Question 1

What is scalp micropigmentation?

Accepted Answer

Scalp micropigmentation, commonly called SMP, is a nonsurgical treatment that uses microneedles (sometimes called nano needles) to embed dots of pigment into the scalp, to mimic the appearance of real hair follicles that have just been shaved. It works by making thinning hair—even long hair—look fuller, or creating the illusion of a full head of hair with a buzz cut, on a fully or partially bald head.

Think of the treatment as a hair tattoo. It's similar to microblading, another form of cosmetic pigmentation, though microblading uses a manual blade and SMP requires an electric tattoo-like device. While some providers advertise the results as temporary, since they can fade after a few years, scalp micropigmentation is considered permanent. The degree of fading over time depends on the individual and the quality of pigment used.

Scalp tattooing has been done for hundreds of years, but the term SMP was coined by Los Angeles-based hair restoration surgeon Dr. Jae Pak in 2009, to describe the process as an adjunct to hair loss treatments. As the medical community began to accept this form of treatment, the term SMP became universally used in the lexicon of hair restoration.

Scalp micropigmentation treatment can work well for people who have lost hair from alopecia areata, aging, male- and female-pattern baldness, hormonal conditions, or cancer. It can fill in a receding hairline or bald patches, make thin hair (including around the temples) look fuller, and hide scars from a hair transplant surgery or injury.

It’s important to find a provider who’s qualified and experienced—you’ll want to find a certified facility with hair restoration experts. Doing some research can help immensely in your decision-making process.

For the best results, follow these safety guidelines.

Avoid pop-up locations or facilities that seem unprofessional (e.g., hotel rooms, vacant office buildings, someone’s home).
While state regulations vary, look for a provider who works in a sterile medical environment, doesn’t reuse needles, and wears gloves and a mask during treatment.
Make sure the office clearly shows certification of SMP training as well as compliance with bloodborne pathogen regulations and a county health permit, much like you would see at a tattoo or piercing establishment.
Investigate the provider’s work: check out before and after photos to ensure they can create results that look real and speak with prior clients who’ve had the procedure.

“Scalp micropigmentation will definitely help by reducing the contrast between your hair and your scalp, giving your hair a more dense look,” says Dr. William Yates, a Chicago-based hair restoration surgeon. “However, it requires an expert to be able to select and blend the ink.”

Question 2

What are the pros and cons of SMP?

Accepted Answer

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.

Question 3

How much does scalp micropigmentation cost?

Accepted Answer

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

Question 4

Scalp micropigmentation before and after pictures

Accepted Answer

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

Question 5

How does scalp micropigmentation work?

Accepted Answer

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.

Question 6

Does scalp micropigmentation hurt?

Accepted Answer

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.

Question 7

What is SMP recovery like?

Accepted Answer

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.

Question 8

How long does scalp micropigmentation last?

Accepted Answer

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.

Question 9

Sources & studies

Accepted Answer

Osnato, Jaime. “Scalp Microblading Is the Newest ‘It’ Treatment for Hair Loss.” Shape, 24 Oct. 2019.

Pak, Jae P. “Scalp Micro Pigmentation (SMP): Novel Applications in Hair Loss.” ResearchGate, Nov. 2011.

“Prohairclinic.” Hair Loss? Discover Scalp Micro Pigmentation - Prohair Clinic.

Rassman, William R, et al. “Scalp Micropigmentation A Concealer for Hair and Scalp Deformities” JCAD, 1 Sept. 2015.

Rassman, William, et al. “Combining Follicular Unit Extraction and Scalp Micropigmentation for the Cosmetic Treatment of Alopecias.” Plastic and Reconstructive Surgery, Wolters Kluwer Health, 7 Nov. 2017.

Rassman, William. “Scalp Micropigmentation SMP.” Cosmetic Town, 12 Oct. 2017.

“What Is Scalp Micropigmentation? - SMP Explained.” Scalp Micro USA, 19 Mar. 2020.

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