Scalp Micropigmentation: What You Need to Know

Pros

• If you’re fully bald or partially balding, the procedure can provide definition for full front, side, and rear hairlines or restore a front hairline. The result is the look of natural hair follicles with a close shave or buzz cut.
• This scalp tattoo treatment can also hide areas where your scalp is visible, creating the appearance of fuller hair.
• It’s appropriate for all skin tones and hair colors, even gray.
• A scalp micropigmentation procedure works well in combination with other hair loss solutions, like FUE hair transplant surgery, according to multiple doctors.
• Because scalp micropigmentation is a kind of tattoo, it’s considered permanent.
• If you don’t like your results, you can have the pigmentation corrected or removed with a laser treatment.

Cons

• You’ll probably need two to four scalp tattoo sessions, unless your provider says otherwise.
• Results can fade a bit after several years—especially if you have too much UV exposure or the quality of the pigment is poor. You can get touch-ups, though most people don’t need them. 
• If you’re prone to keloids (a raised scar more common in olive or brown skin), or you have the herpes simplex virus or a condition like eczema, psoriasis, or vitiligo, a scalp tattoo may not work well for you. Inflamed skin typically does not receive pigment well. "However, many patients who have keloids and inflammatory conditions have had successful SMP," says Dr. Pak.
• The treatment creates the illusion of fuller hair, but it doesn’t prevent hair loss or encourage new hair growth. 
• Rare side effects from the numbing cream or the tattooing itself include an allergic reaction, infection, or inflammation.
• You’ll have to stop using hair loss treatments that contain minoxidil, like Rogaine, while you're having SMP treatment. However, it’s OK to continue using Propecia.

• Average Cost:
• $4,350

• Range:
• $700 - $6,999

Your cost will depend on the size of the area being treated and the number of sessions you need, as well as your provider’s practice location, level of experience, and certification status.

Learn more about the cost of scalp micropigmentation

The scalp micropigmentation photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Dr. Gary Linkov, a facial plastic surgeon in New York City, says that most people will need a consultation, followed by at least two to three treatment sessions. At your consultation, you'll determine the treatment area, pigment color choice, and number of sessions needed. Your scalp will be assessed, and your provider may recommend that you shave your head (unless you have long hair you want to keep).  

Prior to every session, make sure to wash your scalp well. You won’t be able to wash or wet your hair (including sweating, swimming, or using a steam room or sauna) for at least four days post-treatment. 

Your provider should start each pigmentation session by applying a topical numbing cream to your scalp or injections of a local anesthetic, to ease the pain. "Numbing cream typically does not work for scalp, so you may need numbing injections," says Dr. Pak. Your provider will then use a microneedling device to inject pigment that looks like hair follicles—either across the whole scalp or in individual patches, depending on your goals. 

The first appointment is usually the most conservative, since it’s when most doctors map out the hairline. “If you prefer, you may even have a sample patch done so you can see what it might look and feel like before having the full treatment,” says Dr. Sara Wasserbauer, a hair restoration surgeon in Walnut Creek, California.

At the second session, your technician will drastically increase the density of tattooed hair follicles. You may need a third session, even if it's just for tweaks and a hairline adjustment.

Depending on the size of the area being treated, one session usually takes four to five hours. On average, people need anywhere from two to four treatments, spaced a few weeks apart to allow for healing. 

RealSelf Tip: Anyone who doesn't have a fully bald head and wants a natural look should have the pigment applied behind their existing hairline. “It can be used to add a look of density at the hairline, but the dots would need to be placed behind the hairline and not in front of it,” explains Dr. Wasserbauer.

A scalp tattoo reportedly not painful when your provider uses numbing cream. However, even with an anesthetic, the treatment will feel like your scalp is being pricked with a pin over and over again, which can be mildly uncomfortable.

There’s no downtime afterward, so you’ll be able to return to work the next day. Your scalp will be slightly red for up to three days after your appointment, but this depends on how your particular skin type reacts. If you’re concerned, you can have the treatment on a Friday and return to work Monday.

Even after the first appointment, you will see results immediately. The finished look develops over a few sessions, and the pigment “cures” over a couple weeks. Your head may look a little darker than normal for a week or two following your treatment, until it settles in and looks natural. 

In terms of aftercare, avoid getting your head wet (that includes sweating) for the first four days. It’s okay to wear hats or headwear immediately, and you should wear a hat in the sun to protect the pigment—less sun exposure means greater pigment retention, since the sun fades the ink. 

By day five, you can expose your scalp to the sun for 45 minutes to an hour, depending on your skin tone, but make sure to use sunscreen.

Scalp micropigmentation is permanent, like most tattoos, according to Dr. Pak. Much like tattoos or microblading, results can fade after several years. You can get a pigment touch-up, though it often isn’t necessary.

“I see about 10–20% of our patients return for a touch-up after two to three years—not because they need it but because they want to look their best,” says Dr. Pak. “SMP quality and even technique differ from clinic to clinic, so there is no absolute time frame.”

If you don’t like your results, the pigment can be removed with a correctional procedure or laser treatment.