Medical and Permanent Makeup FAQ's

Below you will find a number of questions that are frequently asked about the different treatments I offer.  If you can't find the answer to a question you may have, please get in touch. 

Scalp Micropigmentation for Men and Women


Scalp Micropigmentation is also referred to as SMP or Scalp Tattooing.  It is a specialist procedure where thousands of micro dots are tattooed into the scalp to recreate your natural follicle pattern.  This gives the illusion of hair, where it does not exist.   

This method can be used to create a shaved head look, or to help create density where hair is thinning.  The treatment is suitable for both men and women. 

This treatment is so versatile and can help men and women equally.  It can be used to disguise thinning or sparse hair, male and female hair loss patterns, alopecia, scarring and to create a shaved head look for men with advanced hair loss. It can also be used in conjunction with other hair loss treatments, such as FUE and FUT transplants.  With hair transplants, patients are left with scarring from the donor site(s), so this treatment can help to disguise those. 

Scalp Micropigmentation is carried out using a diluted permanent ink.  What is very important to mention is that this is a GREY based pigment, to ensure that it fades out very naturally over time.  You may have seen many images where the pigment has faded to blue or green - I can assure you that this will not happen with the pigments that I use during the treatment! 

Whilst a permanent pigment is used, you will require colour boosts to keep the colour depth and density up.  This is approximately every 3-6 years, depending on the colour used, skin type, lifestyle and any medication/medical conditions.  All of this will be discussed at your consultation. 

You will need approximately 2-4 sessions, depending on the area to be treated and the density required.  These sessions take place between 10-14 days apart. 

For colour boosts, you are likely to only need one session if you have timely treatments. 

Not really, is my honest answer. Although pain is relative and individual to us all.  Someone with no hair at all is likely to feel it slightly more than someone with some hair density, as existing hair actually makes the scalp a little more spongy. 

I've had clients fall asleep during treatments - so it isn't that painful!

The downtime is very minimal, with most clients returning to work the next day.  You will need to avoid washing your hair for 4-7 days and avoid a power shower on the treated area for 7 days.  Full aftercare is provided at your consultation. 

Price is on assessment, as it depends on the area to be treated and the time it takes. 

The minimum charge is £250.00 per session, which would cover a small to medium scar. 

Female and male density treatments typically start at £500.00 per session.

Male pattern baldness treatments start at £500.00 per session. 


MCA Scar Treatment ( Dry Needling)

MCA Scar Treatment is an incredible treatment that improves the appearance, feel and colour of scars, stretch marks and burns.  It is unfortunately a very little known treatment, so many do not even know it exists.  I hope that the questions below will provide you more information on this treatment, but please get in touch if you require further information.  


MCA Scar Therapy (Multi-trepannic Collagen Actuation) is also known as dry needling or micro needling.

MCA Therapy is carried out with the use of a specialist medical tattooing machine, using a dry needle technique (no pigment/colour used).  The treatment consists of a needle that enters the surface layers of the skin, just enough to cause a minor trauma and stimulate blood flow to the area.  The process causes minute punctures, which creates channels that trigger the body to produce collagen, melanin  and elastin, in order to fill the wounds – therefore promoting further healing.

It is a highly effective treatment that improves the appearance, feel and colour of scars, burns and stretch marks. 

Whilst this isn’t a scar removal treatment (no such thing exists unfortunately), it can improve the look, feel, firmness and appearance of scars considerably.

Most scars can be treated, but there are time restrictions on certain types of scarring (see 'when can scars be treated?'. 

MCA Scar Treatment is really effective on the following; 

  • Surgical/Trauma scars.
  • Stretch Marks.
  • Burns. 
  • Self harm scars.

Unfortunately it is not possible to treat active keloid scarring. Keloid scarring needs to be inactive for a minimum of 3 years and would need a Consultant letter for approval, together with a patch test treatment of a small area of the overall scar to be treated. 

  • Flat, loose and sunken scars can be treated after 3 months. Between 3-6mths, medical consent/approval from a Consultant may be required.
  • Raised/bumpy scars can be treated after 12 months.
  • There is no restriction on hold old a scar is, treatment can take place many years after the initial scar has been established.

There are no absolute guarantee's with the exact results you can expect, as every patient responds differently to the treatment.  Each scar is individual and your own natural healing process will differ from other patients.  

Most scars respond very well to this treatment. I would recommend a consultation so that I can assess the area to be treated and discuss the results you may expect to see, following a course of treatment.  

Below are details of the results that this treatment can provide; 

  • New tissue grows into the damaged skin and collagen, elastin and melanin production is stimulated as part of this new healing process.
  • Loose and sunken stretch marks fill out and appear smoother and firmer.
  • Discoloured scars start to normalise and skin tone/colour evens out.
  • Scars that are raised and bumpy flatten out and become less visible
  • Tight scars relax and become less restricted.
  • Areas of scar numbness begin to have returned feeling.

The area may be red, look a little scratched and may swell. This is all entirely normal and part of the body’s natural healing process. This will settle after a few days, but the body will continue on the healing journey.

Please don't let the visual appearance put you off, as this is very temporary and well worth the end results.  The area may look red for around 7 days following the procedure. I work with a wonderful lady that specialises in mineral makeup,  which can be used immediately after the procedure and during the healing process.   

If the area treated is visible (eg, on the face) then camouflage mineral makeup can help to cover the area .  At your Consultation, I can provide you with a referral for a mineral makeup appointment, where you will be able to have a colour match assessment and a bespoke kit made for you. It is really important only to apply specialist mineral makeup to the area during the healing process, otherwise the results will be poor and you risk infection.  

You will start to see results around 3 weeks after your first treatment. Please be aware that it can appear that the area looks worse initially. This is short term, as the skin starts the healing process and generates new collagen and elastin into the area.  See 'What will it look like after the treatment' FAQ for details on camouflage makeup. 

A typical course of treatment is 3-4 treatments carried out 4-6 weeks apart.

As everyone's skin is different and scar tissue varies significantly, it's not possible to be exact about the number of treatments of exact results. A full discussion will take place at your consultation to discuss your specific treatment plan. 

If you have a scar that is sensitive or you have full feeling in, we will use a local anaesthetic to keep you comfortable.  The treatment isn’t painful and isn’t anything like a ‘tattoo’ treatment so please don’t worry. You may have area's that are a little more sensitive, but it is nothing more than a scratch sensation. 

Yes, this is provided to you at your appointment .  I also recommend the use of RegimA Scar Therapy treatment and Rejuvenated Collagen Shots  and either H30 Hydration or H30 Night Repair for optimal results.

If you are under the age of 18 you will need to have referral from your GP or Consultant.  For those under 18, a parent will need to attend the appointments and fill out the Guardians paperwork.

  • If you have controlled diabetes then we can proceed once we have received full consent from your Diabetic Consultant and you have signed an additional disclaimer regarding aftercare. This is due to the increased risk of infections for diabetics.
  • Chemotherapy, we are unable to treat 5 weeks pre or post chemotherapy. We are happy to carry out a consultation with you, but we will not be able to proceed to treat you until 5 weeks after your chemotherapy has finished. We will also need a letter from your Consultant to go ahead with treatment within the first 6 months.
  • Keloid scarring, this type of scarring is not suitable as it is likely to stimulate further scarring of this nature.
  • HIV or Hepatitis
  • Open or active wounds.
  • Herpes outbreaks, warts, infection or other active inflammation of the skin.
  • Blood thinning medications
  • Anyone with blood clotting health problems or a history of poor healing.
  • Raised moles

The cost is based on the type of scarring you have and the size of the area covered.  For small scars under 5cm, prices are provided on assessment.  

Please see the full price list by clicking here

I recommend at least a telephone conversation (free of charge) to ascertain the type and size of scarring to treat. This will determine the cost and duration of each treatment.  Alternatively, I offer a Consultation for a fee of £50.00 which is redeemable against the treatment once you have booked. 

Semi - Permanent Makeup

Permanent makeup or Cosmetic Tatttoing treatments - what's it all about? 


Semi Permanent Make-up (SPMU) is also know as permanent makeup or micropigmentation. They are all one and the same thing!  However, referring to the make up as 'permanent' is a little misleading.  

SPMU differs from standard tattooing, as the pigments used are carbon free and contain oxides. Oxides are designed to fade out of the skin, which is important with SPMU procedures, so the look can be adapted over the years.  Whilst there is no definitive time-scale, on average you can expect your make-up to last between 1-5 years (there are some exceptions to this).  Most clients will come for a yearly top up to keep their colour looking fresh, but this isn't essential. 

Technically it's defined as semi permanent.  Semi permanent makeup (SPMU) is carried out using oxide based pigments that are designed to leave the skin over time. This is really important, as it allows your SPMU to be adjusted to your style and maturity.

On average, SPMU lasts between 1-5 years. However, we are all very different and exactly how your skin will retain the pigment can not be known.  For some client's, their SPMU is still going strong for over 5 years, for others - they may find it begins to fade around 18 months.  Much of this is dependent on your skin type and the base colour of the pigment used.   All of this will be discussed with you at your consultation, but if you do have any questions about this, please just get in touch. 

This is the first question I always get asked!  And the response is - not nearly as much as you think it will! 

The needle or needle configuration used is only 1.5mm long and uses very fine needles. It is very different to standard tattooing, which using an entirely different machine, needles and pigments - standard tattooing is also implanted around 3.5mm into the skin and hurts considerably more! I also use local anesthetic to make you more comfortable.  I would say 'mild discomfort' would best explain eyebrows and eyeliner treatments. Lips treatments some clients find slightly more uncomfortable, but usually towards the end.

I've never had anyone cry and they all come back for the top up it can't be that bad!  

For eyebrows you can expect them to be a little red for around 24hrs afterwards. The brow area tends not to swell.  For the first 7 days the colour will appear darker and more prominent, this is during the initial healing state.  Your brows may scab (do NOT pick at the scabs, as you will cause gaps in the pigment and have poor results).  You can use the aftercare balm as instructed.  Your colour will fade by around 30-50% during the healing process). 

There is a 28 day healing process, where you may find that some of the colour fades/disappears completely, or disappears and comes back. This is completely normal!! Do not panic!  You will need to have your top up treatment within 12 weeks of the initial treatment, this is where the process is completed. Again, you will go through a 28 day healing process - after this time your treatment is complete. 


With eyeline treatments, you can expect the eye to be swollen for up to 48hrs after your treatment. You'll look like you've been crying....there's no point fibbing - it's not a pretty look! So dark glasses may well be the order of the day!  The healing process is the same as the brows, except you can't put any balm on the eye liner. No make-up for 5 days on the eyes ( mascara girls!) So my advice is not to have a date night within the first 5 days! 


With lips, it's slightly different. This is without a doubt one of my absolute favourite treatments and the end results are just gorgeous.  That said, there's no denying that the initial stage is a little less pretty.  You can expect your lips to swell - although the extent really differs from person to person. I have had clients that have had nice plump lips that look great, and others where they have swollen up a little more.  The lips will scab at around days 3-5 and will flake off - again, no picking!  As the lips are a membrane, a milky film can appear to have formed over the lips, making the colour look opaque - this is completely normal.  During the healing process some or all of the colour may fade or disappear.  You will need a second treatment at between 4-12 weeks from the first. Your true results settle between 4-12 weeks after your second treatment. 

I get asked this a lot.   Yes, you'll be fine. I'd probably not make any social arrangements for 48 hours (eyeliner and lips can swell).  

Lips are the most noticable during the healing process as they swell for the first 48 hours, appear much darker (where the lips bruise and blood rushes to the surface) and they also slightly scab during the healing process. After 7 days most of the healing is completed and you will be almost back to normal, save for a feeling of 'chapped' lips. 

It's important not to wear makeup on the treated area, in line with the aftercare, so be prepared for this. 

If you have previously had SPMU carried out and you're not happy with the results, please call me.  I offer correction work and happy to discuss your treatments with you. 

The minimum age that I will treat for Permanent Makeup that is not medically related is 21. 

If you are under the age of 21 and you require Permanent Makeup for medical reasons (including but not limited to;  post chemotherapy, alopecia or trichotillomania) then please get in touch.  I will require a recommendation and consent from your GP or Consultant before I am able to treat you. 

If you are under the age of 18 you will need to have referral from your GP or Consultant.  For those under 18, a parent will need to attend the appointments and fill out the Guardians paperwork.

Breast Cancer Treatments


I get asked this a lot - in fact, it's the most common question!

For eyebrows and eyeliner, the answer is 'you will feel it'! Although I do use an excellent local anesthetic that will keep you as comfortable as possible. Personally I found plucking my eyebrows more painful that the tattooing!  If you have the eyelash enhancement treatment (soft eyeliner, it's not a defined line, but gives the illusion of lashes), then this is very minimal discomfort.  Eyeliner slightly more uncomfortable, I'd describe it as a bit 'scratchy'. 

Areola and nipple tattooing discomfort is really dependent on the sensation you have.  I use a local anesthetic, which helps.  Some ladies feel nothing, whilst other's experience some scratching sensation. 

The results will be semi-permanent and you are likely to need a colour boost at some point.  This isn't an exact science and everyone's experience is slightly different.  Semi-permanent makeup lasts between 1-5 years typically, although some clients will go years without ever needing a top up.  There are many factors that affect how long treatments last, including skin type, colour used, sun exposure and general aftercare. 

Most clients will return at around 18-24 months for eyebrow and lash line treatments.  Some clients will want a colour boost sooner, whilst others much longer. 

For the areola tattooing, 2-3 years is average. 

You will need to wait at least 3 months before you are able to have this carried out.  The type of reconstruction you have had will determine the time you will need to wait. 

If you have had reconstructions from tummy fat or thigh muscle, you may be able to have your areola/nipple tattooed between 3-6 months. 

If you have had implants, then I recommend waiting up to 9 months, as implants can take this amount of time to drop and settle. 

Your surgeon will be able to give you an indication as to how your reconstruction is likely to settle. 

Please feel free to contact me to discuss this further.  We can arrange a Consultation so I can assess and advise you. 

This will depend on the type of surgery you have had. 

If you have had a single mastectomy, I will match the new areola to your existing breast.  I will match prescriptive colours to your existing areola and then use shading/highlighting techniques to create a 3D effect. 

If you have had a double mastectomy then really we can choose the colour, shape and style of the areola and nipple that you would like. Some clients like to bring photographs with them of what they would like to achieve. 

If you have a nipple then this will be tattooed and blended into the areola.  If you don't have a nipple then this is where the 3D technique really comes into it's own. I will use the 3D techniques to give the illusion of a nipple. 

Please be assured there is a full consultation process, we talk through everything together and I don't start the tattooing procedure until you are comfortable and happy. 

If you have scarring that you'd like to improve the appearance and feel of, I'd recommend the MCA Scar Treatment/Dry Needling.  This treatment is fantastic, it really helps to improve the look and feel of the scar tissue.  A typical course of treatment is 3 treatments around 6 weeks apart.  I would recommend this before carrying out the areola and nipple tattooing. 

In case you're wondering....this doesn't hurt particularly either! More numbing cream and it's a very light scratching treatment, just to bring the blood to the surface to kickstart the healing process again. 


The general 'rule' is no treatment 5 weeks pre/post chemotherapy. Although many Consultants will approve the tattooing of eyebrows as long as both treatments complete a week before chemotherapy starts.  Two treatments are carried out a minimum of 4 weeks apart. 

No, please don't worry - I can create very natural looking hair stroke eyebrows, or a very soft powder brow finish (the Ombre Brow is amazing for soft powder finish).

You can see lots of questions relating to eyebrow treatments in the Permanent Makeup section of the FAQ's. 

This treatments is much softer than an eyeliner. Essentially, tiny dots are tattooed along the lash line. When this treatment heals, it gives the illusion of eyelashes, as it creates soft definition. As it isn't a continual line, it doesn't look as though you have eyeliner on.   

This treatment is a one stage procedure only, so you will not need to return for a top-up at 4-8 weeks like the other procedures. 

Data Protection and Privacy Policy

I am sure that you have all heard about the new GDPR rules that are in force from 25th May 2018.  I suspect you have been bombarded with hundreds of emails begging you to stay in touch from providers, suppliers and every other Tom, Dick and Harry! 

To make it really clear, I thought I'd add it to my FAQ's for ease and simplicity! 


I hold personal information completed by you at your consultation or at your appointment.  This information includes your contact details and any information relevant to the treatments you are having carried out.  This information is kept in paper form and stored in a secure locked filing cabinet. 

I also hold email address and telephone numbers both in your contact forms, in emails you have sent to me and telephone numbers on my mobile phone. 

I only obtain and hold information that is relevant to the treatment that you are having. 

I collect and hold personal data for the following reasons; 

* So I can contact you via email, text or telephone to discuss treatments with you or to send you an appointment reminder. 

* So I can assess suitability for treatment. 

* To keep a record of treatments carried out. 

* To keep a record of your appointments and products used. 

If you have made contact with me regarding a treatment, but not responded or booked in - I will destroy your contact details after 12 months.  This is usually in an email form or text message.  I will delete email address' and remove telephone numbers from my phone. 


If you have had a treatment with me and not returned for further treatment, your treatment record and consultation forms will be kept for 7 years and then destroyed responsibly. 

I collect email addresses and certain other Personal Information to contact you about treatments, appointments and other information that might be of interest to you. You can review, amend or ask to have this information deleted by emailing Your Personal Information will not be passed onto any third parties. We will do our upmost to keep your email address private and will only use your email address to send you information about Nikki Butler Medical and Cosmetic Tattooing.

You have a right to access any data I hold about you and I will deal with any subject access request within 30 days . Please email for any requests - with the subject matter "subject access request". 

You have the right to ask me to stop processing your data. Please email me to let me know if you want me to erase, stop or amend any part of the information I hold for you. 

If you have any complaints, you can contact me and I will do my upmost to resolve any issues you may have. I am the Data Protection Officer and if you feel your complaint has not been dealt with satisfactorily, the supervisory authority for data protection in the UK is the Information Commissioner’s Office (ICO) which you can contact on 0303 123 1113 or via their website at