Scar Camouflage - Getting Patient Selection Right

The foremost responsibility a practitioner has, is to inform the patient that permanent tattooing will not erase an abnormality or scar. The practitioner also has to ask ‘Does the expectation of the patient meet within the realm of possibility.’

Other thoughts for the practitioner to consider prior to taking on a patient are:

Is the scar tissue less than 1 year old? - as working prematurely on scar tissue that is not fully healed can create further damage to the scar.

If the scar is a skin graft or burn medical clearance is required as the intrusion of the needle or any further trauma to the site may risk necrosis of the tissue.

The practitioner must examine the tissue to determine if the scar is significantly bumpy or irregular in texture as the semi permanent make up procedure will not completely flatten the scar.

The practitioner must examine the tissue to determine if the scar is red or pink in colour, as this tissue may not be healed sufficiently to proceed with re-pigmentation.

The scar may require pre treatment such as laser treatment to remove redness or to even out an excessive bumpy irregular texture.

The practitioner must examine the tissue to see if the scar is darker than the surrounding tissue especially around the edges as the scar may darken further with the intrusion of the needle during the procedure programme.

Does the area for re-pigmentation have a large surface area? If so is the client/patient prepared to accept partial camouflage or prepared to meet the demands of the procedure programme?

Is Vitiligo present on the proposed treatment site? If yes has the hypo-chromatic lesion been in remission for at least 1 year. If not going ahead with the permanent makeup treatment programme may trigger the disorder to manifest itself in other areas of the body and face, or spread outside the re-pigmented site.

Is the client/patient recently tanned or does he/she tan regularly? Because the camouflaged area will not tan and leave a demarcation line when tanning occurs.

The practitioner must examine the tissue to see if the surrounding tissue contains freckles, moles, veins, broken capillaries, hair growth, five o clock shadow or patchiness as these imperfections will have to be replicated within the camouflage site otherwise the appearance will never appear uniform. In some cases imperfections such as spider veins in the surrounding tissue could indicate that the client was not suitable for the procedure as it would be difficult to successfully replicate such blemishes realistically.

Once these factors have been considered the practitioner can consider must prepare the client for the appearance of the scar during the healing process. During and after the procedure the area will display redness and capillary breakage that resembles the original trauma and can last approximately a week. In some cases the appearance can have emotional consequences for the client/patient.