Supplies used for tattoos on a table that can cause scars from tattoos

Scars From Tattoos: Are You At Risk For Tattoo Keloids And Other Tattoo Scars?

Tattoos & Piercings

Scars from tattoos are a rare problem, but when they happen they can override all the positive benefits of these ancient forms of body art. Like scars caused by injury or surgery, a tattoo scar can never be fully removed once it happens. So, understanding your own personal risks for getting scars from tattoos is worth doing before getting inked.

What Causes Scars From Tattoos?

A tattoo scar is created in the same way all scars are formed. Anytime an injury occurs within the skin layer called the dermis, the body’s repair mechanism kicks in to heal the wound by forming scar tissue. Because tattoos are created by penetrating the skin’s dermis repeatedly with the tattoo needle, scars from tattoos actually arise with every tattoo. But, in the vast majority of cases, tattoo scar formation is so pinpoint and minor that it is imperceptible and poses no problem whatsoever. In rare cases, however, a tattoo scar can arise that is much more noticeable. There are 3 main reasons this can happen:

  • problems with the tattooing technique
  • healing complications
  • personal scarring tendencies

Scars From Tattoos: Tattooing Technique

The extent to which skin scars from tattoos or any other injury depends on the depth in the skin the damage reaches. An ideal tattooing technique has the needle penetrate into the very upper layer of the skin’s dermis. If the tattoo is overworked and the artist penetrates the needle deeper in the dermal layer, a greater scarring reaction is provoked. This can cause a tattoo scar that is visible, in the same way a deeper incision or laceration leaves a visible scar. So, in summary, tattooing too deep into the skin is a technical cause of scars from tattoos.

Diagram showing how scars from tattoos can form from poor tattooing technique
Tattoo needles that penetrate the upper dermis (black) leave scars but they are essentially invisible. Penetration into the deeper dermis (orange) provokes scars that can be much more visible.

Healing Complications Can Cause Scars From Tattoos:

Tattoo Scabbing Is Normal In The Early Tattoo Healing Stages

Tattoo scabbing is a normal part of tattoo healing. The multitude of skin penetrations by the tattoo needle provoke bleeding during the procedure, and similar to other injuries that bleed, a scab forms. Because the tattoo needle creates so many tiny skin injuries that bleed, tattoo scabbing can be extensive, covering the majority of the inked area. It’s important to care for tattoo scabbing correctly to avoid the scabs tearing off which can both damage the tattoo and provoke scarring.

Image showing heavy scabbing and tattoo bubbling that can lead to a tattoo scar
Tattoo scabbing like this is normal (Image Credit Sarah-Rose Flickr)

Tattoo Bubbling

Tattoo bubbling is when tattoo scabbing becomes water-logged. Significant scabbing traps water from washing and showering. Application of tattoo lotion exacerbates the problem by placing a waterproof layer over the water-logged scabs so that normal drying by evaporation doesn’t happen. When tattoo scabbing becomes saturated with water, tattoo bubbling occurs and the scabs become boggy and sticky. This can be a problem because the scabs will be more likely to come off with even gentle contact. That can lead to damage to the tattoo art and also provoke scarring. Tattoo bubbling is also easy to get caught on clothing which can pull scabs off. Here are some pointers to help avoid problems related to tattoo bubbling:

Tattoo Bubbling Prevention

  • dry tattoos well after washing
  • use thin films of tattoo lotion, don’t “goop” it on

Tattoo Bubbling Treatment

  • stop washing your tattoo until the scabs are fully dried out
  • stop using tattoo lotion until tattoo bubbling has fully resolved
  • while your tattoo bubbling is present, be very careful to avoid scabs being torn off


Scars From Tattoos: Allergy

Red pigments have been shown to be the most likely color to cause a tattoo allergy. Allergic reactions can cause various degrees of skin inflammation and irritation from mild redness and itching to severe dermatitis. In some cases, the allergy is made worse in sunlight, and some allergies only come on years after the tattoo was done. When a severe allergic reaction occurs, skin inflammation can cause damage to the skin that could lead to scarring. Also, itchiness associated with tattoo allergy can provoke scratching which can dislodge scabs or damage the skin in other ways that could provoke a tattoo scar to form. If you believe you are experiencing a tattoo allergy:

  • avoid scratching to prevent skin damage and possible scars from tattoos
  • contact your tattoo artist to let him or her know what’s going on
    • ask for a list of the types of ink products used
  • see a doctor if the reaction persists who may prescribe oral antihistamines or cortisone products
Image showing allergic reaction to tattoo ink that can lead to scars from tattoos
Blistered and scabbed tattoo

Scars From Tattoos: Infection

A tattoo infection can present itself as spreading redness, warmth, increasing pain, and tenderness. Symptoms can then progress to fever and general unwellness if not treated. Infection can cause scars because of the inflammation and additional scabbing it causes. Both can damage deeper skin layers and provoke a noticeable tattoo scar. To help avoid a tattoo infection, take it upon yourself to:

  • ensure you are going to a reputable tattoo professional
  • confirm that needles are one-time use and sterile
  • ensure sterile gloves are being worn by the tattoo artist
  • ask for information on the pigments being used for your tattoo (color, manufacturer etc.)
  • follow post-tattooing instructions carefully
Tattoos are basically minor surgical procedures and should be done with disposable gloves

Scars From Tattoos: Granulomas

Tattoo granulomas can form as a result of the body reacting to pigments in the ink. This is similar to how your skin would react to a splinter that is not removed. Inflammation and bumpy growths that are either minimal or quite extensive are the results. Tattoo granulomas often occur only in parts of a tattoo that are of a certain colour. This is because different colours are composed of different types of metallic ions that the skin may or may not react to. Tattoo granulomas can be difficult to treat and may need intervention by your doctor such as cortisone injections or even tattoo removal. Scars from tattoos can result from tattoo granulomas because of the inflammation and damage the granulomas can cause to the deeper dermis of the skin.

Scars From Tattoos And Personal Scarring Tendencies:

How any individual is “programmed” to heal is determined by an incredibly complex interaction of factors such as genetics, body area being tattooed, skin tone, and many others. Some individuals are simply more at risk to form noticeable scars from tattoos than others. For this reason, the tattoo artist can’t fully control when a client scars from tattoos. To understand what tattoo scars can be like, let’s take a step back from tattoos momentarily and look at three main types of scars seen after any type of skin injury:

Type Of ScarWhat They Look LikeExample
normal/maturefine, flat and blend well “good scars”Normal breast implant scar that is fine and flat
hypertrophicraised, red and thicker type of scar
keloidconsidered the worst scars extensively raised, thick, discolored; grow far outside the area of the injury to the skinKeloid skin scar that is very raised thick red and raised
widespreadflat, pale, wide, and stretched scarsA wide flat stretched skin scar

Tattoo Keloids: The Worst Case Scenario

Tattoo keloids are the thickest, heaviest, and frankly, the most unsightly type of tattoo scars. Both hypertrophic scars and keloids can also be itchy and tender. Tattoo keloids are by far the most dreaded form of tattoo scars because they grow far outside the boundaries of the tattoo, and can grow to extreme sizes. They are also very difficult to treat once they occur. For that reason, understanding your tattoo keloid risk and reconsidering proceeding if it is substantial is likely the best approach to avoid this devastating type of tattoo scar. Tattoo keloids are most likely to form in certain body areas like the shoulder or middle of the chest. A tattoo keloid is also more common in certain ethnic groups, especially those with darker skin. A family history of keloids has also been shown to be a risk factor for tattoo keloids.

A tattoo of a whale that turned into a large keloid tattoo scar
This tattoo of a whale formed a major keloid
Keloids on an arm that resemble keloid scars from tattoos
A tattoo scar that forms keloids can look like this


Tattoos are more popular than ever. They provide a means of self-expression matched by few other forms of body art. Most tattoos heal perfectly well, providing clients results they’re proud of. In some cases, scars from tattoos form as a result of problems with tattooing technique, healing complications, and personal healing tendencies. Knowing how to care for your tattoo and understanding your own personal risks for forming a problematic tattoo scar such as a keloid are the best approaches to avoiding this underestimated problem.

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