Now You See It, Now You Don’t

Uncovering scar camouflage


Permanent makeup expands much further than the well-known and popular cosmetic applications. Scar camouflage is hugely in demand. Even the smallest scar that is well camouflaged can be life-changing for an individual. Scar camouflage not only helps someone regain lost confidence but face the world with assurance. Often, you will even see a buoyancy in their step. As a practitioner, the reward is tremendous! 

Although most definitions of camouflage refer to what our soldiers wear, the most accurate descriptions of permanent makeup scar camouflage are these five types: concealing coloration, disruptive coloration, disguise, mimicry, and deception. You will notice none of these definitions refer to DISAPPEARANCE, and it is critical to explain to clients that their issue will not disappear but can become well concealed. 

Even the smallest scar that is well camouflaged can be life-changing for an individual”

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Scar camouflage requires additional training not included in fundamental makeup courses but is often grouped with areola training. It should not be part of a practitioner’s repertoire without proper training. Understanding color theory is a must to perform successful camouflage. However, many courses in color theory tend to be too complicated and don’t relate to the color components of human skin. Skin is a living medium, and quite different from selecting colors to paint a wall.  

Understanding Ethnicity is Imperative 

One’s DNA will determine how their scars both form and heal. There are ethnicities whose scars tend to keloid, heal raised or hypertrophic, or heal much darker color than their surrounding skin tone. This is referred to as hyperpigmentation. Keloids can be found in facelift scars on fair women, especially behind the ears, as well as on African Americans. 

Keloids should not be tattooed, but instead referred to a dermatologist or surgeon that may reduce them with injections or laser prior to camouflaging. Hypertrophic scars can be camouflaged, but when in doubt, refer clients to a dermatologist for either treatment or medical clearance. Hyperpigmented scars are very sensitive to any intrusion, which can make them appear darker.

Keep It Simple!

Breaking through the often muddled and unrelated information on color, human skin can be broken down into three main color components: Pink, Beige to Brown, (depending where the client falls on the Fitzpatrick scale), and Gold. These apply to both warm and cool undertones. 

One last piece of critical information is the understanding and appreciation of white, which is Titanium Dioxide, used more heavily in fair, flesh-toned pigments, for Fitzpatrick’s 1 to a fair 3. To match these fairer complexions, these pigments will contain a greater degree of Titanium Dioxide. 

Titanium Dioxide consists of a very large particle size and will outlive the Pink, Beige, and Gold. It never leaves the skin! It will tend to float to the skin surface after time, and even appear dimensional, like cottage cheese. Worse yet, it will turn a yellowish color and become even more unsightly. 

We often see this unsightly effect when a practitioner attempts to cover a mistake with a light, flesh-tone pigment loaded with Titanium Dioxide, and presents this dimensional, yellowish color that appears to be floating above the skin surface. 

A simple solution for greatly reducing the amount of Titanium Dioxide when selecting a color match for fairer complexions is to select a deeper shade of the client’s skin tone and dilute it with sterile water. This is generally a light to medium brown shade, which will have less Titanium Dioxide. Adjust the Pink, Beige, and Gold, as though you are creating a darker foundation makeup. Once you have achieved this deeper shade of their skin tone, dilute with sterile water. 

Always smear this color over the area to be camouflaged to see if you have a good match. Make any adjustments before you begin to tattoo. 

Needle Selection 

Needle selection will vary according to the size and shape of the scar. Many requests for camouflage consist of white or light scars from surgeries, accidents, scars from dog bites, face lifts, hair transplants, cleft lips, breast reductions, mastectomy scars, vitiligo, self-mutilation scars, burn scars, and stretch marks. These can all be achieved with the above color matching tips. A great exercise is color mixing for various complexions. You will be more confident when you actually begin working on clients. 

Scars should be healed for at least 12 to 18 months, with the exception of red or purple scars. It is during this initial time that most scars will tend to change by lightening in color and even flattening out. Self-mutilation scars must be healed for 12 to 18 months with no new areas appearing injured. It is recommended the client has undergone treatment for this behavior before you engage.  

Vitiligo should be in remission for a minimum of one year, with no new areas appearing in that timeframe. Attempting camouflage on vitiligo of the hands is often not as successful as other areas of the face and body since they are washed and used constantly. Hands can also be quite uncomfortable for the client. 

Stretch mark camouflage may not be as successful as you or the client had hoped for, since the texture is often difficult to disguise. Micro-needling may help reduce the sheen on these scars prior to camouflaging. Hypertrophic scars (raised scars) can be reduced with micro-needling or laser before performing camouflaging.  

Red or purple scars may not be ready for camouflaging, since this is often an indicator that the scar has not had the 12 to 18 months of healing prior to camouflaging. Red, purple, or dark scars require a different approach for camouflaging, which is actually the direct opposite of white scars. These scars REQUIRE Titanium Dioxide to block the red, purple, or darkness. Mixing a color that matches the surrounding skin, or even a shade lighter, will help to conceal these scars. 

Develop Your Eye

Practicing color mixing on your friends, family, or clients helps prepare you and develop your eye for the balancing of Pink, Beige or Brown, and Gold. 

Always smear your formula across the area you are camouflaging, allow it to dry, and ask yourself “what is missing and what does this formula still need?” It will be one of those three components. 

If you have taken a class in scar camouflage and are still new to it, work on scars that are hidden and only camouflage a small area of the scar. Do not start on the next area until you Have your client return for an evaluation.

After two weeks, you can see if your camouflage formula was on point, or what you would do differently on the next area of the scar. Allow six weeks for healing before the next camouflage session. Let your client know this will take multiple sessions to complete, but don’t commit to how many applications their scar camouflage will take. Remember, don’t overpromise, let your client be pleasantly surprised! 

How Do You Price the Unknown? 

Charging by the visit is best to ensure you won’t quote a price you will regret. For the initial color test on the scar, quote something reasonable, so your client feels they can afford to return. A good rule of thumb is half of what you charge for your brow procedure for the initial color test. If it takes 90 minutes for a brow procedure, structure your fee to be half of your brow fee and allow 30 to 45 minutes to perform the color test. If you are finished quickly, discuss and plan their future visits while they are with you. For future visits, determine the length of time your next step will take and price it accordingly. These are simply suggestions to help guide your pricing.