Feel free to ask any post-operative and recovery questions you have on this forum. Keep kid-friendly paints and markers in places around the house that are simple to get to. Rubbing Alcohol - Rubbing alcohol can remove permanent marker stains without harming wood surfaces. Using a cotton ball, cloth, or paper towel, dab a vigorous amount of white vinegar on the ink stain. We consulted top orthopedic experts and combed through customer reviews to help you choose the best couch for good posture and a healthy back. I have a total of 6 scares and 3 of them he must of used some sort of marking pen that can still be seen. by Heidi | Dec 3, 2022 | Skincare Health Tips | 0 comments. I removed the majority of the makeup I used with a makeup remover towel. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Hope it fades:). it worked! Foot Blot the area while and be sure to replace the cloth regularly as ink is removed. This not only can improve a patient's appearance by restoring her youthful, feminine proportions, but also help bras and swimsuits fit more comfortably and attractively. Spray a small amount of WD-40 on a cloth or paper towel. 6 / 10 Traditional permanent markers that you find at office supply stores arent intended for your skin. Apply with a cotton ball and massage in a circular motion for several seconds. For most plastics, especially hard plastics, you can simply draw over the permanent marker with a dry erase marker and wipe it away! reveals Peters. Laser resurfacing (adult). Using a cotton ball, cloth, or paper towel, dab a vigorous amount of white vinegar on the ink stain. Morgen Henderson is a writer who grew up in Utah. After ablative laser resurfacing, your skin might stay inflamed for up to several months. You May Also Enjoy 15 Common Stains Your Kids Will . When I applied insect repellent, I noticed that the Sharpie ink had dried. This article has 24 testimonials from our readers, earning it our reader-approved status. 0000006937 00000 n Chemical-based Removers. Oil-based solvents are used in makeup removers to remove makeup that has dried to the skin. A small squirt of hand sanitizer rubbed over the stain with a paper towel should take it right off. Test this solution on a small area first, and then apply it directly to the marker stain and let it sit for a moment or two. As with any type of stain, always start the process of getting a permanent marker stain out of clothing, with a small, inconspicuous area, so you can see how your specific garment reacts. Baby Oil. Always be careful when using rubbing alcohol, nail polish remover, and hairspray near an open flame as these products are highly flammable. Step 3: Using the cotton ball, push down into the stain, so it makes good contact with the towel so the ink can absorb. The last thing you want to do is accidentally make the problem worse!, Windex and Mr. Clean Magic Erasers: Some folks absolutely swear by this technique, says Peters. Use rubbing alcohol to remove permanent marker from fabric upholstery, including microfiber upholstery. Maybe think about using a specialized tool like a tattoo marker or body art pen. It can make your skin more sensitive and result in friction burns. With regular washing and the natural oils from your pores, permanent marker will eventually fade. If you want to get permanent marker stains off your skin more quickly, there might be some options available. In: Fitzpatrick's Dermatology. That sounds crazy! To completely cover the marker-stained area, mist sunscreen on it. It will also remove all the remaining residue of the permanent ink stain. To remove permanent marker from skin, use a cotton ball soaked in rubbing alcohol. Let it soak for at least five minutes. Workout Peters explains that wool can be more fragile than many man-made fabrics like polyester, so its extra important to test a hidden area and start small. And all of it is gone, thanks to the alcohol hack! After removing Sharpie marker, any chemical-based remover can be used. You may have to repeat the steps laid out above a few times to acheive success, but with a little effort and patience, you can remove most permanent ink stains. You may go through every removal method you can find to remove permanent marker olive oil, magic erasers, baby oil, makeup remover wipes, isopropyl alcohol, abrasive cleaners, etc. Permanent marker stains, especially on plastic, can be extremely stubborn. Either cream or spray-on sunscreen will work. Apply a small amount with a cotton ball, then rinse with warm water. It will therefore eventually disappear over a few days. Banana Peel. Allow the stain to soak for a few minutes while the child bathes, then wash and gently rub oil over it with a cleaning cloth. How Long Does It Take to Get Sharpie Off Skin? All rights reserved. Alcohol can be found in sunscreen, especially spray-on and quick-drying varieties. Smell Rubbing alcohol is another solution which is the most common one, and is effective in removing ink and marker stains. If theres more than a small amount youll need a cloth to wipe away the ink. The Sharpie pen worked well today for my daughter. When mixed with warm water, you can make a gentle scrub to exfoliate the top layer of skin. Choose a toothpaste that's not gel, because it won't work. You should look for markers made specifically for the skin if youre interested in using them on your skin for temporary tattoos or sports. It just looks like regular surgical scars. This article has been viewed 1,683,150 times. thats basically what a tattoo is, ink under skin. These include baking soda and bleach. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. 0000011581 00000 n If the stain has been sitting for a while or is particularly stubborn, you may want to use an abrasive method. Use this approach twice daily. Laser resurfacing can't eliminate excessive or sagging skin. Put just enough shaving cream in your hand to cover the injured area. But once the treatment area begins to heal, you'll notice a difference in your skin quality and appearance. If you want to learn how to use toothpaste or nail polish remover to clean up permanent marker, keep reading the article! Your doctor may do laser resurfacing as an outpatient procedure. If your garment is older or thinner cotton you can try diluting the rubbing in alcohol in water, Peters says. For more stubborn stains, you may need to resort to acetone or nail polish remover. Depending on the makeup of the ink, it may take two to three days for permanent marker or Sharpie stains to naturally fade if you dont make any direct attempts to remove them from your skin. If wikiHow has helped you, please consider a small contribution to support us in helping more readers like you. Keep in mind that gel toothpaste wont do the trick. The cotton ball must be soaked in rubbing alcohol to clean it. Sometimes, it seems like no amount of scrubbing can make the stain budge. Manifestation The instructions for removing Sharpie from your skin are the same, whichever stain remover you choose: Most wood is pretty sturdy and can handle any of the compounds listed above under What removes permanent marker? New skin usually covers the area in one or two weeks and full recovery takes at least a month. There are a variety of powerful cleaners and household products that can safely remove stains from your skin. Applying Bathroom Soap. You can remove permanent marker from a variety of surfaces using basic household cleaners and materials. 0000001778 00000 n Find out how to get other stains out of your carpet here. The faster you can remove the ink, the less time the evaporation process has time to affect, and the greater chance that you can successfully remove the ink before it really does become permanent, he points out. If you have olive or coconut oil at home, apply a small amount to your skin and rub in gently before rinsing away. Also, dont use any ingredients to which you have a known allergic reaction. In a pinch, you can get rid of the pigments in permanent markers using household chemical-based removers. Permanent marker will stain your rag just like it stained your skin. 0000004026 00000 n Toothpaste During my 1 month visit with my surgeon, I showed him my incision marks. The ability to remove permanent marker from clothing differs from the ability to clean hard surfaces. And, heres how to get ink stains out of clothing. You may take a pain reliever and use ice packs. Fabrics are porous, and any ink they come into contact with can be absorbed by them. Apply gentle circular motions as you massage it in. To remove it, wipe with a washcloth or paper towel. Side effects are milder and less likely with nonablative approaches than with ablative laser resurfacing. Hydrogen peroxide can be used to get rid of Sharpies in an unusual way. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. xref How Much Do Custom Orthotics Cost and Are They Worth It or Not? Also, permanent marker fumes can be irritating to your eyes, nose, and throat. Despite the fact that they are labeled washable markers, your childs skin may suffer from skin irritation and difficulty removing them. Apply a small amount of coconut or olive oil, if you have any on hand, to your skin and gently rub it in before rinsing. A panniculectomy is elective surgery performed to relieve symptoms from an overhanging apron of skin. Mayo Clinic does not endorse companies or products. Then wipe off the stain with a damp cloth and circular motions. Avram M, et al., eds. #Permanent_markers are a great tool for artists and students because they don't need any water or other materials, but they can be quite difficult to get off. These are also waterproof, but unlike your traditional Sharpie marker, there are no toxic ingredients included. Apply it to a cotton ball or Q-tip and gently scrub at the stain. Have you tried to remove it yourself with things like nail polish remover? Whitening Toothpaste. Go slowly, dont irritate your skin too much in the process. Baking soda and bleach are some examples. So, grab an old towel or washcloth that you don't mind a stain potentially transferring onto, and follow the instructions below to learn how to remove marker marks from any surface. It will therefore eventually disappear over a few days. If you have permanently marker stains on your skin, they will not become permanently visible because they can be removed with rubbing alcohol or other solutions. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Any of the techniques on the following list are safe to try out. AskMayoExpert. How to Cure a Weed Hangover Effective Ways of Relieving. A good way to use olive oil is to use it for permanent markers as well as washable markers. 0000003668 00000 n If your skin has stubborn stains, you can treat them with a sea salt scrub or olive oil massage. Allow it to remain on and take effect for a while. Your email address will not be published. Hairspray - Hairspray is an effective way to remove permanent marker stains on wood. With Magic Eraser, it is no longer necessary to remove permanent markers from plastic. It's best to use a baking soda toothpaste, but if you don't have one you can simply use regular toothpaste mixed with baking soda. Try to keep small children away from permanent markers. The article received 22 testimonials from our readers, ranking it as a reader-approved piece. In this video I will share an easy way to get permanent marker off skin without using alcohol. This surgical marker removal pen is designed to remove purple measurement dots from your client s skin, ensuring you will. But be sure not to use something too abrasive as you could irritate your skin. 9th ed. Another way to get permanent marker off your skin is with makeup remover. Simply wet a cotton ball with alcohol and rub it in circular motions until the stain disappears. Exercise % of people told us that this article helped them. To dissolve the ink, you should use diluted bleach (1/7 part bleach to water). As a result of surgical treatments or microblading we face permanent marker that looks harder to. No need to hold back here and feel free to use as much as you need. We include products we think are useful for our readers. You may need to repeat this process a few times to remove all of the marker. Blot the area while and be sure to replace the cloth regularly as ink is removed. 2020 ObesityHelp, Inc. All Rights Reserved. Can gel pens work with these techniques? Fruit Already wash your bedding regularly? Did you know you can get expert answers for this article? This really helped, thanks so much! Rinse the area with warm water and soap to remove any residue. Alexiades M. Nonablative skin resurfacing for skin rejuvenation. 64 41 Edmonson KG, et al., eds. Unlike tattoo ink thats actually embedded in your skin, permanent ink think Sharpie markers only touches the surface. If you dont have rubbing alcohol, use nail polish remover or a hair spray instead. If the stain is still fresh and not set too deep you can actually scrub the ink away with a pencil eraser. Phototherapy in skin of color. Prior to using anything on your skin for the first time, be sure to check the ingredients and perform a patch test. Sea Salt Scrub. Therse are the most effective solutions for how to remove permanent marker from plastic or non-porous surfaces: Rubbing alcohol Ethyl alcohol or isopropyl alcohol (often called 'rubbing alcohol') is very effective at breaking down the chemicals in permanent inks. If you want to learn how to use toothpaste or nail polish remover to clean up permanent marker, keep reading the article! When I had my knee surgery I had to mark my own leg and the marks I made (Silly me already half-doped on meds made a smiley face) removed instantly with an alcohol prep pad. 0000015024 00000 n To apply the rubbing alcohol to the skin, gently apply a cotton ball. Theoretically, permanent marker stains could also be removed using this method. The Sharpie marks can typically be completely eliminated with all other natural oils and everyday items after 1-2 days of repeated use. These oils may aid in adhesion to your epidermis. 0000007188 00000 n During ablative laser resurfacing, an intense beam of light energy (laser) is directed at your skin. Another option is standard rubbing alcohol, but that may irritate sensitive skin. Permanent ink, like that used in Sharpie markers, only touches the skins surface, unlike tattoo ink, which is actually ingrained into the skin. As an alternative, you could spray sunscreen on the paper towel and use that to remove the marker stain. 0000003490 00000 n 0000005318 00000 n If you rub alcohol, nail polish remover, or hand sanitizer on the permanent marker, it will dissolve. Calories Wipe the cloth around the smooth surface you wish to clean several times. You can clean permanent marker from leather without damaging the fabric using white vinegar as a stain remover. Leah Groth covers everything from cleaning hacks and consumer products to travel and pets for Readers Digest. Apply a small amount with a cotton ball and rinse with warm water. Rub the area for a few minutes and then rinse off with water. Tough on germs, gentle on hands. 2 Clean the affected area with toothpaste. Heres Why You Might Want To Start. Before washing and rinsing as usual, apply a small amount of oil to the afflicted area. While toothpaste might seem like an unlikely product to use in removing permanent marker stains off wood, it is a great option for floors. Lemon is a well-known natural cleaner for your home. Do not rub. To learn more, continue reading. Natural exfoliating properties exist in sea salt. Ever have a Sharpie leak on your hands while writing? Using the cloth or paper towel, do a combination of small circles with heavy blotting. Click here to learn how to remove other kinds of stains from leather using natural ingredients! The conventional permanent markers that you can buy at office supply stores arent meant for skin. I was trying to take it off with a makeup wipe. In the following section, learn more. 0000004175 00000 n Last Updated: December 2, 2022 Begin blotting with a clean cloth or cotton ball. Be cautious to avoid any contact with the eyes, mouth, or hands when applying any cream or lotion to a childs skin. As with cleaning hard surfaces, you can also use rubbing alcohol to do the same. This trick also works great for most metal surfaces, he explains. Comparing this to household chemical-based removers, it is also a less abrasive option. Most fabrics can be worked with using simple methods. 0000006782 00000 n Kids can paint their faces and bodies with a variety of erasable and washable markers that are available. Last medically reviewed on January 16, 2019, Henna dye can be used on your skin to create intricate, temporary tattoo patterns. Bleach can harm your lungs and absorb into your skin. Click here to learn how to remove other kinds of stains from leather using natural ingredients! The worst that can happen from these substances is that they can be toxic and harm your organs. The fumes from permanent markers can also irritate your nose, mouth, and eyes. Hydrogen peroxide is the safest of all natural cleaning solutions. Follow these three steps to clean your cotton item: It's important that you don't touch the marker before you put it into the washing machine, or else you risk rubbing the stain deeper into the fabric. Mayo Clinic is a not-for-profit organization. When removing Sharpie, use some of these products and methods. A breast lift restores a firmer, perkier, and more aesthetically pleasing shape to sagging breasts. When an injured person drinks alcohol, they can kill any germs or bacteria on the wound. Rubbing alcohol wont damage the carpet or leaving it looking worn out but it will remove the permanent ink, he explains. It can be done with: Both methods can be delivered with a fractional laser, which leaves microscopic columns of untreated tissue throughout the treatment area. on 8/1/10 12:18 am, edited 8/1/10 1:54 am. The best way to remove markers from your skin is to use Baby Oil or Baby Lotion. Be patient, if it still looks that way in a year then worry about it, but he could be right. If the stain is faded or gone, it will be significantly faded. This type of laser removes the thin outer layer of skin (epidermis) and heats the underlying skin (dermis), which stimulates the growth of collagen a protein that improves . Although the name suggests otherwise, if you accidentally get permanent marker on a surface you didn't intend, or one ends up in the hands of a very young, but very inspired creative, there are ways to remove it. In 15 minutes, it was all off! Concrete. #Permanent_markers are a great tool for artists and students because they don't need any water or other materials, but they can be quite difficult to get off your hands. Using rubbing alcohol, you can remove permanent markers from the skin. It's caused by blood leaking out of the tiny vessels called capillaries. Required fields are marked *. After the ink has been broken down, it can be washed away by washing it with soap and water. Check out six more brilliant ideas for cleaning furniture without using harsh chemicals. Michelle Driscoll is the Owner of Mulberry Maids, which is based in Fort Collins, Colorado. Removing permanent marker from carpet is simple with a little nail polish remover. 2. Tattoo Use additional permanent marker colors to make a tie-dye shirt when you can't get the marker stains out. In theory, this could also work with permanent marker stains. Skin Marker EZ removable InkTM Mini Green Regular Tip can be removed by removing it and using it again. Advertising revenue supports our not-for-profit mission. We are no longer supporting IE (Internet Explorer) as we strive to provide site experiences for browsers that support new web standards and security practices. If you have baby wipes or makeup wipes, you can try scrubbing it with those as well. Mayo Clinic Staff. Does Sharpie permanently stain clothing? Permanent ink comes off metal pretty quickly with rubbing alcohol, according to Peters. The effects can last for years. Olive Oil Or Coconut Oil. 2019; doi.org/10.1016/j.det.2019.08.006. Selecting skin-friendly or specialized products is always the best option when removing Sharpie from the skin. Rubbing alcohol, hairspray, and alcohol-based hand sanitizer can also pose similar problems though the latter two are less concentrated and therefore less likely to cause problems. https://www.uptodate.com/contents/search. How Long to Boil Spaghetti Cook Pasta Perfectly. Skis Before tossing your permanent marker-stained clothes into the trash, try dabbing the spot with hairspray that contains alcohol. Once in a while, its possible to get permanent ink on your skin. Denim is a sturdy, tough material that can handle the most effective ink removers like rubbing alcohol or nail polish remover, he explains. I tried the hand sanitizer hack, and. wikiHow is where trusted research and expert knowledge come together. 0000019223 00000 n If you're undergoing nonablative laser treatment or fractional Er:YAG laser resurfacing, you'll likely need 1 to 3 treatments scheduled over weeks or months to get the results you're looking for. Use this method twice per day. 0000001682 00000 n How To Remove Surgical Skin Marker. Its also very simple to follow the instructions. The idea behind mineral oil, or baby oil, is that it can attach to excess oils on the skin and then remove all substances. Epidural Needles How Big Are They & How Do They Work. Always perform a patch test before using any non-skin product on your skin for the first time. While the same dry erase marker trick will work with non-porous metal, he maintains that the best option is to simply use plenty of rubbing alcohol. You can learn more about how we ensure our content is accurate and current by reading our. Be sure that the hairspray contains alcohol, as not all hairspray products do. This content does not have an English version. How can you do this? Accessed Nov. 9, 2021. Tooth Extraction Now you want to remove it from your skin. Gently scrub the area with the soap and water to remove the marker. Use a cotton ball to apply it to the stain and scrub it off with circular motions. One of the most effective ways to remove permanent marker stains is rubbing alcohol. In two steps, you can pretend as though nothing ever happened: If you have any painted furniture pieces, such as cabinets or dressers, that end up with permanent marker on them, vegetable oil can do the trick. Follow the same instructions for using rubbing alcohol to remove Sharpie from clothing. Always apply the alcohol or acetone using a cloth or cotton ball and never apply directly to the garment. Bye Bye Belly Juice Side Effects You Should Know. Laser resurfacing. There appear to be a number of OH people there. "So I drew stuff all over my hand and fell asleep and when I woke it was stained. Permanent marker can be easily removed or faded by washing or wiping household items. 104 0 obj<>stream ", "I was drawing with my sister and I had marker all around my fingers. Lose Belly Fat Many different solvents are very good at getting rid of various kinds of tough stains from various kinds of surfaces. Household chemical-based removers can remove permanent marker pigments if youre in a pinch. Accessed Nov. 10, 2021. How To Remove Permanent Marker From Skin After Surgery To remove permanent marker from skin after surgery, you will need to use a mild soap and warm water. Dermatologic Clinics. Pour it onto a washcloth or piece of paper, then rub the stain gently to remove the color. Put a little hydrogen peroxide on a cotton rag and wipe it over the area that has the marker stain. Alcohol-based hand sanitizers are also effective at removing permanently marker-colored ink from hands. Required fields are marked *. Always read the label before using and test on a small, inconspicuous area . Repeat this simple process until the stain is fully removed. There are a number of different methods you can use to get it out of different fabrics, especially if you don't have stain removers on hand. Although marker ink will not kill you, some unforeseeable consequences can occur when you try to paint over your skin with markers. If you have permanent marker on your skin, you can remove it in a few simple steps. If you have traces of nail polish remover on your hands, wash them with soap and water. If you have a toddler who has gotten permanent marker on their skin, dont worry! Can You Get Ink Poisoning from Drawing on Yourself With a Sharpie? Tell me what you guys think. It can also treat loss of skin tone and improve your complexion. Leather Permanent marker can be easily removed from leather surfaces using distilled white vinegar. "My granddaughter got permanent paint marker all over her hands doing a hand print. No, using a Sharpie to draw on your skin wont make you ill with ink. Continue spraying the repellent and rubbing the marker stain until it dissolves completely. This site complies with the HONcode standard for trustworthy health information: verify here. Dec. 20, 2021. In many ways, sharpies and permanent markers have more in common with spray paint than they do with a ballpoint pen, Guy Peters, owner and founder of MOP STARS cleaning service, explains to Readers Digest. How to Remove Permanent Marker from Skin. In general, some permanent marker removal methods and products are more effective than others, depending on the skin type and sensitivity of the recipient. Follow these steps below: If permanent marker ends up on one of your glass items, such as a window or mirror, you can remove it with nail polish remover or rubbing alcohol by doing the following: In addition to working well to remove stains from walls and plastic, you can use dry-erase markers to remedy a situation where you may have mistakenly used permanent marker on a dry-erase board. As is often the case, the best option here is going to be rubbing alcohol. It's been 6 weeks since my surgery and they have not gone away. Laser resurfacing can cause side effects. Thats great when you want to label an item or draw a picture, but not so great when it gets on your skin. Top Reply Quote AngelLaura92 on 8/1/10 1:56 am This aids in dissolving the permanent markers ink pigments. Always use skin-safe products to remove permanent marker before moving on to household products. Dont spray the leather directly as not only will this give you way more than you need, but youll likely end up with WD-40 getting sprayed in more places than you want. Side Effects Our editors and experts handpick every product we feature. If you need alcohol for these types of tasks, you can still use other methods to remove the markers from your skin. Oil and soap are frequently combined in shaving cream. A method for removing permanently marker-based tattoos from the skin. How Long Can You Take a Bath After a New Tattoo? My profile page: product reviews, tips for your journey, hi protein snacks, hi potency delicious green tea, and personal web site. Work the shaving cream into the skin by applying it with a wet washcloth. When I had my knee surgery I had to mark my own leg and the marks I made (Silly me already half-doped on meds made a smiley face) removed instantly with an alcohol prep pad. Sweat If you wash your clothes with alcohol-based hand sanitizer, they will be even better. Its also safe for painted walls.. You can purchase skin-safe markers made especially for creating tattoos or other body art if youre interested in doing so. Enjoy! For stubborn, permanent markers stains, nail polish is a popular choice. Wet the area with 70% isopropyl alcohol and gently wipe with a soft cloth until you lift the stain. If the stain remains, try hydrogen peroxide, bleach diluted with water (mix according to the bottle's directions . Mayo Clinic; 2021. What have you used to try to remove it? Why not PM a few of those members? You might not want to use harsh chemicals like nail polish remover or rubbing alcohol into your skin, Peters points out. Plus it smells great! Let the vinegar sit on the stain for a few minutes to ensure that it penetrates. As the wound heals, new skin forms that's smoother and tighter. If you do not have any alcohol in the house, you can always go for any good ol' bathroom soap. unlocking this expert answer. 0000002909 00000 n 0000001138 00000 n Furthermore, white vinegar is an excellent solution for removing dry erase marker and glitter glue from clothes. Additionally, some people may experience allergies or burns when using products like vinegar, alcohol, and spirit undiluted. A shaving cream can also be used in a variety of ways. Instructions after sedation for anesthesia for adults. Laser skin resurfacing: Top 8 things you need to know. If that does not work, try something else, such as makeup remover. This article was co-authored by Michelle Driscoll, MPH. Similar to this, keeping canvases and drawing boards nearby for kids would encourage them to use them more frequently than scribbling markers on their skin. Click here to learn how to remove other kinds of stains from leather using natural ingredients! It's best to blot the area with the rubbing alcohol instead of rubbing as it's possible to actually massage the stain further into the fabric. How To Treat Skin Irritation Under Your Breast, The Renewing Layer Of A Reptiles Dead Skin, The Importance Of Hydrating Your Skin Twice A Day. Triple check that the marker youre using is a dry-erase marker and not a Sharpie. As its name suggests, permanent marker is designed to bepermanent. Save your kitchen cabinets from permanent marker doodles with vegetable oil. Even if its baby oil or lotion, keep it away from your mouth and eyes. Go ahead and label your plastic containers with a permanent marker. Consult a physician if skin rashes or swelling resulting from permanent marker stains appear. It is best to avoid using bleach, baking soda, and solvents like benzene, acetone, toluene, or methanol.

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how to remove permanent marker from skin after surgery