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Not eligible for a hair transplant? Scalp micropigmentation, or SMP, might be the answer for your hair loss problems


Scalp Micropigmentation (SMP) is a tattoo technique where tattoo pigments are placed on the scalp in a stippling pattern to look like a shaved head of hair. When done properly, an observer can’t tell the difference between a shaved head and a tattooed head. Many patients with Alopecia Totalis have been treated with SMP.


At the ISHRS meeting in Alaska, essentially every doctor had the opportunity to view a patient with Alopecia Totalis and no one reported that they could tell it was a tattoo. Clearly this is an art form as much as a technical process.


SMP tattoos last the lifetime of the patient however, many do fade over time requiring touch-ups. Most patients do not return for touch-ups but some do want to address the fading that occurs over time.


Patients who had scalp micropigmentation are told not to go directly in the sun, and if they do, use a high SPF skin blocker. It is always best to use a hat for extended sun exposure. If there is frequent sun exposure without being protected, the color of the tattoo pigments may turn a slight green or blue color.


There are many good candidates for hair micropigmentation.  Men who want to shave their head and have their pattern of balding to appear looking like a full head of hair with a shaved scalp. Many autoimmune disease patients are ideal because they can’t have a hair transplant (e.g. Alopecia Areata, Alopecia Totalis).


Also, there are patients who don’t want to have a transplant or aren’t good candidates like depleted donor areas, or hair transplant process that was never finished and for many reasons, can’t be finished. (e.g. Class 5,6,7 patients).


SMP is very effective in treating scars from previous transplants and for treating the old type of ‘plugs’. Women with thinning hair are great candidates for this type of procedure as well.


For many, the concept of getting a tattoo on the scalp is foreign. Most patients, once they see the results, have a better understanding of the outcome (see Thus, the consultations tend to be longer because it is not a mainstream approach to their balding problem.


The scalp micropigmentation procedure for an average full head can take a cumulative 20-25 hours in three or more sessions. Half the head for treatment of scars is usually 10-13 hours. To minimize the pain during the procedure, a full scalp block with xylocaine anesthesia is used.


SMP procedures occur every day and are increasing in popularity. Some physicians report more patients getting hair micropigmentations than hair transplants.

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