Still confused about how permanent SMP is. Does it fade to the point that it is almost all gone?

Scalp micropigmentation uses pigment, so, in essence, it is tattooing. Like all tattoos, sun exposure and other variables can cause them to fade. Here are somethings to know about scalp micropigmentation:
SMP, or scalp micropigmentation, is a painless procedure that uses highly specialized equipment and unique techniques to carefully and expertly inject all-natural, color-tailored pigments into the scalp creating a completely natural look of the patient’s hairline. A typical procedure involves an initial consultation and two pigmentation sessions to achieve the desired results. You can wash your head the fourth day after the treatment and, during that time, avoid any strenuous activity that will prompt undesired sweating. Once the procedure is complete, the results of a Scalp Micropigmentation treatment can last up to five years.
At the Foundation for Hair Restoration in NYC, I work with the world-renowned hair expert Dr.Jeffrey Epstein and his team to create beautiful, natural results for any hair type.
Most importantly, consult with an experienced hair restoration surgeon for a complete range of options that are appropriate for your situation.
Gary Linkov, MD
Hair Loss Specialist
Manhattan

Scalp MicroPigmentation is basically a tattoo.  It will fade and it will change color.  It it sounds too good to be true, then it probably isn't.You can think of temporary SMP like henna tattoo. 

Scalp pigmentation or any other name it goes by is using inks or pigments applied to the skin. Unlike traditional art tattoos coloured pigments are not used but instead a black tone in varying degrees of deepness. The skin characteristics and sun will certainly have an affect on how long the pigment lasts and how it fades. Along with the skills of the practitioner and the quality of the pigment used. Over time they all fade. It´s difficult to predict the pattern or how long it will take before it properly goes. 

Scalpmicropigmentation comes in two varieties (1) the temporary type which lasts 1-2 years, possibly less. This requires a redo every time it fades and (2) the permanent type which we do as shown in the web reference below.  I published often in medical journals about the value of the permanent type of SMP. In our thousands of patients, about 20% will return for a touch-up in 5 years or so. I like to think of it as permanent, but tattoos does always stick around and if you expose them to the sun, they fade more often.