The loss of eye lashes and eye brows as a result of Alopecia Areata can be as devastating as the loss of scalp hair. When mine began falling out, it seemed like more than I could handle. My lashes were my most beautiful feature and losing them was very traumatic. My brows each fell out at different times. I worried about how I could pencil in one and make it look like the other, the one that hadn’t yet fallen out. I was also very anxious about what I’d do when both were gone…how would I be able to draw an even arch, and how could I make the pencil look textured - like a growing brow instead of a mark smooth and flat to the skin?

Because of my own experiences, I can quickly identify and empathize with others facing the challenges of Alopecia Areata. When one of my long-time clients came to me with a problem relating to her bangs, I immediately suspected issues with her eyebrows. Her hairstyle was perfect for her face. Yet she insisted that her bangs were too short and wanted her hairpiece returned to the factory so longer bangs could be added.

As we talked I noticed that she didn’t look me in the face; she completely avoided eye contact. I felt like she was hiding behind her bangs and hair. Remembering my own misery I asked: “Are you unhappy with your bangs because you want longer ones to cover your lack of eyebrows?” At this point she looked at me and started crying. This poor woman was not only dealing with her lack of eyebrows, but with the results of cosmetic tattooing that had turned blue - a deep shade of aqua in fact. I could also relate to this frustration. Sometime after my brows had been tattooed, they had turned to a lavender-grey. It took several years to correct the discoloration.

When I learned about cosmetic tattooing, I was very excited and was one of the first to have the procedure done. The discoloring just mentioned can be easily prevented, and good cosmetic tattooing can make a world of difference for people with Alopecia Areata. It can “create” natural looking eyebrows that will last. It’s similar to body tattooing in that pigment is injected into the derma layer of the skin, but cosmetic tattooing has become an industry and an art form in its own right. Many cosmetic tattoo artists use new digital, handheld equipment that is specially designed for the industry and is much lighter than the traditional equipment used in body tattooing. Several different tools are required to get the pigment in properly, and the technician’s choice of needles along with her artistry is what creates a brow that looks life-like.

The cosmetic tattooing of eyebrows is generally a two step process. The technician - or you yourself - will first draw your eyebrows on using brow pencil. This can take a little while, but it’s good to keep in mind that real growth eyebrows are not twins. Our faces are naturally asymmetrical, and our brows are not exactly the same. Once the brows are drawn, the technician will go to work. The actual injection of pigment will take between 45 minutes and an hour. Though nothing is fool proof, the procedure is relatively safe and most people are very happy with their results.

One of the most common questions my clients ask about the process is if it hurts. The best answer I can give is the honest one: You’re going to feel it, but it’s not going to kill you! I think the pain involved is well described as “an annoyance.” Topical numbing has improved over the years and most cosmetic tattooists will anesthetize the skin. Sometimes people with thicker skin will feel less discomfort than thinner skinned people. People of Mediterranean descent tend to have thicker skin than the red-headed Irish or blonds. In general, though, I think the anxiety most people feel going in is worse than the hurt.

Discoloration isn’t something you’ll have to worry about if you do your research. It results from not using the right combination of pigments in the first place. A good tattoo artist will know and understand color well, and will also get the pigment in deep enough to prevent premature fading. Fading occurs over time because your face is always exposed the environment, but tattooed brows can last up to 2 years before needing to be refreshed. The sun will accelerate fading, so always use a good sun block. Be aware also that creams used to bleach skin spots and microderm abrasion will speed up fading. Alopecia Areata clients might need touch ups more frequently – once every year or year and a half - because the lack of hair follicles makes their skin tighter and tougher to penetrate and get pigment into. The touch up process however, is easier for both client and technician, because the brow is already drawn in.