Recently Karen Hudson (tattoo.about.com) had contacted me to do an interview about Scarification for the book she has written (Living Canvas) that is now on the bookshelves across North America.  It's a comprehensive book about all major forms of body art and includes a section on scarification.

Karen Hudson has been writing for About.com since 1999.  Tattoos, body piercings and other forms of body modification are her passion.  She loves being able to help people as they embark on their own journey toward self discovery and expression through body art. Karen's goal is to preserve the reputation and respect of this art form through education, by teaching people the importance of safety and serving as an advocate for body art acceptance in the modern world.

If you only do cutting, why do you choose that method over branding? Have you tried both methods?

Although I have never tried branding, through research I have found that cutting allows me to have more artistic freedom over the design and produce a more intricate looking scar.  I find I can do more than basic geometrical shapes when using a scalpel.  Plus the smell of branding has always offended me!

When someone mentions “Scarification” most people assume its “Branding” automatically.  Branding is described as burning the skin, usually with a heated piece of metal.  Scarification by cutting is simply what it sounds like…using a scalpel to cut an image/design into your skin to eventually turn into a scar.  

What tools are used to effectively perform the initial cutting? This includes even minor items needed – what do you have to have set out before you can get started?

The tools needed are relatively simple, the main tools being a scalpel handle and multiple sterile blades.  I also use Nitrile gloves, disposable sleeves, disposable apron, face mask, sterile gauze, and antiseptic skin prep.  There are multiple types of blades available for a scalpel.  I have experimented with many different blades until I found two types that I frequently use for most of my cuttings I perform.  Similar to how an artist would use multiple paint brushes to create different effects for a painting, the same is similar to using different scalpel blades for scarification.  Some blades are curved, straight, smaller and larger all resulting in different uses depending on the design I am cutting. 

What kind of consultation do you go through with a client before you will do this procedure on them?

I like to meet in person to discuss the procedure from start to finish educating the client about the whole process.  During the consultation I will discuss their design ideas, the size and placement on their body they want to get it done.  Sometimes we will both come to the conclusion that a tattoo would be better suited for what they are looking for.  I will also ask if they have any other scars on their body so I can get an idea “how” they scar.  I’ll touch base on the aftercare, risks and healing methods.  I’ll also try to discuss what kind of job they may have which can determine how to take care of it or where on the body would be best suited for the cutting.  Most of the time clients have found me by doing there own personal research about scarification so they have some basic knowledge about the procedure.  Basically I like meeting first to break down the whole “Client/Artist” relationship.  I like getting to know who I will be leaving a permanent scar on.  Out of town clients are more difficult to do this with but a simple phone call or multiple discussions through email is a good way to start. 

Most warnings are discussed through the initial consultation.  The basics being infection control and proper aftercare methods used after the cutting is completed.  I also have to warn them about the outcome of the scar itself.  It’s impossible to tell someone how their scar will look once it’s healed.  Some peoples scars will raise, some will indent, some will be very pink/red/purple while some people’s will scar more white and hard to even see the end result.  For some clients this is what intrigues them about scarification.  It is one of the only body modifications that your own body has complete control on how your scar will turn out.  It’s a real gamble as I can cut the same design on multiple people in the exact same spot on their body yet it can heal completely different on each client.  To many people this uncertainty is scary and would probably choose getting a tattoo instead of a scar.    

I’ve helped out many different clientele from different age groups both male and female.  I would say most of my work has been done on people between 18-35 years old.  One of my favourite clients was a middle aged professional woman with existing “self cutting” scars on her inner forearm from a darker period in her early teenage years.  She came to me with hope that she could be proud of showing off her arm once again as she mainly wore long sleeve shirts year round to hide these scars.  After a consultation with her we decided on a flower design that incorporated and disguised her self inflicted scars.  Now it’s a positive scar that’s she’s proud to show off rather than a negative memory. 

Would you consider the people that choose scarification to be more “hardcore” or edgy than tattoo clients?

Nope, some of my clients have never even been into a tattoo studio before.  Many have found it hard to believe they have found an artist that can help them out with the body modification they were hoping for.  This form of scarification is solely for people who enjoy the look of scars.  Others may love the feeling of a healed scar.  Just like many people get tattoos and piercings to decorate their bodies, the same is true with scarification.  Some people prefer the look of scars vs. ink or jewellery.  This is no way related to self cutters who harm themselves. 

Some clients have existing scars which remind them of terrible times in their lives, such as car accidents, self cuttings, work related injuries etc.  I can usually sit down with a client and discuss a way to turn their negative scars into a positive piece of art.  By creating a new scar this is usually a turning point in their lives.  Many people have their own personal reasons for getting body modifications and I believe that everyone I've worked with has left our studio changed for the better in some way.

Is cutting considered a surgical procedure? Does the law have any specific requirements (at least in your area) in regards to this kind of practice that is different from tattooing or piercing?

Unfortunately in the area of Canada that I live in there are no regulations for tattooing, piercing or scarification.  Hopefully in the near future this will change as long as health board officials and government are fair with the regulations they set forth.  I would hate to see them ban all body modification instead of having a properly licensed industry.  This would help keep our industry safer and help keep some less qualified amateurs from operating poorly run establishments.

Can you walk me through the process? Do you do a stencil first like before a tattoo? Is it done the same way as a tattoo stencil? What do you do first?

Yes it is quite similar as setting up to do a tattoo.  First I prep the skin, and then apply the stencil of the design on your body.  Once the stencil is in place and agreed on the body placement we can start the cutting process.  First I start outlining the whole design with a scalpel, very shallow, just enough to break the skin.  This stage feels quite similar to getting a tattoo.  The reason I do this is just incase part of the stencil gets smudged or removed during the cutting.  As I am constantly wiping the skin and keeping the area clean so it’s quite easy to loose part of my stencil in the beginning. 

Once the design has been lightly cut, I now apply the topical anaesthetic which penetrates into the shallow outline.  This helps control the bleeding significantly and also helps dull the pain during the procedure.  Now I can concentrate on re-outlining the whole design making sure to cut to the proper depth and width making a uniform looking outline throughout.  Most of the cutting I do does not require “skin removal.”  The outlines are created mainly by cutting at the correct depth and width which opens up the skin to get the desired result.  Sometimes the design I’m working on will require some minor skin removal, such as the inner parts of the four leaf clover design, or the belly and tail of the dragon I did on my client’s ribs. 

Once everything looks great to me and the client, I’ll clean it one more time, bandage it, and discuss aftercare one final time before they leave. 

What do you need to watch out for?  How do you keep it clean while you’re working when there is a lot of blood loss?

During the cutting process I’m always aware of how my client is doing.  Usually this is done by having regular conversation with them which helps keep their mind off the procedure and makes it much easier.  Most clients will describe the pain of cutting similar to getting a tattoo.  The blood flow during the cutting procedure is quite minimal due to a topical anaesthetic spray that I use.  Typically used as a pain reliever for tattooing I’ll use this spray to help take some of the “edge” off.  The epinephrine in the spray helps shrink the blood vessels which will slow down the bleeding allowing the anaesthetic to work longer.  This helps both the client and me immensely.  The client sits more calmly and with the restricted blood flow it helps me see how deep or wide my cuts are allowing me to be more precise with a uniform looking end result.  During the cutting I’ll use sterile gauze to help absorb any excess bleeding.  

Some people can scar with minimal effort while others are much more difficult to scar.  Each part of the body will determine how deep or wide I would need to cut.  It’s important not to cut too deep yet also not to shallow so it disappears.  It’s a difficult process to cut at a precise depth/width throughout the whole design but with many years of practice it has gotten much easier. 

What do most of your clients think of it? How does it feel in the few days after getting it done?

Most will describe it as irritating, especially if clothing is rubbing on it frequently.  Usually during the first few days of the healing process it will sting when you’re in the shower with direct water spraying on it.  Then over the next few weeks or months it will become itchy and annoying at times.  This eventually goes away.   

If a client is in a lot more pain than anticipated, how do you coach them through it? What do you suggest to cope with pain?

Breathing is very important.  I’ve met many clients in the past that will continue to hold their breath when they are getting a piercing, tattoo or scar done.  Usually this results in the client passing out.  I just like to ask a lot questions that the client has to answer to keep their minds active and off of the procedure itself.  Once we’re talking and joking around it usually helps ease their mind.  

Is there ever a danger of the client going into shock with very large designs or significant blood loss?

Going into shock and passing out is very uncommon but can definitely happen.  Eating properly and being healthy with plenty of rest before you appointment will usually help out a lot.  If a piece is too large I may suggest breaking it up over a couple of appointments instead of just one long one. 

I believe one of the main dangers of getting any scarification is the lack of qualified artists performing these procedures.  Many artists will just decide to try it out because they saw it done online or they’ve heard of another person doing it in their city so they decide to just “give it a try.”  If you’re seeking out a scarification artist be sure to ask a lot of questions and do as much personal research as you can.  Also check out their portfolio of scarification including some healed pictures as well.  Infections are also a concern but with proper wound care it is minimized significantly. 

Trying to get a feel for how long the process takes. This clover you did-About how long did that take in comparison to something larger and more detailed like this dragon?

The clover design on the back of the calf took about 1.5 hours and the dragon on the ribs was approximately 4 hours.  

Once the process is done, I’m guessing you bandage the client up? What aftercare products do you recommend to them and what is the aftercare process?

Common sense is a huge part of the healing process.  I’ll bandage the cutting immediately afterwards and instruct the client to keep the bandage on over night.  Then remove the bandage and wash the cutting with warm water and antibacterial soap.  If the wound starts to bleed again I’ll recommend bandaging it once again for a few hours then repeat the cleaning process.  It’s important not to keep the cutting bandaged all the time as it provides a nice warm environment for bacteria to breed in.

Obviously, the purpose is not to HEAL the wound, but to create a scar – how do you do that and keep it safe and clean at the same time?

I’ve heard of many different ways to slow down the healing process of a scar.  Some people will irritate it using lemon juice, or agitate it with a new toothbrush.  I prefer just using the “leave it alone” method by just keeping the wound clean and letting your body do the healing on its own.  I find this way the safest method and it usually heals in a more uniform looking scar.

With improper aftercare or getting a cutting by someone that is not using sterile equipment or not using proper infection control practises can result in some dangerous infections.  Staph infections such as MRSA are definitely a more serious issue that can occur.

Keep an eye open for abscesses (pus filled deposits under your skin), boils, small red bumps or pus filled blisters around the cutting.  If you’re ever unsure about what it might be it’s best to have a doctor check it out immediately.

How often does a client lose part or all of the design due to improper scarring? Is there anything that can be done at that point, other than re-cutting?

It’s possible to re-cut certain areas of the scar that didn’t heal the same as other parts on the design.  Although it isn’t too common for people to come get re-cut, it is a possibility.  I try to not do any touch ups to the cutting until at least one year after it’s been cut.  As it can take a while for a cutting to heal it may change over the course of the year.  I suggest it’s always best to wait before re-cutting the design too soon if needed.  

Scarification has quickly become a new passion of mine.  Although I was fascinated with many cutting artists in the early stages of my piercing career, I waited until I absorbed as much knowledge as possible before I agreed to do my first cutting.  When I became intrigued by scarification I really noticed Blair and Lukas Zpira’s art.  Both these artists were making beautiful scars.  I remember always comparing my earlier cuttings with their portfolios to encourage me with improving my skills. 

Since I started cutting in 2003 I've been lucky to work along side some of the best scarification artists in the world.  Scar Wars (www.scarwars.org) is the first convention of its kind dedicated solely to the art of scarification and brought many of us artists together to share ideas and techniques.  Check out Wayde Dunn, John Joyce and Ryan Ouellette just to name a few scarification artists really pushing the boundaries of scarification.  

I've also traveled doing guest spots and scarification around North America.  Some travels have brought me to Quebec City, Las Vegas, Philadelphia, Los Angeles and Montreal.  I love taking my passion on the road.  Some future tour goals would be Japan, Australia, Europe and Brazil.

I’m guessing blood must not bother you much—do you even see it or do you only see the art you are creating?

Blood doesn’t seem to bother me much at all.  As I’ve been a piercer for almost 9 years now I’ve seen my share of blood and I haven’t had much of a problem with it.  When I’m doing a cutting on someone they are usually shocked how little it bleeds.  I try to keep the area as clean as possible at all times so it doesn’t freak out the client if they were to suddenly look at what I’m doing.  Blood seems to spook a lot of people as blood is usually associated with pain so once you see blood it seems to hurt more.  I try to keep the areas of the cutting covered with sterile gauze during the procedure so it’s not so scary looking. 

You seem to have taken scarification to a higher level than many – there is a caliber of quality to your designs that I haven’t seen anywhere else.

Thank you!  I am glad to have met other scarification artists that are willing to share information with me.  There are only a small percentage of people in this industry that are doing some amazing scar work.  Luckily many of us are close friends and we talk frequently online always offering each other some helpful tips and constructive criticism.  We try to all meet up at least once a year at Scar Wars or at the APP (Association of Professional Piercers) convention to discuss new techniques and share our secrets.  Getting to work beside some of the best scarification artists is the best way to improve our skills.

Is there something that you do that makes the difference between you and the other scarification artists out there?

I believe my passion for scarification shows through with each piece of my work.  I really enjoy helping clients through their transition during these modifications.  Talking with people and helping them through a difficult and stressful event such as getting a cutting is very rewarding.  Each client has their own personal reasons for getting a cutting done and I will take my time to ensure that each client receives the experience and expertise they deserve. 

I am constantly continuing my education within the body modification industry. Each year I attend the week long APP conference in Las Vegas. At this conference we have an opportunity to partake in many different classes specifically dedicated to the piercing industry. Some yearly classes I've attended are bloodborne pathogens, first aid, infection control, anatomy, piercing techniques, studio set up and inspection just to name a few.

One of my specialties would be making each client feel comfortable during the whole procedure.  I maintain an excellent rapport which is long lasting even after they leave our studio.  I will also put the safety of my clients first.  It is very important to me that you are 100% satisfied with your visit and all your questions are answered before you leave our studio.

Yes I do.  Before I started doing any scarification on clients I wanted to experience it for myself first.  My artist of choice was Blair in Toronto, Canada.  As we’ve met a few times prior I felt really comfortable with him and we finally set a date to get it done.  Blair cut a 4 inch cherry blossom design into the back of my calf.  I was extremely pleased with the outcome and have since thought about adding more to it. 

Below is an example of my scarification work on YouTube...enjoy!