pores within 15-20 minutes under a film. Important: Do not overexpose TKTX on vascular skin! 20 minutes is the maximum. If left too long, the skin may turn red from chemical exposure before work even begins. Stage 2. Secondary Anesthesia ("Stop-Blood") This is your main lifesaver. Secondary anesthesia is applied only to open (already punctured) skin. It must contain epinephrine (adrenaline). Experts' recommendation — GeLido Anesthetic Cream. The magic of action: As soon as you see a drop of blood or lymph appear — apply GeLido in a thin layer. After 60-90 seconds, you will see "magic": the skin will turn white. The epinephrine has constricted the capillaries. Bleeding stops instantly. GeLido's Advantage: Unlike cheap analogs, it does not "harden" the skin. The skin remains elastic, accepting pigment, rather than turning into a piece of rubber into which it is impossible to pack ink. See the full catalog of professional products: Anesthetic Products Section 4. Work Technique: Stretching, Speed, Gliding Even with the best needle and anesthesia, you can ruin everything with improper technique. Here are the three pillars of working with difficult skin. 1. Stretching is the secret to success On mature, flabby skin, the stretch must be not just strong, but "three-point." You must stretch the skin so that it becomes like a drum. If the skin bounces under the needle, you are not implanting pigment; you are just tearing the epidermis. But on couperose skin, the stretch must be moderate to avoid provoking vessel rupture from tension. Balance comes with experience. 2. Gliding and Cleaning Dry and thin skin does not forgive friction. If you wipe pigment with a dry cotton pad, in 10 minutes you will get swelling like a boxer, and the skin will "close up." Rule #1: Forget about water and baby wipes. Use BERGAMOT Klever Beauty Antibacterial Foam. It contains ingredients that soothe inflammation and tighten pores. The foam dissolves pigment without friction. Rule #2: Never work "dry". The needle must glide over the skin. Use Bubble Gum Klever Beauty Vaseline. It creates a protective film. Apply a drop of Vaseline to the brow and work through it. This reduces vibration and prevents unnecessary trauma. 3. Voltage and Speed Lower the voltage! If you work at 6.5-7.0 V on normal skin, drop to 5.0 – 5.5 V on vascular skin. Work slowly. Your hand movement (stroke) should be light and "flicking," as if you are stroking the skin with a feather. Section 5. Step-by-Step Procedure Protocol (Cheat Sheet) Print this algorithm and hang it near your couch. Cleaning: Degrease the skin with Klever Beauty foam. Anesthesia (Start): Apply TKTX Black under film for 15-20 min. Sketch: Draw with a soft pencil, without scratching. First Pass ("Framework"): Take a Kwadron Optima 25/1 RLLT. Voltage 5.0 V. "Pendulum" motions. Work with the tip of the needle, barely touching. The goal is to outline the shape and open the skin for secondary anesthesia. Gently wipe with Vaseline. Secondary Anesthesia: Apply GeLido for 2-3 minutes. Has the skin turned white? You can work. Main Filling: Work in short sections (1-2 cm each). Pass — wipe — apply Vaseline. Do not return to the same area multiple times to avoid "over-plowing" the skin. Finish: Apply a soothing product. Take photos. FAQ: Questions That Worry Masters Why doesn't the pigment stay, even though I do 3-4 passes? This is a classic problem of "swollen" skin. Due to trauma, lymph is released, tissues swell and close the passage for the needle. You are "knocking" on the swelling, and the pigment does not reach the dermis. Solution: As soon as you see severe swelling — stop. Take a break, apply GeLido (it reduces swelling), and move to the other eyebrow. Work slower but more precisely. It's better to under-do it and add at the touch-up than to turn the brow into a wound. What to do if I see a bruise (hematoma) right during work? This means you hit a blood vessel. 1. Immediately stop working at this point. 2. Press hard on this spot with a cotton pad soaked in secondary anesthesia (GeLido) or Visine solution. Hold under pressure for 3-5 minutes. This will stop the subcutaneous bleeding and reduce the size of the spot. 3. Do not try to pack this spot with skin-colored pigment! It will only make it worse. What to do if the skin "hardens" (becomes hard and white as paper)? This is a chemical burn from an excess of adrenaline or too frequent application of secondary anesthesia. Pigment will not enter such skin — it has become like rubber. Actions: Wash off the anesthesia. Apply a thick layer of Vaseline. Wait 10 minutes until the skin relaxes a bit. If it doesn't become soft, let the client go. You will finish the work during the touch-up session. Conclusion Working with difficult skin is a test of your qualifications. Don't be afraid of it. Having sharp Kwadron Optima needles, stable GeLido and TKTX anesthesia, and an understanding of the processes in your arsenal, you can create masterpieces even on "paper" skin. Build your professional kit for sensitive skin in the Anesthesia and Cartridges sections on the "Tatushechka" website. Remember: quality consumables pay off from the very first procedure with client gratitude.