Tattoo scarring can happen from the tattooing process itself, an allergic or infection-related reaction afterward, or improper aftercare, and while some texture change is common and expected, raised or discolored scarring can often be minimized or treated with the right approach. This guide covers why tattoo scarring happens and how to treat and prevent it.
This is general information, not medical advice.
Why tattoo scarring happens
A tattoo is created by repeatedly puncturing the skin with needles to deposit ink into the dermis (the deeper layer of skin below the surface). This is, by definition, a controlled skin injury, which is why the skin naturally goes through a healing process afterward, involving some inflammation and tissue repair. In most cases, this heals without visible scarring beyond the tattoo’s intended lines and shading. Scarring becomes more likely, or more visible, in several situations:
- Technique-related trauma: needles going too deep, excessive repeated passes over the same area, or overworking a section during the tattooing process can cause more tissue damage than typical, increasing scarring risk
- Infection: bacterial infection after tattooing, whether from an unsanitary tattoo environment or inadequate aftercare, significantly increases the risk of more prominent scarring
- Allergic reaction: some people react to specific tattoo ink pigments (certain colors, particularly red, are more commonly associated with reactions), which can cause raised, itchy, or inflamed areas that may scar
- Picking or scratching during healing: disrupting the natural scabbing and peeling process during tattoo healing increases the risk of textural scarring
- Individual scarring tendency: some people are simply more prone to raised scarring (including keloid or hypertrophic scarring) regardless of technique or aftercare, a factor largely outside anyone’s control
Types of tattoo scarring
Hypertrophic scarring involves raised, thickened tissue that stays within the boundaries of the original injury. Keloid scarring is a more significant overgrowth of scar tissue that extends beyond the original wound boundaries, more common in some skin types and with a genetic predisposition component. Textural or ink-loss scarring refers to areas where the skin’s surface becomes uneven or where ink has been pushed out or faded unevenly due to underlying tissue damage, sometimes called “blowouts” or scarring-related fading.
Treatment options
- Silicone sheets or gels, a well-evidenced approach for reducing the appearance of raised scars over time, applied consistently for weeks to months
- Corticosteroid injections, used by dermatologists for more significant raised or keloid scarring to help flatten and soften the tissue
- Laser treatment, which can help address both scar texture and some forms of pigment-related irregularity, performed by a qualified dermatologist or laser specialist
- Microneedling, sometimes used to help improve the texture of scarred skin by stimulating collagen remodeling
- Cover-up or touch-up tattooing, once any active scarring or inflammation has fully settled, sometimes used to help visually minimize the appearance of textural scarring within the design itself
Prevention: proper aftercare matters most
The single most controllable factor in preventing tattoo scarring is following proper aftercare instructions from your tattoo artist: keeping the area clean, moisturized (without over-moisturizing), protected from sun exposure during healing, and avoiding picking, scratching, or exposing the fresh tattoo to unsanitary conditions (pools, hot tubs, and similarly), since these behaviors are among the most common controllable contributors to poor healing and scarring.
When to see a dermatologist
If you notice significant raised, painful, spreading, or worsening scarring, particularly with signs of possible infection (increasing redness, warmth, swelling, pus, or fever), see a dermatologist promptly, since early intervention generally produces better results than waiting for a scar to become fully established.
Frequently asked questions
Is some texture change after a tattoo normal?
Mild texture change during normal healing (some initial raised, scabbed skin) is expected and typically resolves; persistent raised or discolored scarring beyond normal healing is what actually constitutes true scarring.
Can tattoo scarring be completely removed?
Treatment can often significantly improve the appearance of tattoo scarring, but complete removal isn’t always achievable; realistic expectations and consultation with a dermatologist help set an appropriate treatment plan.
Are some people more prone to tattoo scarring?
Yes, individual scarring tendency (including a predisposition to keloid or hypertrophic scarring) varies significantly between people and is largely outside anyone’s direct control, regardless of technique or aftercare quality.
What’s the best way to prevent tattoo scarring?
Choosing an experienced, reputable tattoo artist and carefully following proper aftercare instructions (cleanliness, appropriate moisturizing, avoiding picking or sun exposure during healing) are the most controllable prevention factors.
Can I get a tattoo over an existing scar?
This is possible in many cases, though scar tissue can hold ink differently than normal skin, so consulting an experienced tattoo artist about the specific scar is important before proceeding.
References
- General dermatology references on scar formation, keloid and hypertrophic scarring, and tattoo aftercare best practices; consult a dermatologist for evaluation and treatment of significant or concerning tattoo scarring.