The realistic risks
Bacterial: Staphylococcus and Streptococcus skin infection, presenting as spreading redness, heat, swelling, pain increasing after day two, and pus. Viral: HSV reactivation (see cold sores). Atypical mycobacterial: rare outbreaks traced to pigment diluted with non-sterile water or contaminated product — a reason to use only sealed, reputable pigment and sterile diluents. Bloodborne (HBV/HCV/HIV): essentially a cross-contamination failure, not a lip-specific risk.
Prevention chain
Health screening; hand hygiene and gloves; sterile single-use needles and decanted pigment; barrier film on everything else; skin prep; a light, non-over-worked technique; and clear written aftercare with a contact route for problems.
If infection is suspected
Do not 'wait and see' a spreading or febrile infection — the client needs same-day medical care and likely antibiotics. Keep photos and the product/needle records. Superficial mild redness on day one that is settling is expected; anything escalating is not.
