There’s a lot of confusion about whether tattoos cause keloids. Some warn that you should never get a tattoo if you’re prone to this type of scar tissue.
If you’re unsure about whether it’s safe for you to get a tattoo, keep reading to learn the truth about keloids and tattoos.
A keloid is a type of raised scar. It’s made up of collagen and connective tissue cells called fibroblasts. When you’re injured, these cells rush to the damaged area to repair your skin.
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You can also get a keloid from a tattoo. To seal the ink into your skin, the artist pierces your skin again and again with a needle. This process creates many tiny injuries where keloids can form.
Keloids are hard and raised. They have a smooth and shiny surface, and they can hurt or itch. Keloids stand out, because they’re typically reddish-brown and end up longer and wider than the original area of injury.
A hypertrophic scar forms when there’s a lot of tension on a wound that’s healing. The extra pressure makes the scar thicker than usual.
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The difference is that keloid scars are bigger than the area of injury and they don’t fade with time. Hypertrophic scars are only in the wound area and do tend to fade with time.
Your artist may be able to use an ink that’s less likely to show on your skin — like white ink on pale skin tones — to tattoo a dot or a small line. If you don’t develop any scar tissue during the healing process, you may be able to get a tattoo here or elsewhere.
The practice of inking over a keloid is called scar tattooing. It takes a lot of skill and time to safely and artfully tattoo over a keloid.
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If you’re going to tattoo over a keloid or any other scar, wait at least one year to make sure your scar has fully healed. Otherwise, you might reinjure your skin.
Choose a tattoo artist skilled at working with keloids. In the wrong hands, the tattoo might damage your skin even more and make the scar worse.
If you already have a tattoo, watch for thickening skin that looks rounded over the inked area. That’s a sign that a keloid is forming.
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If you do see a keloid start to form, talk to your tattoo artist about getting a pressure garment. These tight clothes may help minimize scarring by compressing your skin.
Cover up the tattoo with clothing or a bandage whenever you go outside. UV light from the sun can make your scars worse.
As soon as the tattoo heals, cover the area with silicone sheets or gel. Silicone can help slow the activity of fibroblasts and collagen formation, which cause scarring.
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Silicone sheets reduce the production of collagen, the protein that comprises scar tissue. They also prevent bacteria from getting into the scar. Bacteria can trigger excess collagen production.
You can also see a dermatologist with experience treating keloids — specifically tattoo-related keloids, if possible. They may be able to recommend other reduction techniques.
There’s no solid evidence that over-the-counter creams like vitamin E and Mederma shrink scars, but there generally isn’t any harm in trying.
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Keloids aren’t easy to get rid of permanently. Your provider may need to use more than one of these methods to fully remove the scar — and even then it may come back.
Keloid removal can also be expensive. It’s generally considered to be cosmetic, so insurance may not cover the cost. Your insurer may consider paying for part or all of the removal process if the scar affects your movement or function.
Removing a keloid that has grown on a tattoo may have a negative effect on the ink. It ultimately depends on how close the keloid is to the tattoo and which removal technique is used.
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Using more than one treatment method can increase the likelihood of permanent removal. For example, getting corticosteroid injections or cryotherapy and wearing pressure garments after surgery can help reduce your risk for return.
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