I regularly see super clean shading on realism pieces. Is this just from experience and confidence? I'm putting a lot of time and effort into learning to do good graduated shading but it always seems to look a bit 'dirty' when practicing.......
Try building your values. A lot of time I go in with my ligher wash first paying attention to not spending to much time in an area because i'm going to come back over top of that with darker tones to build up to the tone i want. This also allows for the skin to open up which in turn helps to get the ink in.
its basically some mix of trial and error plus theory&technique. my experience was this: for fakeskin i basically just practiced everyday and within a few months started to get better and better, cleaner gradients and smoother shading. my mentor would show some techniques but i remember just figuring out on my own. it's still good to have someone critique you and tell you what your doing wrong though. ie very technical things like voltage,needlehand, needle selection etc...
for real skin it's definitely a bit harder as you have to get good photos of your healed shading and the entire process is forsure more difficult because the healing process just adds another couple layers of difficulty to the study process. Finding a decent mentor and/or being surrounded by talented artists you can consult is a huge help.