EWJ June 2024 web - Journal - Page 66
The Benefits of Medical Tattooing
Within the Rehabilitation Process
by Rae Denman-Tanner
Rae Denman Medical Tattoo & Expert Witness Ltd
“Scarring may be skin deep but their psychological
impact goes deeper still. The evidence is decisive; the
presence of scars can result in clear markers of mental disturbance in patients with associated symptoms of
depression, anger, anxiety, and post-traumatic stress.
A scar creates physical, emotional and psychological
marks. Identity is called into question and individuals
must integrate the scar with their sense of self in order
to achieve psychological acceptance. This process
causes a change of behaviour and reduced functioning, socially and psychologically, driven by a fear of
being singled out. This is supported by the theory that
scar visibility acts as a mediator of psychological distress; thus, hiding the scars relieves maladaptive behaviour and often leads to a return to normal
functioning. Leaving us with hope that these psychological scars can be managed and even reversed.”
The change in appearance threatens sense of self and
personhood. Patients must grieve for what has been
lost and often there is a lack of continuity between the
two self-images.’
The impact of the visible difference is not measured by
whether the area of concern is big or small, can be covered by hair, makeup or clothing, is obvious or even
barely visible. The impact is more often a deeper emotional response.
Scarring can impact a persons return to socialising,
relationships and confidence. Rehabilitation aims to
increase a persons independence and physical
function after injury and to a return to as much of the
previous ability as possible. A typical route to rehabilitation may involve scar revision surgery, laser treatment and physiotherapy to improve the quality and
reduce visibility. However, a scar cannot be fully
removed and will often remain visible due to its
discolouration.
As a Medical tattooist, I am often in the final stage of
a patient’s recovery from trauma or surgery, and regularly presented with patients requiring my expertise
to help reduce the visible impact of their scarring.
Physiological effects of scarring:
• Refraining from wearing certain items of clothing
• Deflecting intimate or personal relationships
• Avoiding public environments
• Inability to work
Medical tattooing is the process of implanting medical
grade pigment into the dermal layer of skin to camouflage and colour it, in order to recreate the surrounding skin tone. Any part of the body can be
treated, as well as any skin tone. There will be different recommendations depending on skin tone, age
and texture of skin, and the type of scarring and how
it has healed. Other features such as freckles, veins
and blood vessels can also be tattooed to help add
realism to the area.
Medical Tattooing can visibly reduce the appearance
of a scar by blending the colour of the scar into the
surrounding skin tone. It will draw the attention away
from the scar so that the client does not focus on it as
much, and that strangers/friends at a conversation
distance are not drawn to look at it and comment.
A scar is a mark that is left on the skin after a wound
has healed. They occur as a natural part of the healing process. Scars tend to fade over time although
they never completely disappear.
It negates the requirement for cosmetic camouflage
cream which although is a very good solution, is time
consuming on a daily basis. Moisturisers, sun protection, makeup can all be used over medical tattooing
once it is healed. It is a low risk treatment with the
main risk being infection which is minimised by an
aseptic work environment and the client following the
aftercare routine.
Medical Tattooing does not remove scarring, but does
make the scar look visibly reduced, sometimes invisible. It is gently invasive with no risk of any added scarring as the needle doesn’t penetrate deep enough.
The pigment will retain it’s colour, but can be faded by
UV rays, use of retinol products and the body’s lymph
system. Colour boosts are required every one to five
years, to keep the area looking optimised, realistic and
camouflaged.
Scars that can be visibly reduced with Medical
Tattooing;
• White or paler than the surrounding skin.
• Healed and sealed (Scarring needs to be fully healed
which can range from 3-6 months for some minor
surgical procedures to 6-12 months. Scarring can be
older than this without any negative effect to the tattooing result)
• Smooth or within 0-0.5mm change in depth (raised
or indented)
A typical route to rehabilitation
‘Following a critical incident, previously held beliefs
about one’s self are called into question and reevaluated. One theory by Moss & Rosser 2012, describes
the skin as a protective barrier separating self from the
environment. A scar can be viewed as an intrusion the barrier is no longer whole and one is left exposed.
EXPERT WITNESS JOURNAL
64
JUNE 2024