As the popularity of permanent makeup continues to rise, many individuals are seeking to understand the factors that can affect its longevity. Recently, attention has turned to GLP-1 medications, commonly prescribed for weight management and diabetes. This blog post explores the potential impact of GLP-1 medications on the fading of permanent makeup.
We will examine the scientific basis behind these medications, their effects on the body, and how they may influence the durability of cosmetic enhancements.
By shedding light on this emerging topic, we aim to provide valuable insights for anyone considering or currently using permanent makeup while taking GLP-1 medications.
Are GLP-1 Medications Making Permanent Makeup Fade Faster?
A pattern I started noticing in my PMU clients—and the macrophage connection that made me curious
After 26 years working with permanent makeup, I’ve learned that the skin can teach you things that you won’t necessarily find in a textbook.
When you work with the same type of procedure for many years, you begin to recognize patterns. You see how different pigments age, how different skin types retain color, and how two people can receive essentially the same procedure and have completely different results months or years later. That’s why something I’ve been noticing over the past several months caught my attention.
My clients who are taking GLP-1 medications, such as semaglutide or tirzepatide, have been coming back for touch-ups sooner than my clients who are not taking these medications. And when I started seeing this happen repeatedly—rather than with just one or two clients—I began wondering whether there might be something behind it. Then I noticed another detail that made the whole thing even more interesting. It wasn’t necessarily the entire brow that was losing color. The black component seemed to be fading more than the warmer component.
That is particularly interesting in my work because I use black iron oxide, not carbon black. The warm portion of my pigment system is made with organic pigments, so I’m essentially seeing two different pigment chemistries in the same brow behaving differently over time. And before anyone worries, I’m not describing this as a bad result.
When the warm pigment remains and the black loses some of its intensity, I can simply refresh the black at the touch-up appointment. I don’t have to rebuild the entire brow. In some cases, it actually saves me time.
So my question wasn’t, “How do I stop this?” My question was much more basic: Why might this be happening? I decided to look into the science and that’s when I ended up learning much more about macrophages than I ever expected to.
What do macrophages have to do with permanent makeup?
If you’ve never heard much about macrophages, you’re not alone. They’re not exactly the first thing most people think about when they think about permanent makeup. Macrophages are immune cells found throughout our tissues. One of their jobs is to recognize, engulf and process particles and cellular debris.
When we implant pigment into the dermis, the pigment becomes part of a living biological environment. It isn’t simply sitting there untouched. Macrophages interact with those pigment particles, and researchers have actually been able to see this happening in human tissue.
For example, histopathological research on permanent eyelid pigmentation using iron-oxide pigment found that, 18 months after implantation, most of the remaining pigment was located inside macrophages in the dermis.
Read the human histopathology study on PubMed
Another study examining permanent eyeliner found that most of the pigment present 12 months after implantation had been phagocytosed by macrophages. Pigment was also found in fibroblasts and mast cells.
Read the permanent-eyeliner study on PubMed
A separate histopathological study of blepharopigmentation also found that the pigment in the dermis was largely located inside macrophages.
Read the blepharopigmentation study on PubMed
That tells us something important about permanent makeup longevity: the pigment isn’t simply deposited into the skin and left completely alone. The immune system becomes part of the story.
Pigment retention is more dynamic than I thought
One of the things I found particularly fascinating while researching this is that pigment can remain in the skin through a dynamic process involving macrophages. Researchers have described a process in which macrophages capture pigment, and when those cells die or are replaced, pigment can be released and subsequently captured by other macrophages.
In other words, pigment can go through a kind of capture, release and recapture cycle. That helps explain why pigment can remain visible for years even though the individual cells holding the pigment don’t necessarily live for years.
Read the macrophage research on tattoo pigment persistence on PubMed
This research was not specifically performed on eyebrow PMU, so I don’t want to pretend that every detail translates directly to permanent makeup. But it does give us a valuable piece of the puzzle.
Macrophages are active participants in what happens to pigment after it is implanted into the skin. That made me wonder what happens when something changes the behavior of those cells. And that’s where GLP-1 medications come into the picture.
What does black iron oxide have to do with it?
This is another important part of the story, because I am not talking about carbon-black tattoo pigment. My black PMU pigment is black iron oxide, while my warm pigments are organic.
I became particularly interested when I found a 2025 study that looked specifically at iron-based pigments and macrophages. The researchers exposed macrophages to black and red iron-oxide pigments and found that both were efficiently internalized by the cells and were relatively poorly dissolved inside them. Interestingly, the two pigments did not behave exactly the same way. The study found that red iron oxide produced certain mitochondrial, oxidative and inflammatory effects in the experimental macrophage model, while those same effects were not observed with black iron oxide.
Read the 2025 iron-oxide/macrophage study on PubMed
That distinction matters to me because I don’t use red iron oxide for the warm portion of my pigment system. My warm pigments are organic, so I’m not taking findings about red iron oxide and trying to make them explain what I’m seeing with my black iron oxide. The more useful takeaway is that researchers have demonstrated that black iron oxide itself is taken up by macrophages and interacts with them at the cellular level.
The 2025 paper also has a published corrigendum, which is another reason I think it is important to link directly to the scientific record rather than simply quoting a study without context.
Read the published corrigendum to the study
At this point, though, I want to make something very clear: this research does not show that black iron oxide fades faster in people taking GLP-1 medications. It simply gives us evidence that black iron oxide and macrophages have a real biological interaction.
Then I started looking at GLP-1 and macrophages
Most people know GLP-1 medications because of their effects on blood sugar, appetite and body weight. But GLP-1 signaling is involved in other biological processes too, including pathways related to inflammation and immune-cell behavior, and yes, researchers have specifically studied GLP-1 and macrophages. One study using human monocyte-derived macrophages found that GLP-1 influenced STAT3 signaling and increased markers associated with an M2-type macrophage phenotype.
Read the human macrophage study on PubMed
Another study found that GLP-1 could influence macrophage polarization through the JNK/STAT3 signaling pathway in an experimental model.
Read the GLP-1/macrophage polarization study on PubMed
Researchers have also investigated the GLP-1 receptor in relation to macrophage migration and found evidence that GLP-1 receptor signaling can influence macrophage movement during inflammation.
Read the GLP-1 receptor/macrophage research on PubMed
More recent research continues to investigate the relationship between GLP-1-based therapies, macrophages and inflammatory signaling. The important point for my question is not that GLP-1 has been shown to remove pigment, well It hasn’t. The important point is that GLP-1 signaling can influence macrophage biology. And we already know that macrophages interact directly with pigment in the dermis. That is where the question becomes interesting.
So, could GLP-1 medications be affecting PMU pigment retention?
This is where I have to separate what I have observed from what science has actually proven. There is currently no published study showing that semaglutide, tirzepatide or another GLP-1 medication causes black iron-oxide permanent makeup pigment to fade faster. I looked specifically for research connecting GLP-1 medications with tattoo fading, permanent makeup, iron-oxide pigment retention and macrophage handling of PMU pigments.
I did not find a study that directly answers that question. So I’m not going to tell you that GLP-1 medications cause faster fading. What I can say is that the biology gives us a reasonable question to investigate. If GLP-1 signaling can change macrophage behavior, and macrophages are involved in the retention and handling of pigment in the dermis, could those changes affect the persistence of certain pigment particles? We don’t know, and that’s okay. Sometimes the most interesting questions are the ones science hasn’t answered yet.
Why am I seeing the black fade more than the warmth?
This is the part that keeps me curious.If the entire brow were simply fading faster, there wouldn’t be as much of a mystery. But that isn’t what I’m seeing.
The warmer organic residue can remain while the black iron-oxide component loses intensity. That gives us a very interesting situation because we’re looking at different pigment chemistries in the same treated area. There are several possible explanations. It could involve differences in how macrophages interact with different pigment particles. It could involve changes in macrophage behavior associated with GLP-1 signaling. It could involve changes in the skin itself. It could be related to the significant weight loss that often accompanies GLP-1 treatment. Or it could involve several of these factors at the same time. And there may be another explanation we haven’t considered. Right now, we simply don’t have enough evidence to say which one is responsible.
What about the weight loss itself?
This is another piece we can’t ignore.
Many people taking GLP-1 medications experience significant weight loss, and substantial changes in body composition can also change the skin, which is a living tissue. Its structure, volume, hydration and connective-tissue environment can change as the body changes.
So even if we eventually establish that GLP-1 users have different PMU pigment retention, we would still need to determine whether the effect comes directly from the medication, from weight loss, from changes in the skin environment, or from some combination of factors. That’s why I think a proper study would need to separate those variables rather than simply comparing people who take GLP-1 medications with people who don’t.
And no, I’m not worried about my clients
I want to emphasize this because the phrase “fading faster” can sound alarming. I’m not seeing this as a reason for my clients to be concerned. The warm residue that remains isn’t a problem for me. If the black component has simply lost some intensity while the warmer organic pigment is still present, I can refresh the black at the touch-up appointment. I don’t need to correct the color, I don’t need to rebuild the entire brow and I don’t see a reason to change the pigment system I’ve chosen to use.
This is not an article about telling people to avoid GLP-1 medications, and it certainly isn’t an argument for replacing iron oxide with carbon black, it’s simply an observation that made me curious about what is happening biologically beneath the surface.
Maybe we need to rethink what “longevity” means
Permanent makeup artists often talk about how long a pigment lasts, and naturally, clients want to know how many years they can expect from their brows, eyeliner or lips.
But after researching this, I found myself thinking that longevity may be a little more complicated than a number of years. Pigment interacts with immune cells, macrophages can capture pigment, which can be released and captured again and different pigment chemistries can behave differently and the skin itself changes throughout our lives. So perhaps the better question isn’t simply: “How long will this pigment last?” Maybe it’s: “How will this particular pigment behave in this particular skin over time?” That’s a much more interesting question.
What I would love to see researchers study
If other PMU professionals begin seeing the same pattern, I think this would be an interesting subject for proper research. A study could compare pigment retention in GLP-1 users and non-users while controlling for factors such as pigment chemistry, pigment color, age, skin type, procedure type, implantation depth, time since treatment, amount and speed of weight loss, duration of GLP-1 therapy and the specific medication being used. Even more interesting would be laboratory research.
Researchers could expose macrophages to different PMU pigment chemistries in the presence and absence of GLP-1 receptor agonists and see whether anything changes in the way those cells interact with the pigment. Does pigment uptake change? Does retention change? Does release or redistribution change? Does macrophage behavior change? Those are questions that could potentially take us from an interesting observation to an actual scientific explanation.
What we know—and what we don’t
After going through the research, this is where I landed. We know that iron-oxide PMU pigment can be found inside dermal macrophages in human tissue. We know that black iron oxide is efficiently internalized by macrophages in laboratory research, we know that different iron-oxide pigments can behave differently at the cellular level, we know that GLP-1 signaling can influence macrophage biology, but we do not yet know whether GLP-1 medications cause faster loss of black iron-oxide PMU pigment.
That last piece is still missing and I think that’s important to say. I’m not interested in taking an observation and turning it into a sensational claim just because it makes a better headline so I’d rather say: “This is what I have consistently observed. This is what the science tells us. And this is the part we still don’t understand.” To me, that’s much more interesting.
Why I decided to share this
After 26 years in permanent makeup, I’ve learned that some of the best questions start with something very simple: “Why am I seeing this?” That’s exactly what happened here. I noticed that my GLP-1 clients were returning sooner for touch-ups. Then I noticed that the black component seemed to be the part fading more noticeably, while the warm organic pigment remained. That didn’t make me panic or make me want to change my pigment system, it made me curious so I started researching and what I found was a fascinating intersection between permanent makeup pigment, macrophages and GLP-1 biology.
There is enough science to tell us that these things are biologically connected in different ways however there is not yet enough science to tell us whether those connections explain what I’m seeing in my studio. Maybe future research will show that they do or maybe it will show that another factor is responsible and maybe other PMU artists will start observing the same thing and we will eventually have enough real-world data to understand the pattern better. For now, I’m simply sharing what I’ve noticed and what I found when I went looking for an explanation.
Because sometimes the professionals working with real people every day notice the question before science has had a chance to answer it. And this is one question I would genuinely love to see answered.
Scientific sources
Iron-based pigments and macrophages, including black iron oxide
PubMed — Beyond the ink: Cellular and molecular effects of iron-based pigments on macrophages
Corrigendum to the iron-oxide/macrophage study
PubMed — Published corrigendum
Permanent eyeliner and macrophage uptake of pigment
PubMed — Light and electron microscopic findings with permanent eyeliner
Blepharopigmentation and macrophage localization of pigment
PubMed — Histopathological observations and X-ray microanalysis
Iron-oxide pigment inside macrophages after implantation
PubMed — Histopathological findings in blepharopigmentation
Macrophage capture, release and recapture of pigment
PubMed — Unveiling skin macrophage dynamics explains tattoo persistence
GLP-1 and human macrophage polarization
PubMed — GLP-1 induces M2 polarization of human macrophages via STAT3 activation
GLP-1 and macrophage polarization
PubMed — GLP-1 modulates macrophage polarization through JNK/STAT3 signaling
GLP-1 receptor and macrophage migration
PubMed — GLP-1 receptor and macrophage migration
Bea Robinson
Permanent Makeup Artist and Smart Touch Skin Solutions Owner