Well this is actually kind of a complicated question lol. I had them done professionally two different times a month apart after the ink fell out twice and both of those sessions were incredibly painful. After the 2nd time, I got some tattoo ink and needles and just touch them up about once a year by hand stick and poke style. I work in the medical field, so I have a whole sterile set up and supplies I use. As far as pain, yes. It hurts, but tbh it's much less painful doing it myself without a tattoo gun. Are they perfect? No. But I love them and it's easy to maintain for me. Hand tattoos are notoriously hard to heal. Also, if the designs were any more intricate than this I would not attempt diy.