I have several scars on the back of the head, a recent procedure gave me yet a big new one to cover and deal with..

I am concerned about the look, once my hair is wet- these now are very visible, unnatural and difficult to explain-a subject I’d rather not discuss at all. Is the Micro Pigmentation a possible “fill in fix” to these scars, and if so, how do I deal with the way my hair color will look in say, 10 years when I am completely grey/white and thinning yet even more in the back? Matching skin, hair color is important.

I currently have dark brown/grey hair which I dye for the time being. Thank you.

The pigments have their limitations, but are particularly good for men who want their hair shaved to almost scalp level (closely cropped). You are correct that as you gray, the pigment may produce problems, but usually these pigments gray a bit anyway. I would have to see you, at least see the pictures of your scars and their locations before rendering more thoughts.

Repair of scalp scars takes experience and your situation of having a surgical correction that made it worse is common when the surgeon does not really understand scalp repairs. I have seen many scar repairs by well known plastic surgeons and still they get wider after the surgery. If you are in the Los Angeles area, there is no substitute for a good examination, as it may be possible to fix these scars.

I am a 21 yr old male diffuse thinning in the NW6 pattern. I am currently on finasteride but I know it will not last forever.

Is this look possible with SMP? It is pretty much the only hope I have left.

Yes, this is a good option… but you must get educated on the facts that go along with it. Remember, this is a permanent decision so it needs to be thought through carefully.

Here is a 22 year old in your similar situation — Client 17. He started losing his hair when he was 16 years old and had worn a hat everywhere he went. After the SMP procedure he told us he went out for the first time without a hat on! SMP is not for everyone, but it does have its use in certain segments of the balding men.

I have long hair and am interested in SMP. Can I put pigment in my hair to make it look fuller?

Scalp MicroPigmentation (SMP) works best for those who want to shave their hair (keeping it clipped very short). Even hair as long as 1/2 cm may not look right with SMP. You must remember that this is a permanent pigment (tattoo) without a three-dimensional texture.

Let’s say you had a scar on your scalp from surgery. If you shave the hair around the scar, SMP can mimic the same look (thus disguising the scar). When the hair grows, there will be an uneven step-off look until your hair grows long enough to cover it. Another issue with SMP is the color matching. If you have brown hair, SMP may not match if the hair is kept long. SMP works for shaved brown hair, because the hair color almost looks grey when it’s that short. So if you match the color of a shaved hair, it will not match with the long hair (unless your hair color is black).

In a minority of cases we do use SMP in between the hair to make it look fuller. In effect, this is coloring your scalp to diminish the contrast between hair color and scalp color. If you do this, you will need to keep your hair longer (5cm+ or so) so that it would not look like you tattooed your scalp. This method is only recommended if you are never going to cut your hair short (for life), because if you shave or cut your hair short it will not look right.

In summary — SMP is not so simple. It’s a permanent procedure that works best for shaved hair where we use a shade of grey (not brown). If you keep your hair long and we use your dark brown pigment to give you fullness, cutting your hair short later will cause the different color to stand out. If you want some permanent color to your scalp while keeping your hair long, it’s doable, but not advised for everyone. I think temporary camouflaging products such as DermMatch and Toppik are the best for those situations.

Would you perform SMP on a young patient with a receded hairline just to fill in the receded corners, if he still wish to keep his hair longer? I mean to the point where these areas are covered anyway, to allow the option of shaving the head in future, or just to provide more coverage if the comb forward isn’t cutting it? I’m talking no more than an inch of recession either side.

If you are considering Scalp MicroPigmentation (SMP) then you should be prepared to keep your hair cut short (buzzcut with no guard). If the bald area is covered anyway, I’m not sure why you’d want to have it done. If it’s not covered, the hair should be kept clipped short to keep the pigmented area from looking abnormal. This might not be the solution for you, since SMP does not usually look as good in the hairline with hair kept long. It may work in certain case by case individuals, but it is not intended for the frontal hairline unless it is worked in conjunction with hair transplants.

SMP is not for a simple quick fix because as a young man, you need to consider more corner recession and possibly significant recession as you get older. This should should be considered permanent, so you would be committed to get more SMP procedures as you continue to bald.

Hello Doc, SMP seems a very good option to me, since I’m probably heading to a Norwood 6/7. I love the cropped look!

In what extent is it possible to choose the darkness? Is it possible to have it darker than the remaining hair on the back and sides, so that it looks like the hair on top is a little bit longer/fuller that the hair on back and sides?

I would like to shave it every day, because I don’t think it looks good to have the 3D effect on my remaining hair and a 2D effect on the SMP. Thank you.

We can control the darkness of the color, but a darker Scalp MicroPigmentation (SMP) will not give you the look of longer hair. If you shave your head (perhaps with a short clip guard on), the ‘donor fringe’ cropped look is what we try to achieve.