by Linda H Dixon MD and Brandi Romero ©

2015-10-10 21:48:01

BDD Body Dysmorphic DisorderThe purpose of this article is to discuss Body Dysmorphic Disorder and micropigmentation. Usually the domain of plastic surgeons, it can present in clients seeking permanent makeup so it is important to be aware of ways they may present for micropigmentation. These are not just picky people. People who suffer from BDD have an underlying mental illness which needs diagnosis and treatment before we should work on them.

The questions to ask are: Can we make these clients happy? Should we even try? If you do try, are you more likely to get blamed for bad results and even sued by these clients? To what lengths will a client with BDD go to "punish" you and make your life miserable?

One of your first clues to a client with BDD is how they react to a mirror in your reception area. Do they pay more attention to themselves or to checking in for their appointment.

CLICK HERE to read Mayo Clinic Staff discussion of Body dysmorphic disorder

The first documented reference to Body Dysmorphic Disorder was by an Italian psychiatrist named Enrico Morselli who coined the term ‘dysmorphophobia’. Morselli noticed that some of his patients experienced acute fears of deformity and painful desperation1,2.

Since Morselli’s description of this condition, many psychiatrists have added to the understanding of the disorder and its treatment resulting in the description that now resides in the DSM-5™3.

“Body dysmorphic disorder (BDD): Individuals with body dysmorphic disorder are preoccupied with one or more perceived defects or flaws in their physical appearance that are not observable or appear slight to others.”

The outstanding feature of the condition is a preoccupation and even an obsession with perceived flaws in one’s physical appearance. To another person those flaws may be minor or even non-existent but to the BDD sufferer they are exaggerated and cause anxiety and distress. A person with BDD may go to extraordinary lengths to remedy their perceived deformity including seeking out cosmetic and surgical treatments; they may spend prolonged period of time obsessing over or attempting to conceal their imagined defects which in their view make them ugly to others4

BDD most often begins in early adolescence and occasionally in late childhood.5 Its effects can be quite debilitating particularly for those who have no insight into their condition. Some patients may realise their perceptions are exaggerated. Other patients may be convinced that their delusional self perceptions of ugliness and deformity are real 5. The altered perceptions of self can be so overwhelming that the patient may also suffer recurrent bouts of depression and might even feel suicidal at times6,7.

One of the dangers associated with providing permanent or long lasting cosmetic and/or surgical treatments for BDD sufferers is that both the patient and the treatment provider can be locked into a never ending cycle of Treatment-Dissatisfaction With Outcome-Requests/Demands for Additional Treatments4regardless of the quality of the outcome.

The needs of the BDD sufferer are far beyond the skills of a MicroPigmentation specialist and fall squarely within an area of specialised medical and psychiatric treatment. In most instances a gentle but firm suggestion that the patient should seek assistance and guidance from their treating doctors is the best option.

Micropigmentation technicians should never permit themselves to be pressured or bullied into providing services to a client. Permanent make-up is an elective procedure. The practitioner is not obligated to perform these services, especially if these services are against the practitioner’s judgement and/or personal conscience. We suggest that the following disclaimer could be added to your web site and printed literature. Since local regulations may differ, legal advice should be obtained.

All procedures are considered elective. (Insert Your Name here) may accept or deny service to any potential client (patient) due to potential medical concerns and/or personal conscience.
References upon request. 

B2B Medium Brown

WARMUP says it all. WARMUP Kolorsource pigment modifies, warms and corrects most inorganic colors that are considered cool or cold. Examples: Gray, Blue and Green are all cool. In Microblading our colors tend to "pull" gray or ashey. Just add WARMUP to your favorite NuBrown colors, mix well and begin.  CLICK HERE to see Dr. Dixon's video on how to use WARMUP with some of your favorite NuBrown Colors.  Used alone, WARMUP is a nice lipcolor for blondes who want a natural lipcolor. Color fades so the color that fades the slowest leaves a residual color. You know that BROWN IS NOT A COLOR! It is a blend of colors. For those who prefer the safety of MRI Safe Kolorsource brow pigments with an inorganic green base, you may have observed these blends occasionally over time (sometimes 7-8 years) reveal a greenish tone. This is easily balanced by Warmup or Bubblegum. It depends on the client's skin tones, their exposure to sunshine or suntanning booths (South Florida), the client's age and skincare products (anti-aging creams and acids).  As in all cases, do NOT mix pigments from a different manufacturer with Kolorsource pigments. Do not hesitate to call us with concerns or questions.

Do the WARMUP TEST to see how it works: Put 2 drops of your favorite pigment on a piece of paper.  Make a smear. Now, add 2 drops of WARMUP. Mix together and make a smear agin. You can see the how WARMUP or Bubblegum balances your brow colors that have an inorganic base including green. Call 888-452-4946 with questions.

ORGANIC COLOR CORRECTIONS: Use B2B Medium to correct old blue/gray brows from Tattoo Ink (carbon black).  B2B is also useful in brows that have healed green. Use B2B Dark to correct Blue Eyeliner. Use alone or add to your eyeliner colors.Teeter Totter

CLICK HERE for any questions or concerns regarding our products. This includes Pigments, Equipment, Topical Anesthetics and Accessories.

Just complete the PRODUCT REPORT and we will be happy to contact you as soon as possible.


CLICK HERE for Common Eyebrow Color Corrections and Case Report.


You'll agree, we've all seen and had brows that have changed color over time.  The original brown brows may change to colors such as pinkey, orangey, blue, purple, greenish or gray. Browns are made from blending several colors together. This is necessary as there is no pure brown pigment. Each color in the blend contributes to the final healed result and the faded color over time. The undertones of our client's skin plus their environment affects these changes. Someone in Florida who worships the sun or loves tanning beds will have accelerated color changes. Skincare products such as Retin A and Glycolic acid affect pigments as well. You don't see as many changes in areas where the sun doesn't shine much such as Alaska.

This is predictable because one characteristic of each pigment used is call light-fastness.  In other words, how fast does a pigment fade?  Some colors fade quickly and others more slowly.  Because some pigments fade more quickly than others a residual color becomes the dominant color visible and will need neutralizing or balancing.

Because pigments fade at different rates over time, the color that fades the fastest leaves the the slowest fading color or colors in the blend visible as the residual color.  This can be seen as a pinkey-orangey, purple, gray or green residual color. Because this happens in almost every brow over time, CORRECTIVE colors have evolved to control the undesired healed color.

GREEN BROW: In a green-based brown, the green is the last color to fade and may need to be balanced. The benefits of a green-based brow is that the resulting brow color is MRI safe. This is very important to some professionals and their clients. Here is a photo of a client with a slight greenish hue after 7 years. She didn't notice it but I did and I used hairstrokes with Auburn and Dream Nubrown. In some people there may be more green so you'll use Bubblegumor B2B Medium to neutralize the green.  Use it alone or with a desired color.


PINKEY, ORANGEY BROW: In an iron oxide black-based brown, the black fades first and leaves a pinkey, orangey brow.   KOLORSOURCE pigments have brow colors with browns blended with either a black base or a green base. You can see on the Kolorsource chart whether a pigment has any ferromagnetic properties or not.  Black iron oxide is known as magnetite for its magnetic properties and can affect an MRI. A slight tingling or burning sensation may be felt by the patient when they have an MRI. No serious problems have occurred, however, according to the expert doctor at

GRAY BROW: This is a common color resulting from a blend with carbon black or tattoo ink alone. Gray can result from a blend of inorganic colors that have "ashed" out as well. You'll see a lot of eyebrow pigments with "anti-this" or "anti-that" modifiers. But in the long run, left alone, those colors will heal gray. The good news is KOLORSOURCE B2B Medium warms up gray brows beautifully.

BLUE/PURPLE BROWS: We have created B2B Medium to correct old "tattoo blue" or even purple brows.  B2B stands for "Blue-to-Brown".  All corrective colors used for balancing need 1-2 applications.  Question? Call 888-452-4946.

KOLORSOURCE Pigment Chart: You will see a PLUS + sign or a MINUS - sign next to each Kolorsource brow or eyeliner color on the laminated color guide. You can test your pigment bottles, no matter what manufacturer brand you use, with a magnet. You can pick up a magnet at your local hardware store to test your bottles of pigment. SEE FOR YOURSELF: Look for a Kolorsource brow color in the "Find Product" box and you'll be taken to the pigment which has the description plus 4 smears of the color to show the undertones (Warm, Neutral or Cool) and the effect of adding Bubblegum or Blooper or Neutral Flesh to the color. Green or red brows are easily balanced.  Bubblegum will neutralize green brows and most green based NuBrown colors neutralize unwanted pinkey, orangey brows. Some manufacturers have modifiers that need to be added to their colors before you start to prevent them from ashing out or going green over time. Many Kolorsource professionals have learned to add Bubblegum to their NuBrown colors for this purpose. Feel free to call and ask questions. 888-452-4946. We're here to help guide you.

Brow SerumOffer your clients an extra bonus for their brows. Mostly for brows, but works for eyelashes too, Dr. Dixon's BROW SERUMhas been several years in the making. It contains the newest effective peptides and natural ingredients to condition and enhance the environment to the hair follicles.

BROW SERUM helps wake up dormant hair follicles.  Use once or twice a day over eyebrow area. Then, before returning the wand to the container, close your eyes and apply any excess to your top eyelashes. Allow 3-4 weeks to see results. Reduce application to every other day once brow hairs start growing. The hairs will grow quite long sometimes so be sure to keep them groomed and trimmed. Very helpful in permanent makeup clients with sparse brow hairs. Your brow clients will appreciate your help to restore their own brows (and lashes) too. Retail Price: $49.00. Handy applicator prevents wasting even a drop!  Item #1036  5.9 ml.

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