On Thursday 1 October, I had the opportunity to speak at the Motor Accident Solicitors Society (MASS) conference. My presentation, ‘Working with Scars: The Treatment Pathway in Medico-Legal Practice’ brought together two parts of my work: medical tattooing and my role as an independent expert witness.

A very warm welcome

The evening before the conference, I joined some of the MASS organisers for a drink and dinner at a Greek restaurant. They made me feel welcome straight away. It was a relaxed evening, and I enjoyed talking with people who work in the legal field and share knowledge through the conference.

The next afternoon, I stood up to speak to an audience of solicitors. It was my first time presenting to this audience, and I hoped to explain my work clearly and show why a proper understanding of the scar treatment pathway matters.

Why talk about this with patients?

Most people who know my work know me as a medical tattooist. They may be looking for help with a scar, a skin graft, pigment loss or another visible difference. My medico-legal work sits alongside my clinical work, but it has a different purpose: to give an independent clinical opinion when someone’s injuries and future needs are being considered as part of a legal claim.

Why might that matter to a patient? Because a scar is not always the end of the story. Its appearance can continue to change as it heals and matures. It may affect comfort, movement, confidence and everyday choices. Someone may spend time covering it, avoid certain clothes or activities, or feel anxious about other people noticing it. That impact may not be clear from a photograph or a short description alone.

An expert witness is there to provide an objective opinion, not to argue for either side. My duty is to the court. I look at the scar’s colour, texture, symptoms and effect on the person, as well as the treatment they have already had. I consider what further options may be suitable, what each could realistically achieve, and what care and costs may be needed in the future. Medical tattooing may help some people, but it is not right for every scar.

A scar treatment pathway

There is no single treatment sequence that suits every scar. Depending on its age, colour, texture, symptoms and location, options may include scar revision, laser, scar physiotherapy, microneedling, medical tattooing or skin camouflage. These treatments can be used at different stages, and camouflage cream may be useful while other options are being considered. The important thing is to understand what is suitable, and when.

Medical tattooing places pigment into the skin to reduce colour contrast or restore the appearance of a feature. It cannot remove a scar, flatten a raised area or correct significant changes in texture. Some scars need other treatment first; some may not be suitable for tattooing. Pigment can fade or change over time, so future colour boosts will be needed. A realistic plan considers both likely improvement and ongoing care.

That was central to my presentation. The useful question is not simply, “How much will medical tattooing cost?” It is whether treatment is suitable, when it should happen, what improvement is realistic, how many sessions may be needed, and what provision may be appropriate in the future. A cost without that clinical pathway is simply a figure. A properly assessed treatment plan gives that figure meaning.

Thank you, MASS

I came away feeling thankful: to Jane, Sue and Paul for inviting me and making me feel so welcome; and to everyone who listened. Speaking to a medico-legal audience for the first time was a nerve-racking step, but it was a privilege to share how clinical experience can help explain the options, limitations and future needs connected with scarring.

For patients, I hope the main point is simple: a scar is not necessarily the endpoint. There may be options to explore, and it is reasonable to want clear information about what they can and cannot achieve. Good planning starts by understanding the whole pathway.

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