What is SMP?

You may not have heard about Scalp Micro Pigmentation (SMP) but here is why you will want it.

What is Scalp Micro Pigmentation (SMP)?

Cosmetic deformities can result from various types of alopecia or even post hair transplantation procedures. Patients with such deformities seek aesthetically appealing longer-lasting options. Scalp concealers are commonly used by men and women to camouflage these deformities. Scalp micro pigmentation (SMP) is one of the concealers recently gaining popularity. Objectives: SMP is a novel technique wherein microdot tattoos are placed in a stippling pattern to mimic hair follicles that are cut close to the scalp and various variables affecting its outcome were evaluated. Methods: Forty-five subjects were recruited for the study. The various factors affecting the outcome of SMP—the angle of the needle against the scalp, depth of needle into the scalp, time of the needle contact in the scalp, speed of the rotor, the resistance of scalp, the color of pigment, the viscosity of dye, needle number, needle thickness, and pattern of dot placement—were systematically studied in 15 patients through clinical photographs and trichoscopy. The ideal depth of pigment deposition was assessed through histopathological examination. After using these optimum variables, standardized SMP was performed in 30 patients with hair loss (3 patients with cicatricial and 27 patients with diffuse non-cicatricial alopecia). SMP was also used to create an aesthetically denser hairline. The outcome of the procedure was evaluated using standardized global photographs. Results: The ideal parameters were established to achieve standard reproducible results. There were great patient satisfaction and acceptance of the procedure. All the patients showed moderate to great improvement after the procedure with satisfactory scalp coverage. Adverse events were transient which were seen in the form of edema and redness. Conclusion: SMP offers a non-medical, tattoo-based cosmetically appealing and effective “cover-up” that hides the unsightly conditions. The cosmetic tattoo placement creates an illusion of thicker hair

SMP Background

With increasing hair loss, there is a decrease in density of hair, and as a result, the scalp skin can be seen easily due to increase in contrast between hair and skin. This contrast between the hair and skin can be minimized by providing an illusion using various camouflaging or concealing techniques. Camouflaging techniques such as bio fibers and wigs, or concealers such as hair powder are all temporary methods with their own shortcomings. Compared to these modalities, tattooing is a permanent concealer and thus has a pivotal role to play in such patients. Scalp micropigmentation (SMP) is an art in the form of stippled painting. Tattooing involves implantation of exogenous metabolically inert colorfast pigments into the skin. SMP is a sophisticated method of placing microdots less than 1 mm in size using one- or three-pronged needles, creating an illusion of hair by decreasing contrast between hair and skin. The process

is performed using manual or electrically driven needles, whereby only pigment particles introduced through the skin surface, below the dermal–epidermal junction, are retained by the dermal macrophages and fibroblasts where they reside permanently, producing an indelible change of the skin color in the form of a recognizable pattern or design.[1,2] The terms “micropigmentation” and “dermatography,” which are both coined recently, convey the aesthetic use of tattooing for medical purposes. SMP is not as simple as body tattooing due to the difference in the anatomy of the scalp skin compared to the rest of the body.

Frequently Asked Questions

How many sessions will I need with Phuket Hair Clinic?

Most clients will require 2 sessions and in some cases 3 sessions. Additional treatments will increase the density or the number of ink dots in one area. More density will result in a darker, more natural look, which will help integrate the procedure into any remaining hair. However, it’s always better to work conservatively and not do too much too quick per session. If you are covering scars, you are more likely to require more sessions as scar tissue absorbs ink more readily, resulting in more significant fading. Treatments on clients with Alopecia may still be completed after 2-3 sessions. However, the sessions are likely to be longer, especially if the client is suffering from aggressive Alopecia Areata, patchy hair loss, or Alopecia Totalis, the total loss of all head hair. 

Is the SMP treatment painful?

Scalp Micro-pigmentation requires a small needle to be inserted into the upper dermis of the scalp. A certain amount of discomfort is inevitable; however, most clients report the sensation to be nothing more than mildly irritating, even therapeutic. The general consensus is that the pain varies from a 3-4 out of 10. Some parts of the scalp, for example the temporal regions and the hairline, can be more sensitive. Additionally, some people experience more discomfort than others, and people who have used hair systems for a long period of time, or have a significant amount of scar tissue to cover, are also prone to a higher pain level. Pain can be minimized with an over the counter painkiller before each session as well as with application of numbing products. 

What is the recovery/healing period?

You may experience some redness and swelling on the scalp for a few days after the procedure. The pigment initially will appear a few shades darker and can take one to seven days to lighten-up and in rarer cases up to 14 days. Bruising can also occur which may cause the treated area to appear darker or to appear slightly blue. This is relatively uncommon affecting approx. 1 in 10 clients, and goes away after a few days.


What if I’m a hair system or hairpiece user?

If you normally wear a hair system, rug, or hairpiece, be sure to NOT to wear the hair system for 10-14 days before the procedure to allow the skin to breathe. By not doing so, you will take the chance that the procedure will not take properly. 

What if I have hair transplant scars?

Scar tissue reacts differently for each client, so, therefore, those areas will be approached with extra caution and may require a greater number of treatments. In addition, you should come back within five to seven days or when swelling disappears for a session that strengthens the fast fading pigment in the scar area. Treatment duration ranges from 30 minutes to 2 hours depending on the treated area. 

What if I have recently undergone laser treatment?

Scar tissue reacts differently for each client, so again, those areas will be approached with extra caution and may require a greater number of treatments. In addition, the client should come back within five to seven days or when swelling disappears for a session that strengthens the fast fading pigment in the scar area. Treatment duration ranges from 30 minutes to 2 hours depending on the treated area. 


Hello! My name is Anne.

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