To treat or not to treat Different scar types. Chapter II

In the 1st chapter we touched upon the types of scarring that poorly qualify for micropigmentation procedures. There are, however, types of scars which not only can, but also should be treated with the help of camouflaging tattooing.


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Atrophic scars have pitted appearance which is peculiar as the skin resembles the Moon’s surface. These are deep scars that stem from such skin conditions as acne or chickenpox. In terms of histology, however, the causes of their formation are not absolutely clear. Just like with keloid and hypertrophic scars, the main factor for their apparition is troubles in collagen production, but the deeper understanding has not yet been acquired. It is thought, however, that the mechanism of their formation originates in the reaction of collagen fibers and subcutaneous fat to inflammation. Consequently, the treatment of this type of scars requires collagen boost thus patients with atrophic scars are good candidates for collagen induction or skin needling.


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Scar contractures are an abnormal occurrence that usually follows burns. The scar pulls the edges of the skin together causing tightening in the area and restriction of movements. This type totally qualifies for micropigmentation. However, micropigmentation treatments should be numerous as the burned areas do not retain pigment well. It is worth mentioning that when performing micropigmentation directly on the scar contractures the scar can be relieved after the pigment has been applied thus contributing to uneven application and, what is more, an asymmetrical look when performed on the face. Highly satisfying results can be expected if the procedure of scar relaxation is performed prior to the micropigmentation treatments.


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Last but not least, the most common type, flat and pale scars, are the most common ones to form after any injury or surgery. Slightly red and swollen at the beginning, they grow paler overtime and do not rise over the level of the surrounding skin. Depending on the depth of the wound it may take up to one year for such scars to heal, but it is absolutely important to let for the healing process to complete before performing any treatments, even if it is clear from the beginning that the appearing scar will fall in this category. Since the scar tissue in this case lacks pigmentation, it appears white compared to the surrounding skin. This discoloration can be quite disturbing for the patients, so a micropigmentation treatment can be performed as the scar presents no danger of complications.

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