Permanent makeup ink that is injected to enhance eyebrows, eyelids and lips can cause disfiguring reactions that may last for years, doctors warn.

In a letter appearing in Thursday's New England Journal of Medicine, Masja Straetemans of the U.S. Centers for Disease Control and Prevention and her colleagues described allergic reactions from the cosmetics. 

From 1988 to 2003, the U.S. Food and Drug Administration received five reports of adverse reactions after permanent makeup procedures. Beginning in 2003, more than 150 reports were made.

When researchers interviewed 92 women about side-effects that occurred after permanent makeup procedures, the most commonly reported were:

• Tenderness, in 95 per cent of cases (87 patients).
• Swelling, in 91 per cent (84 patients).
• Itching, in 88 per cent (81 patients).
• Bumps, in 83 per cent (76 patients).

"Our findings show that application of permanent makeup can result in serious, long-term disfiguring reactions," the study's authors concluded.

"Consumers and medical professionals should report adverse reactions to permanent makeup procedures to the FDA."

Canadian reports of adverse reactions to cosmetics should go to Health Canada's Consumer Product Safety Bureau.

Women reported symptoms that lasted from 5½ months to more than three years.

In 68 per cent of cases or 63 patients, the reactions had not completely resolved by the time of the interview.

Healing occurred faster among people who said they did not report a history of allergy, the researchers said.

In March, a Toronto dermatologist warned about allergic reactions to a common ingredient in permanent hair dye and black henna tattoos, called para-phenylenediamine or PPD, that can cause serious symptoms in some people.

In 2004, the American Institute of Intradermal Cosmetics in Arlington, Texas, recalled and replaced inks in its Premier Pigment brands of permanent makeup after problems were reported to the FDA.