Definition & Overview

Tattooing or the intradermal introduction of insoluble opaque pigments to correct colour skin defects including micropigmentation is a procedure used wherein permanent colours are introduced on the skin by puncturing the skin. Traditionally, tattoos are used for decorative purposes, but nowadays they are also being used for several other cosmetic purposes, such as covering up unsightly skin defects. The procedure can be used to reduce the appearance of scars, birthmarks, or skin discolouration, among others.

Who Should Undergo and Expected Results

Patients who should undergo tattooing as a cosmetic procedure are those who suffer from colour skin defects or skin pigmentation disorders. These are conditions that cause an abnormal mark or colour on the skin, such as:

  • Birthmarks
  • Scars from wounds or injuries
  • Sunburn
  • Light or Dark patches
  • Surgical scars

Since the colour of the skin is influenced by the pigment called melanin, any problem that affects the melanin may cause abnormal discolouration of the skin. Unfortunately, the melanin cells in the body can sometimes become unhealthy or damaged. Skin pigmentation disorders, which can affect either the entire body or just small parts of it, include:

  • Vitiligo, or a condition that causes patches of lighter-coloured skin to appear
  • Addison’s disease, or a condition that causes a bronze discolouration of the skin, among other symptoms, due to the inadequate secretion of hormones produced by the adrenal cortex
  • Hypopigmentation
  • Hyperpigmentation

Other factors may also cause skin discolouration, such as pregnancy and excessive sun exposure.

Tattooing, which also includes a procedure called micropigmentation, works by introducing insoluble opaque pigments intradermally with the goal of mimicking the patient’s normal skin colour. By doing so, any surface colour skin defects will no longer be visible.

While micropigmentation and tattooing are similar in many respects (both involve the introduction of pigments into the skin), the two procedures typically produce different aesthetic results. This is because tattooing uses tattoo needles that penetrate the skin deeper. Thus, it usually results in colder undertones. Micropigmentation, on the other hand, requires a more complex procedure that may take multiple sessions to complete.

How is the Procedure Performed?

Tattooing is performed with the use of a handheld tattooing machine with a needle attached to one end. The machine pierces the skin repeatedly with the needle. With each puncture, the needle also implants an insoluble opaque pigment into the skin. The procedure, which is often performed without anaesthesia, may cause some pain accompanied by a small amount of bleeding. The procedure can produce complete results after just one session.

Micropigmentation, on the other hand, may require 2 to 3 sessions, and the patient may require a touch-up after 30 days.

Possible Risks and Complications

Tattooing makes several small punctures on the skin surface, so there are some risks and potential complications involved in the procedure. These include:

  • Allergic reactions – The pigment dyes used in tattooing procedures can cause allergic skin reactions that may, in turn, cause symptoms such as itchy rashes.

  • Skin infection – It is possible for the skin to become infected due to the procedure.

  • Bloodborne diseases, which may occur if the equipment used is contaminated with blood that is infected with bloodborne diseases such as tetanus, hepatitis B, and hepatitis C

  • Granulomas – Sometimes, raised bumps called granulomas may form around the area where the insoluble opaque tattoo pigments were introduced.

  • Keloids – Tattooing can also cause an overgrowth of scar tissue that may result in keloid formation.

Patients who experience allergic reactions or infections following a tattooing procedure should seek medical treatment.


  • “LeBlanc P, Hollinger KA, Klontz KC. “Tattoo ink-related infections – Awareness, diagnosis, reporting, and prevention.” N Engl J Med 2012; 367:985-987.

  • Glassy CM, Glassy MS, Aldasouqi S. “Tattooing: Medical uses and problems.” CCJM 2012 Nov;79(11):761-770.

  • Garg G, Thami GP. “Micropigmentation: tattooing for medical purposes.” Dermatol Surg. 2005 Aug; 31(8 Pt 1):928-31.

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