Scalp Micro-Pigmentation — An Alternative to Hair Transplantation

New Hair Institute is pleased to introduce a new service we’re offering —

Scalp Micro-Pigmentation (SMP)

Like any tattoo process, the technique involves placing a special pigment into the skin of the scalp to mimic ‘hair follicles’ almost to the size of a closely cropped head of hair. Think 5 o’clock shadow or stubble. We have been using Scalp Micro-Pigmentation (SMP) for two purposes:

  1. As an alternative style for making a balding person look full headed with the placement of pigment into the scalp (example below)
  2. To camouflage the scars from a strip procedure or anywhere on the scalp. Almost any size scar can be treated with SMP (example will be posted in the coming weeks).

So what does it look like?

NW7This patient came in for a hair transplant consultation. He likes his hair cut close, so follicular unit extraction (FUE) would have been a reasonable way to get there without a detectable linear scar that traditional strip surgery would inevitably produce. The problem for him is that he needed somewhere between 4000-6000 grafts to cover the balding area. We routinely offer up to 1500 FUE grafts per session and recommend the strip technique for larger sessions. That means that he could have been looking at 2-5 FUE surgeries to obtain the final look he wanted and as he continued to bald, he might run out of donor hair before completing the final look he wanted. This patient was heading towards a Norwood class 7 pattern, and eventually he might need 6000-8000 grafts to follow the hair loss he would experience over time when/if his Propecia would stop producing the benefits he is now getting from the drug. As hair transplantation is a supply/demand process, would he have enough hair to complete the entire transplant process to a fully evolved Class 7 pattern? I doubt that he would.

The pictures below tell the rest of the story. He came in with his balding pattern and left the same day with a completely different look, certainly not a balding look.





I want to emphasize that this patient will have to maintain this short-clipped look unless he elects to have a hair transplant. The upside of this technique beyond what you see is the low maintenance he will have, just trimming his head about every other day. If he is against medication use (like Propecia) this style allows that choice, but as balding progresses as it inevitably will, touch-ups of the SMP technique will be needed. The downside of this is that the pigment is considered permanent, so the style must be acceptable for him and it is a lifetime decision.

This patient elected to do the process under local anesthesia to subdue whatever pain might be there during the procedure, but like any cosmetic tattoo procedure, it can be done without anesthesia. He may require one or two touch-ups to the look that he now has, as the pigment tends to fade a bit after the first session, but he does not have to look at repetitive surgeries into his future.

He’s been thrilled with the initial results. His overall comments to me reflected upon the freedom that his new look gives him and how much he loved rubbing his bald head. No more styling gels and repetitive worries about going bald have made him a happy man. He also knows that when hair cloning or hair multiplication become available (fingers crossed), he can just add the value these breakthroughs will give him, and maybe get him the hair that he wanted at some appropriate time in the future.

Over the next few months, we’ll show more of the work we have been doing with Scalp Micro-Pigmentation (SMP). Contact my office at 800-NEW-HAIR (or 310-553-9113) for pricing and availability.

Update: I answered a bunch of questions posed by our readers in the comments below.

Tags: scalp micro-pigmentation, smp, hairloss, hair loss, new hair institute

30 thoughts on “Scalp Micro-Pigmentation — An Alternative to Hair Transplantation

  1. Very interesting news on SMP, Doc.

    I have a few questions:

    A. Can you do SMP with a thinning but not bald scalp? That way, you could “darken” the color of the scalp below the thinning hair and make the hair look denser.

    B. Can you combine SMP with a hair transplant? That way, you could achieve the same effect, making less hair look fuller.

    Thanks so much.

  2. Looks very good. Congratulations!

    I am a bit confused though. People have been writing to your blog for quite awhile about scalp tattooing and each time, in your answers, you warned people to be cautious of the process. You have even stated that you are not a “fan” of the procedure in one reply. When did you become a fan and why the sudden reversal?

    The following are quotes from one of your answers to a person who asked about the procedure awhile back. Are these concerns no longer an issue? Have they been addressed?

    “I wonder if you’re sitting across from someone at dinner would it look like someone drew on their scalp with a pen? If the light hits your head wouldn’t it still shine like a bald head? Over time, tattoos with fine lines will blur… so how will that change on the scalp?”

    You also warned that they can turn green after awhile.

    Personally, I think the idea sounds and looks great, but I am skeptical of how you went from being against the procedure to actually offering it yourself in such a short time.

  3. This is interesting. I wonder what it looks like in person though, and would the ink change colors or fade like tattoos do? I hope he wears sunscreen every day on his head.

    The after pictures look just like how the actor Joey Lawrence currently looks. He has a buzzed haircut, but the color of the hair on top of his head seems a slightly different shade than the sides, which made me wonder if he had tattooing done, or if it was makeup for his tv show.

  4. It looks very good but when this guys hair turns gray and then later white this will be awful…He will have a better chance explaining a linear scar at the back of his head with a shaved head due to some kind of accident than this possibility…Doesn’t sound like a “master plan” that we all hear about at all!!

  5. I imagine the Dr will probably be transplanting 1000-2000 hairs around the scalp and doing the tatoos. That way not only does his hair look full from a distance, but when up close and when touching it it should minimise any noticeability of the procedure

  6. This, unfortunately, does not look natural. I think scalp tattoos are unethical. They are expensive, they always look horrible and they never fool anyone (but I’ll bet they confuse a lot of people). This man looked much, much better before.

  7. To be honest…upon close inspection, it looks really bad. It’s clearly fake. And I agree with how it’s odd that you went from being really against scalp tattooing to all the sudden offering it yourself.

    Don’t worry, you were right to begin with. It doesn’t look good, as evidenced by the pic you shared with us. From a distance, yes, it looks okay. If I were standing within 5 feet of the guy, I would think he looked weird.

  8. From the top perspective and the profile it looks OK, but it looks ridiculous and too geometrically perfect from the front. Kind of analogous to when women use marker to fill in their eyebrows.

  9. TBH having to shave my head everyday to keep an even look seems to be more high maintenance. however I have to admit that the results look good in the picture particularly the hairline.

  10. Good stuff! This could act as a semi-permanent replacement for products like Couvre. It could really help give an illusion of greater density.

  11. Robert West-
    The fee for a very bald man or a person who has his entire head done is $6,000. This will cover the main session and one to three touch-up sessions as the pigment may initially fade. Generally, fees for this can range from $3000-6000 depending upon the extent of the work.

    Everyone is different and I would make judgments on each person on a one-on-one basis. It is critical to establish realistic expectations and this is something the doctor and the patient must work out in person. The same type of initial examination will be done on all new patients to form the basis of a good, productive consultation and to build a good Master Plan so that everything you do will anticipate more hair loss over time and the consequences of any and all decisions made. And yes, we have been doing combined procedures of SMP and hair transplants.

    Daniel Knepshield-
    There is overhead here and risks, and I do not want to minimize these issues. I have, over the years, seen many patients who have had tattoos to their head and they looked totally unnatural, almost freaky… so from that experience, I established opinions from what I saw. I have seen some excellent results from a variety of places offering this type of service and amongst the best of them, the results can not be easily told from a full headed clipped scalp. Keep in mind that most people will accept what they see.

    The patient shown above told me that he went to work and met with his colleagues 5 days later with great anxiety. A few noticed that he shaved his head and liked the change, but others just accepted his new hair style. No one asked him “What did you do to your scalp?” The pigments do still carry the risk of changing color to blue or green, so keeping out of the sun and wearing sunblock for sun exposure is critical.

  12. Bill and Jack Smith-
    Graying may be a problem as age sets in. Dyeing the hair to keep the balance between a dark scalp and white hair will be important for the future of many of these patients.

    Some may pick it up if they know what they are looking for, many people will not. Nothing is perfect in this world.

    Good insights, but there will be no blank rule here and the patient and the doctor will have to discuss this.

    Afraid, no… but over exposure to the sun is not a good idea. Using a hat outdoors or a good sun screen is critical when sun exposure occurs.

    Tattoos can fade or change color under intense sunlight so protections are important with the use of a hat or a good high SPF blocker.

  13. Other hair replication places are using “special” needles with smaller size than the ones you’d find in a tattoo parlor, are you using these same kind of needles? Also they claim to use a “special” ink that won’t fade or turn blue/green are you using this same ink? How do you control for blotching over time? Thanks…

  14. one of the best things about the buzzcut is the feeling that is created when you rub your hand over the shaved area, is there anyway to mimic this feeling?

  15. A.Harris-
    We use special needles to get the effect you see. The dyes are standard cosmetic tattoo pigments. They may fade or turn color so that is why you need to be sensitive to sun exposure.

    We did an FUE procedure on one patient so that he would have stubble on his scalp. For those who had a previous transplant, the stubble was already there. We will show examples of these over the next few weeks.

  16. Is there any risk of allergic response to the pigments?
    I have had increasing allergic responses to a number of medications and foods over the past few years (hives). It would be catastrophic to have a whole scalp covered with this and then find out it triggers a hive response.

  17. I am worried about the dots looking too big or getting blotchy over time. My other concern is about the pigment used. I want to make sure the ink does not look bluish or greensih over time.


  19. Kudos to NHI !! I have had transplantation performed by NHI in the past – They are nothing but the best. Developing the Micro -pigmentation procedure is an indication that they are listening to their patients and putting forth the effort to help….Way to go NHI…keep up the good work

  20. This procedure is definitely not for the nervous. I have been using a powder concealor for years now and eventhough I have enough hair left to creat a natural look with the poweder , I still get nervous about who sees what when I am standing in a line, or under bright light. The only comfort comes in knowing that I can stop using it and get a buzz cut one day if I chose so.

    Looking at the pictures above, it’s unfortunate to say that the hairline looks too “perfect” and appears to be easily detectable. It’s a big decision to make as it is permanant. I am not knocking it. It’s just not for me!

  21. Could you show us more photos of proceedure used with the transplants . Before and after pics would be best .Its too hard to make a judgement on just one example

  22. While I wouldn’t want to keep a procedure from a well-informed and motivated patient, I have real concerns about this from a practical standpoint. Hair kept very short will have to be dyed very often. Dye stains your skin temporarily – typically, you try to keep it off your scalp and skin, but that would be impossible with such short hair. He might have to dye his hair 2x a week and each time he dyes it, he’ll have a 24+ hour period in which his scalp is visibly stained. The maintenance required seems impractical, verging on impossible.

  23. @ Marc, Depending on the practitioner and the facility you go to they will match your hair color. Over the course of time when you do end up going grey or white you can opt to have the scalp micro pigmentation procedure done over the grey white areas to add the look of the dark stubble to mimic the original procedure. Typically for our clients who have white hair during the first procedure we will blend the scalp micropigmentation into the white/grey haired areas giving a denser darker look to blend seamlessly with the other areas that have the smp procedure. This is where choosing the right facility and practitioner are essential in the make or break of the illusion.

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