We can provide cover for micropigmentation within your medical malpractice insurance policy if you have the relevant qualifications to perform this treatment.
If you are looking for insurance to cover micropigmentation, please contact the team on 0800 634 3881 or email firstname.lastname@example.org.
Hamilton Fraser provides micropigmentation cover for doctors, dentists, nurses, beauticians (NVQ level three general beauty or an equivalent beauty qualification), semi-permanent makeup artists, dental therapists, dental hygienists, dental nurses, pharmacists, paramedics, operating department practitioners and physiotherapists.
Micropigmentation, also known as semi-permanent make-up, hair tattoo or cosmetic tattooing, is a cosmetic procedure used to improve or replace lost colouring on the patient’s skin. The treatment involves inserting coloured pigments into the dermal layer of the skin (just beneath the surface), and is classed as semi-permanent as it can take up to four years to fade. Eyebrow micropigmentation, scalp micropigmentation and areola micropigmentation are particularly popular treatments.
Micropigmentation is most often used on the face to enhance eyebrows, eyelashes, eyelids (as eyeliner) and lips. It is also be used to camouflage or improve scars, even out skin colouring and restore colour to certain areas of skin. As well as being used as semi-permanent make-up, micropigmentation can also be used to create the areola in women who have undergone breast reconstruction following breast cancer treatment. Another common treatment is hair micropigmentation, to create the appearance of scalp hair for people who have experienced hair loss.
Micropigmentation can benefit patients who:
● Want to save time applying make-up
● Are allergic to make-up
● Struggle to apply make-up
● Have thin, asymmetrical or absent eyebrows due to alopecia or chemotherapy
● Want to hide a scar or areas of the skin
● Want to create the appearance of scalp hair (scalp micropigmentation)
● Want to create the illusion of something, for example areola micropigmentation
Following the treatment, there may be some swelling, scabbing and pigment shedding in the treated area but this will be temporary. The pigmentation will appear dark for the first week or so, but this will settle once the top layer of skin has shed. Other potential side effects include:
● Allergic reaction (a test patch should be done prior to treatment to avoid this)
● Local pain, swelling and bruising (this can be eased with cold compresses and painkillers)
● Local infection if sterile precautions are not followed
● Skin conditions may be exacerbated, including psoriasis, vitiligo or herpes
● Some patients who undergo MRI after the procedure may experience swelling or burning at the site due to the pigment
Micropigmentation is not suitable for everyone. The patient’s GP should provide a release form for the following conditions: auto-immune disease, epilepsy, diabetes; haemophilia or blood disorders and/or heart disease of any kind; and cancer or chemotherapy. Micropigmentation should not be performed on:
● Patients who have recently had laser procedures and/or chemical peels, waxing, or any other procedure to the face or scalp that compromises the skin's barrier
● Patients who experience keloid or hypertrophic scarring, or who may be allergic to anaesthetic or micropigmentation ingredients (a patch test should be performed before treatment)
● Patients who are pregnant or breastfeeding
● Patients on Roaccutane (acne medication)
● Patients with skin conditions such as dermatitis, active herpes simplex, rashes, pimples, moles or lesions in or near the treated area
● Patients on blood thinners
Before undergoing a micropigmentation treatment, an analysis of the patient’s bone structure and skin should be carried out. In addition, it is important to perform an allergy test to make sure that the patient will tolerate the pigments that will be applied.
During the treatment itself, the area should be cleaned and a topical anaesthetic applied to reduce any discomfort. A micropigmentation treatment requires a pigment and an instrument with needles to push the pigment into the skin. Some of the pigments used include iron oxide, titanium dioxide, mercuric sulphate, and cadmium sulphate. The colours may have to be mixed in order to obtain the exact shade desired by the patient. A pen-like instrument, similar to a tattoo gun, is used to apply the pigmentation. Most procedures will take up to two hours, depending on the treatment being carried out.
Following the treatment, there may be some swelling in the treated area but this will quickly go down, particularly with ice. The pigmentation will appear dark for the first week or so, but this will settle once the top layer of skin has shed. The patient will usually need two applications spaced four to six weeks apart, and a top up treatment every one to three years.
It can take between two weeks to 30 days for the treated area to heal and the colour to fully settle. Patients should:
● Avoid washing the face or scalp for at least three days to allow the ink to settle in
● Avoid sweating, including from sun exposure and exercise
● Avoid exfoliating
● Stay hydrated by drinking plenty of water and using a water-based moisturiser
Healthcare professionals and beauty therapists who have undergone relevant training can perform micropigmentation treatment.
Practitioners will need to undergo relevant training before performing micropigmentation procedures. The VTCT Level 4 Certificate in Micropigmentation course is a popular course available from numerous providers, and includes training on the below topics:
● Introduction to semi-permanent make-up
● History of semi-permanent make-up
● Lip liner and shading
● Lip blush and full lip enhancement techniques
● Eyebrow techniques
● Eyeliner and eyelash enhancement
● Health and safety
● Colour therapy
● Hygiene and safety
● Understanding machine, needles and pigments
● Patient consultation
● Anatomy and physiology of the skin and relevant systems
● Side effects and risks
In this podcast, Sarah Whitehead, representing the Finishing Touches Group, discusses the benefits of ART and medical micropigmentation for both patients and practitioners with CEO of the Hamilton Fraser Group, Eddie Hooker and Associate Director of Hamilton Fraser Cosmetic Insurance, Mark Copsey. Listen to the podcast to learn more about how medical micropigmentation training can make a difference to people suffering from a wide range of conditions including scars, burns and hair loss.
There are no specific policy conditions that practitioners need to be aware of for micropigmentation treatments.
With any treatment, in the event of a claim insurers will always require proof of manufacturer and the batch code of the product, which must also hold the relevant CE marking. Our article on grey market products provides more information on the importance of sourcing all products from reputable and listed suppliers.
As with any treatment, all known side effects must be explained to the patient in the consultation and the patient must sign a consent form which outlines that they understand the risks, prior to the procedure.
Claims for micropigmentation are rare, but as with any procedure, there is always the risk that an accident can occur during the process, or that an insurance claim could be brought against you, particularly because micropigmentation is a semi-permanent treatment that can last for years - it is important that practitioners are insured should any issues or complications arise.
One potential claims scenario is that a patient experiences an allergic reaction to the ink, for example after it has been applied to their scalp during a scalp micropigmentation treatment to treat hair loss. The ink can contain heavy metals or reactants that may react with the scalp and cause an allergic reaction in some patients, although any allergic reaction is generally short-lived. In this situation, so long as the practitioner has explained in the consultation that this could be a potential side-effect, and that this is documented and the patient has signed consent, the policy would not be triggered and we would deal with this in-house as a dissatisfaction. However, if there is no evidence that the practitioner has explained this potential side-effect to the patient, a claim could be raised against the practitioner, and if they are found negligent the policy could pay out if it were proven that they had not carried out a thorough consultation. This situation highlights that the consultation process is just as important as the actual treatment when it comes to future claims.
Claims top tip: Explaining and documenting any potential side-effects, and getting signed consent, is just as important as the treatment itself. Make sure anything discussed in the consultation is noted, ideally in email form so that you have an audit trail.