Many surgical procedures in the head and neck regions produce visible scarring. The most common of these surgeries are tracheotomies and thyroidectomies. The recent COVID-19 pandemic has caused an increase in tracheotomy scars, particularly in those who survived severe infection with the disease and required long-term ventilation. Individuals with neck scars are at an increased risk of health consequences such as reduced quality of life, depression, and negative body image. Research on attitudes toward and reactions to individuals with such scarring is limited. The purpose of this study is to examine how people rate images of scarred individuals on personality and attractiveness attributions. In addition, dermatography, or medical tattooing, is an emerging cosmetic intervention used to mask scarring, and has demonstrated positive outcomes in cases of breast cancer. This study further aims to examine how people rate images of individuals with scars covered with medical tattoos. Personality attributions were measured using the Five Factor Scale and various dimensions of attractiveness were measured using the Interpersonal Attraction Scale. Acceptability of medical tattooing as a cosmetic intervention for head and neck scars was also examined using the Decision Satisfaction Scale. Participants consisted of 456 young adults and were presented with two series of images, each consisting of a young adult, the young adult with a neck scar, and the young adult with a tattoo covering the scar. Participants were asked to rate each image directly after viewing. We hypothesized that those without scars and those with medical tattoos would be rated more positively on personality and attraction scales than would those with scars. Multivariate analysis confirms scarring and medical tattoos influence personality attributions. Non-scarred individuals were rated more positively in perceived Agreeableness and Conscientiousness traits when compared to scarred individuals. However, when compared to non-scarred individuals, scarred individuals were rated more positively on the Openness to Experience trait. This demonstrates the variability of impressions that a neck scar can elicit. Reactions to scars covered with tattoos were mixed. Medical tattoo recipients were rated more positively on Extraversion and Openness to Experience traits compared to scarred individuals. They were also rated lower on Conscientiousness compared to scarred individuals. Acceptability of medical tattooing was higher in participants who reported lower levels of religiosity and higher levels of social media use. This study highlights the varying effects that head and neck scars can have on appearance and the use of medical tattooing in clinical practice.

Thesis Completion




Thesis Chair/Advisor

Cassisi, Jeffrey


Bachelor of Science (B.S.)


College of Sciences





Access Status

Open Access

Release Date