Shingles is reflected by a "Dermatome", a single nerve that hits a specific area.

If in the nose lip area, probably not an issue with brow tattooing (unless has it when being worked on).

However, without written consent from her doctor is a no go. Especially, since she is not interested in getting one, that is a red flag.

A Dermatome is an area of skin associated with a pair of dorsal roots from the spine.

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Jane Adler, CPCP
Facial Art by Jane
SofTap® Distributor
OSHA Outreach Instructor
http://www.janeadler.com

Really I find eyebrows pretty much okay to tattoo on everyone. If this woman wants to risk that, and she signs off knowing it is a possibility I would likely do them. She obviously wants them bad enough. I guess if someone had a heavy hand it could maybe be a little traumatic but with a light touch, clients fall asleep during the procedure. I hate to be the one to always state things contrary to everyone else but I would do them - send her to me, LOL!

I can see what Maggie is talking about. Herpes Zoster usually remains on a path of a single nerve (Dermatome), if not always. Pretty darn rare to get in more than one area of the face, as an example.

However, the red flag is her not wanting to take any concern for her health for vanity. Better safe than sorry. If not showing that side of her personality, I would type up additional consent for this type of client. Adding since she has had "Shingles" in her lower facial region the client understand additional risks of a possible outbreak in the area previously affected or another and is willing to take on all responsibility for getting her eyebrows done against doctors recommendation. something like that. You need to follow your inner tattoo artist voice. I would have her write out in her won word that she has never had an ocular breakout or any problems with brow area. Never a bad idea to also have a third party witness signature and date too.

Hives or documented shingels?? Or is she assuming? Shingles is very very very painful! Not just itchy hives?

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Jane Adler, CPCP
Facial Art by Jane
SofTap® Distributor
OSHA Outreach Instructor
http://www.janeadler.com

"Although shingles can occur in anyone exposed to the varicella-zoster virus, research has established two general risk factors for the disease: (1) Advanced age; and (2) A weakened immune system. Studies show that people over age 80 have a five times greater chance of having shingles than adults between the ages of 20 and 40. Unlike herpes simplex I, the varicella-zoster virus does not usually flare up more than once in adults with normally functioning immune systems."

Herpes Zoster

Causes and Risks:
Herpes zoster, or shingles, is caused by the same virus that causes chickenpox . It occurs as a result of the virus becoming dormant (inactive) after an attack of chickenpox and re-emerging many years later. The cause of the reactivation is unknown. Usually only one attack occurs, without recurrence. If an adult is exposed to herpes zoster virus and has not had chickenpox, a severe case of chickenpox usually develops rather than shingles.

The virus resides in a dormant condition in the nerve tracts that emerge from the spine. When it is reactivated, it spreads along the nerve tract, first causing pain or a burning sensation. The typical rash appears in 2 to 3 days, after the virus has reached the skin. It consists of red patches of skin with small blisters ( vesicles ) that look very similar to early chickenpox. The rash maximizes over the next 3 to 5 days. Then the blisters break forming small ulcers which begin to dry and form crusts. The crusts fall off in 2 to 3 weeks, leaving behind pink healing skin.

Lesions typically appear along a single dermatome (the body area served by a single spinal nerve) and are only on one side of the body (unilateral). The trunk is most often affected, showing a rectangular belt of rash from the spine around one side of the chest to the breastbone (sternum). Lesions may also occur on the neck or face, particularly the trigeminal nerve in the face. The trigeminal has three branches: the superior which goes to the forehead, the middle which goes to the mid-face and the inferior which goes to the lower face. Which branch is involved determines where on the face the skin lesions will be. Trigeminal nerve involvement may include lesions in the mouth or eye. Eye lesions may lead to permanent blindness .

Involvement of the facial nerve may cause Ramsay Hunt syndrome with facial paralysis , hearing loss , loss of taste in half of the tongue and skin lesions around the ear and ear canal. Shingles may, on rare occasion, involve the genitalia or upper leg.

Shingles may be complicated by a condition known as post-herpetic neuralgia . This is persistence of pain in the area where the shingles occurred that may last from months to years following the initial episode. This pain can be severe enough to be incapacitating to a person, especially if they are elderly.

Herpes zoster can be contagious through direct contact in an individual who has not had chickenpox and therefore has no immunity . Herpes zoster may affect any age group but is much more common in adults over 60 years old, in children who had chickenpox before the age of one year, and in individuals who are immunocompromised. The disorder is common, with about 300,000 cases in the U.S. per year (about 2 out of every 1,000 people).

Localized shingles involving only one dermatome is typical for an outbreak of shingles. Generalized or recurrent shingles may indicate an underlying disorder with the immune system such as leukemia , Hodgkin's disease , other cancers, atopic dermatitis , or HIV infection (ARC or AIDS ). Those who are immunosuppressed because of organ transplant or treatment for cancer or similar disorders may also experience the disorder. Shingles may be an early sign in persons with HIV infection that the immune system has deteriorated enough that they would now be classified as having ARC (AIDS Related Complex) or AIDS.

NancyE