Caroline Day: Why would anyone consider Permanent Make Up (PMU)?

Jean Kiekopf explores the world of PMU and talks about her experience.


In September 2023 I ventured out on a three week camping holiday in Zambia, Africa with four friends – all women, all in our 60s and 70s. We were self driving and out for fun-in-nature and an adventure together. One of my friends, an Aussie aged 77 who is always an inspiration in her energy and enthusiasm for every nuance of the day, had prepared for the off-road adventure by getting her eyeliner tattooed on her upper eye lids! At first this amazed and amused me, as in my naivety I didn’t even know this sort of treatment existed! Where had I been?

Everyday, as we crawled out of the tent, hiked through 40°C in the bush, or splashed in waterfalls and streams in the African wilds off the beaten track, she looked extra amazing: her eyes a little more open and sparkling. None of us put any make up on during the trip and as I was taking lots of photos for our Instagram account, @Ikigai_sisters, it was very noticeable that she looked that bit more awake and ‘well kept’.

I have been wearing glasses for a few years now and to put on my upper eyelid liner was becoming more and more difficult, awkward and challenging. So on returning to England I decided to check out local artists to tattoo this little bit of magic on me. That is when I met the inspirational Caroline Day who is helping men and women with her treatment…

How did you get into this area of beauty and post trauma reconstructive care?

When I was a level 3 beauty therapist student, we had a lady come to our salon carrying out micropigmentation eyebrows, and I was intrigued and wanted to know more. She could carry out permanent make up for eyebrows, eyeliner and lip colour, but also spoke about how there is the medical side of it too. The downside is that the basic training of permanent make up costs about 10k to learn and even more for the advanced techniques!

That’s when I thought, once I’m a mature therapist, I will learn this… and eventually I progressed to do the advanced training including the medical micro pigmentation.

What is the medical micro pigmentation for?

I treat women and men who have had breast reduction / lift and men who have had male breast reduction (liposuction) and have lost their areola due to infection and necrosis after having their areola sewn back on. I also help women and men with all types of surgery scars: anchor scars, skin graft and face lift scars, trauma scars and burns. I use micro needling, which flatten and softens the scar tissue and prepares the scar for camouflage tattooing which helps blend the scar or skin graft into your natural skin tone.

I had a contract at an NHS hospital carrying out restorative 3D areola and nipple tattooing and it was a honour carrying out these treatments and meeting these very brave and lovely ladies! Women have also come to me privately as they have been told that there is a 2 to 3 year wait at an NHS hospital after having a mastectomy and breast reconstruction.

Clients who have private health insurance come to me, including a very courageous young woman age 22 years old who chose to have a double mastectomy as she has the BRACA gene. She now has new areolas and is very happy with them.

What’s the most rewarding part of your work?

I love making that person, who is either finalising their breast cancer journey or breast reduction, feel complete again. This procedure gives them their body confidence back. After chemotherapy, I can create natural eyebrows and eyeliner where the hair has not grown back. Seeing their smiling faces after the procedure is the best.

How long has PMU been available? Have there been developments that have made this more accessible and popular recently?

Permanent make up has been around since 5000BC when Egyptian women were using green from copper ore and Lapis Lazuli for eyeshadows. In 1902, the first modern application of permanent cosmetics was performed by Sutherland MacDonald at his tattoo studio in London. He tattooed the delicate blink blush to ladies’ cheeks and was followed by George Burchett in the 1930’s as a major developer of these techniques.

Like Botox, fillers and plastic surgery, it was film stars who first had access to permanent make up but now it is available to everyone.

In modern times, it has progressed to scalp pigmentation ( SMP ) where hair follicles are created on a thinning hair and or baldness ,3D restorative areola and nipple tattooing, scar camouflage and webbed toes Syndactyly toe separator tattoo and also finger nail replacement.

What have been the greatest challenges as a woman setting up her own business?

Permanent make up is very hard to learn with regards to managing client’s skin, morphology and realistic expectations. I have to accommodate the client’s medication, medical conditions and lifestyle. The client must be prepared to follow the pre treatment and aftercare advice given to them. I take my profession of permanent make up seriously, it should not be put in the same bracket as a beauty treatment that a beautician has carried out – like having your nails done. There is so much to learn with regards to anatomy and physiology, infection control, health and safety, and following local council legislations. I use high end, safe pigments and devices and all my pigments are REACH compliant.

Another challenge is meeting new clients who have had previous micro bladed eyebrows or PMU and even areola micro pigmentation that need correctional work as they have healed into an undesirable colour or shape. Sometimes the client may have to have laser or saline removal to lighten the area first, you simply cannot ‘paint over the area’, skin is like a sponge, it’s not like painting over a wall!

Who is your target client market?

Permanent make up is aimed for people who have busy lives as saves time in the mornings applying make up, who have poor eyesight, or hair loss through thyroxine medication and post chemotherapy. It is suitable for all ages although there are some medical conditions that are contra indicated like pregnancy, auto immune diseases, blood thinning medication, diabetes. Sometimes a GP consent letter is required. The scar and medical micro pigmentation treatments help with body confidence and makes that person feel themselves again as they may believe they’ve lost some femininity or masculinity.