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Background. Unsightly scalp scars, refractory to surgical revision, can pose a difficult therapeutic problem. Application of cosmetics for camouflage is time consuming, repetitive, expensive, and seldom satisfactory. Treatment of scalp scars with micropigmentation has never been reported.

Objective. To show that iron oxide micropigmentation of scalp scars is simple, safe, and effective.

Methods. A commercially available micropigmentation system, sterile needle assemblies, and appropriately colored iron oxide pigments were used in all procedures. Due to the varying textures of scalp scars, greater force was required in some areas to achieve proper needle penetration. Once the scar area was pigmented, the surrounding scalp was also pigmented to obtain a “feathering” effect.

Results. The cosmetic improvement after micropigmentation was always dramatic and all patients were pleased with the results. About 22% of the patients requested a touch-up of the micropigmentation to reinforce the residual pigment. Frontal edema was the only complication and was seen in one patient.

Conclusion. Micropigmentation of the scalp is a safe and effective technique for camouflaging scalp scars.