TikTok users are shunning lip fillers in favor of 'lip blushing.' Here's how it's done, and what the risks are.

• Lip blushing videos, where clients inject color into the top layer of the lip skin, have gone viral on TikTok.
• A licensed tattoo artist and a board-certified dermatologist spoke to Insider about the risks of the procedure.

As Americans continue to search for the perfect, big, bold lips, many people are opting for "lip blushing," a semi-permanent makeup technique similar to tattooing.

Videos about "lip blushing" on TikTok have amassed more than a billion total views, with users filming themselves as a permanent makeup artist shapes and colors their lips.

Insider spoke with Savannah Kondratyev, a licensed tattoo artist at First Class Cosmetics NYC, and Dr. Heather Rogers, a board-certified dermatologist at Modern Dermatology in Seattle, to explain what lip blushing is and the risks associated with the procedure.

Lip blushing involves an injection of color, and is less permanent than a tattoo

Lip blushing is when a permanent makeup artist pokes tiny holes and injects color into the epidermis, or top layer, of the skin, Rogers said.

Because lip blushing is a more superficial deposition of the pigment, the outcome is less permanent than a tattoo, which is formed after an artist injects color into the dermis, or middle layer, of the skin.

Kondratyev said the lip blushing process is more intricate than people realize. She first sets up initial consultations with her clients to determine what they are looking for and whether lip blushing is right for them. She then schedules a "lip mapping" to shape the area that will receive a tattoo.

The tattoo artist then numbs the lips for 15 to 20 minutes before starting, and continues to apply numbing cream during the two-hour procedure to ensure clients feel no pain.

Results take about four to six weeks to develop for lighter-pigmented lips, and six to eight weeks for darker-pigmented lips, Kondratyev said. Within those few weeks, the skin will shed, scab, and swell before clients can see their newly colored lips.

"The best way I can compare it is if you fall down and hurt yourself, you get a scab that scab falls off and you're left with an area that's either lighter or darker (depending on your skin type) until that area is fully healed," Kondratyev said. "The same way with the lips."

Avoid certain products after lip blushing

Although lip blushing is less invasive than a filler or implants, clients must abide by strict pre- and post-care rules.

Clients should avoid putting retinol, glycolic, or vitamin C serums on their lips for weeks before and after their lip blushing to avoid fading the tattoo, per Kondratyev. Consuming alcohol or caffeine 24 hours before the procedure could lead to bleeding or bruising during the process, and Kondratyev said to keep the lips well hydrated before coming in.

If a client has ever gotten a cold sore, even if it was years ago, the cosmetologist said they must take an antiviral medication, such as Valtrex, a few days before and after the procedure. Valtrex is a prescription drug used to treat cold sores and genital herpes.

Rogers said any time the skin barrier breaks, there is a risk to infection. The dermatologist recommends seeing a cosmetic tattoo artist with clean, sterile tools and who applies a microbial soap to the area before starting. After the procedure, Rogers said to use hypoallergenic products like Vaseline to help in the healing process and to avoid causing irritation.

"Vaseline won't make you lose more water and products that have glycerin in them will actually help put water back into the skin," Rogers said. "That just makes so you heal faster, so the likelihood of something going wrong is lower."

How to pick a lip blushing practitioner

Kondratyev said people considering getting a lip blushing should carefully choose a licensed, experienced artist who can provide before-and-after photos of their prior clients. Finding the right permanent makeup artist is imperative, Kondratyev said, because if they can't determine the right color, the artist could permanently give the lips an unnatural or unflattering color.

Kondratyev has worked as a hair stylist and licensed cosmetologist for 15 years before she began specializing in lip blushing four years ago. Recently the tattoo artist only takes lip blush clients, but she said her knowledge of color theory in cosmetology school plays an invaluable part in lip blushing.

For instance, a tattoo artist could make the mistake of putting red color on brown lips. Since brown plus red equals black, the client could end up with with lips resembling Marilyn Manson's.

"You really need to know color theory big time to do this because you can actually destroy someone," the cosmetologist said. "And once that damage is done, it's really hard to reverse if it can be reversed."