Scalp micropigmentation is the process of replicating the appearance of shaven hair, by introducing thousands of tiny pigment deposits into the epidermis of the scalp. When placed by a skilled technician, the recipient appears as if they have a full head of hair, shaved to a very short length.

This post is intended for those who have recently discovered scalp micropigmentation, and want to find out more about the process and its applications.

Without a doubt, scalp micropigmentation is the fastest growing solution for male hair loss in recent history. It is non-invasive, has universal appeal and is permanent, but only if you want it to be. Furthermore, it remains the only permanent hair loss fix to offer instantaneous, guaranteed results.

A large number of people who stumble upon this treatment have no idea where it came from. Nor do they know how it was developed, and how far it has come since it’s introduction. I believe that understanding the history of this solution for hair loss is important. This is because without that background information, it is difficult to do effective research and put it all into context.

Numerous terms are used to describe this process. These terms include scalp pigmentation, micro scalp pigmentation, SMP, MSP, hair follicle replication, tricopigmentation and hair tattooing. Please note that all these terms refer to the same basic scalp technique.

Who invented scalp micropigmentation?

Some of the dates that individual clinics came into being are difficult to ascertain exactly. This is because many providers say they’ve been in business for longer than they actually have.

The information in this article is based on my knowledge and is intended to be accurate. I have been involved with SMP for longer than most, and I base the information here on in-depth knowledge of the industry. If I have made a mistake however, please accept my apologies. I invite any comments or corrections below.

The scalp micropigmentation process was developed by Ian Watson and Ranbir Rai-Watson, co-Founders of HIS Hair Clinic in 2002, and later professionalised and commercialised in 2006. However, people around the world have been experimenting with primative hair tattoo or hair replication techniques for many years.

Scalp Micropigmentation pioneers
Ian Watson & Ranbir Rai-Watson, innovators of modern scalp micropigmentation techniques.

Permanent make-up technicians have been around for a long time, and many of them had diversified into scar and burn camouflage to meet the needs of their customers.

There are documented cases of hair replication using pigments dating back to the 1970’s, however the results were poor and were more of a shading method than an actual replication of hair. Often pigments were used as a means to cover up horrific scars from so-called ‘plug’ surgery, the inevitable result of botched hair transplant procedures.

In 2001, Ian Watson lost his brother to cancer. The stress this placed on Ian, his Sister-In-Law Ranbir, and the rest of the family caused Ian to develop stress-related alopecia. After searching the market for a solution and finding nothing satisfactory, Ranbir started to develop a basic scalp micropigmentation technique to replicate hair on Ian’s scalp.

Following a successful (although basic) treatment in 2002, Ian and Ranbir realised the commercial opportunity they had created and flew to Australia to develop skills in permanent make-up, medical tattooing and artistic tattooing. Following four years of development, including the creation of completely bespoke equipment and consumables, the first professional treatment process was offered to the general public in 2006.

Who were the early providers?

To begin with, HIS Hair Clinic was the only game in town. Shortly after their service was advertised however, a couple of competitors surfaced, namely a Spanish company called Headstyl and an American company called Artistry Concepts. Artistry Concepts, headed by Mark Weston, still trades today, however Headstyl is no longer in business.

A developing market

As the industry started to grow and take shape, more providers like Good Look Ink and Beauty Care Nederland launched new scalp micropigmentation services. They were followed shortly after by Vinci Hair Clinic, an established European provider of hair transplant surgery, and the New Hair Institute, a HT clinic based in California. Scalp Aesthetics also emerged in Rochester NY, and Milena Lardi of Italian firm Beauty Medical started offering temporary treatments on a mobile basis worldwide.

More recently the Shadow Clinic in Australia, Skalp in the United Kingdom and ProHairClinic in Belgium have entered the market, although all three have been around for long enough to be considered as ‘experienced’ clinics. Fast forward to today and there are around 15 major providers, around 100 boutique clinics and close to 1000 small scale practitioners, many of them working solo.

For more information please see the following websites:

Brandwood Clinic
Paul Clark and Simon Lane of Brandwood Clinic, two of the world’s most requested technicians, with a client in progress.

The market leaders in terms of the number of clients treated are HIS Hair Clinic, Vinci Hair Clinic and Scalp Aesthetics. Interestingly, all three providers operate entirely different business models and corporate structures.

In terms of quality, it’s impossible to pinpoint a leader. Whilst the major providers already mentioned do amazing work, equally great results are being delivered by boutique providers too. Solo-technician or single-location organizations like Brandwood Clinic, Scalp Micro USA and Skalptec are turning out results that are just as good as any international chain, and even better in some cases.

The world’s fastest growing solution for hair loss, scalp pigmentation has exploded in popularity. More men than ever before, and an increasing number of women, are choosing scalp pigmentation in favor of traditional remedies such as hair transplant surgery, concealers, hair systems and drug-based solutions.

What is the treatment process?

A relatively simple treatment to undertake, the scalp micropigmentation method consists of depositing small ‘dots’ of pigment into the dermal layer of the skin, with the use of a fine needle. Combined with thousands of other ‘dots’, an illusion of a full head of shaved hair is created.

The client usually requires 2-3 sessions, each lasting approximately 2-3 hours, but time does vary depending on individual requirements. The process is repeated until both the technician and client are satisfied that the semblance of hair cannot be distinguished from the surrounding real hair.

Common applications

Scalp micropigmentation can be applied to much wider range of hair loss variations than hair transplant surgery; from general balding to hairline recession, to burn or surgery related hair loss, and of course alopecia (most commonly alopecia areata). It can be also utilised to conceal hair transplant scars or blemishes as a result of trauma to the head. The method can even be adapted to blend noticeable birthmarks into the scalp.

Does the treatment hurt?

Most people experience a mild amount of discomfort during the early stages of the session, though this tends to become more tolerable as the session progresses. Some areas of the scalp have a denser collection of nerve endings than others, particularly at the sides of the head, and can often be the most challenging to deal with, but many choose to focus on the benefits and the final of the treatment to help contain the sensation.

What is the recovery period?

Once the pigments are deposited, the skin needs to heal. A recovery period of one week should be allowed, so that the micro-wounds created during the procedure may dry up and close while the pigments get assimilated into the dermal layer.

The treatment process must likewise follow a fairly strict procedure that allows the patient’s scalp to heal between treatment sessions. The industry standard timescales are as follows:

  • Day 1 – first session
  • Day 8 (or later) – second session
  • Day 15 (or later) – third session

Basically leave a minimum of one week between each session, however there are a couple of considerations.

First, it is feasible to leave just 5 days between each session for clients who have an issue with time, for example when they’re travelling from far away for their procedure. Second, it is common to leave several weeks between the second and third sessions, to allow time for the pigments to fully settle and to establish whether or not a third session is actually needed.

Are there any common side effects?

Micropigmentation in general has very limited side effects and does not tend to cause adverse reactions. This is because the technique addresses the visual symptom, (the hair loss itself) rather than the underlying cause. This makes a full medical diagnosis less important. Whilst the side effects are limited, the advice of a technician prior to starting treatment is still necessary.

How much does scalp micropigmentation cost?

Treatments vary from clinic to clinic, and also depend heavily on the clients requirements. For comprehensive guidelines see our scalp micropigmentation cost calculator.

Experience is key

A successful scalp procedure relies on an accurate appearance of hair follicles. Pigments that do not blend well with surrounding natural hair follicles, for example deposits that are larger or darker, can cause the treatment to look unnatural and lead to its detection by others. The assistance of an experienced technician regarding the style and specifics of the treatment will ensure that the client leaves the clinic with natural looking ‘hair’ each and every time.

This best results can only be achieved by an experienced technician who has received adequate training, and worked with enough clients to hone their skills. In addition to this, the right inks, needles and equipment specifically made for scalp micropigmentation should be used to ensure consistency and lasting results. The technician should also be well reviewed by past clients.

How long does the illusion last?

Everyone wants to know how long their treatment will last. The nature of the process means that it will fade slowly over a period of time. Whilst the pigments will probably remain visible for 20 years or more, regular top-ups are needed to keep your ‘hair’ looking its best. Most clients find they need top-ups every 3-5 years.

For maximum longevity, it is important to keep the scalp in a good condition. Ensure that your head is cleansed and moisturized daily, take adequate precautions in the sun and avoid topical products that contain alcohol.

What makes SMP so good?

If you’ve followed my story on various forums, you may remember that I made reference to a friend who always said that tattooing your hair back on was “stupid”. You may also recall that this particular friend has no idea that I have, in fact, done exactly that.

I’m dying to ask him how stupid an idea it can really be, if nearly two years after my treatment, he has yet to notice. Unfortunately the right opportunity has never presented itself, so I just nod and smile then laugh with my wife about it when he’s not around.

Headstrong NY client
A great example of a reconstructed hairline. Work by Headstrong NY.

Within a group of friends last night were four guys – three others and myself. Of the four of us, two of us are follicularly challenged (myself and another gentleman who we shall call Mark), and the other two are not.

Remember that my friends and I live in Yorkshire, England, where people have a reputation for telling it like it is. Shoot first, think later is the order of the day where conversation is concerned. So rest assured, it didn’t take long for the baldy jokes to start coming thick and fast. Only they weren’t directed at me.

Although Mark is about 4-5 years my junior, he and I have a similar amount of hair. His balding pattern is virtually the same, and it is also visibly obvious. Like many men he has taken to shaving his head in resignation and acknowledgement that he simply cannot pull off a longer hair look any more.

The only difference between Mark and I, and subsequently the only reason he was at the receiving end of the constant jibes and I was not, is because I have scalp micropigmentation and Mark does not.

Feathered hairline
Incredible hairline work by Vinci Hair Clinic

When men have any sort of hair loss procedure, whether it is hair transplant surgery or PRP, or buy an off-the-shelf product like Propecia, Rogaine or a shake-on concealer like Viviscal, or if they choose to wear a hair system, by far the biggest fear that all men share is the fear of being found out.

Despite this, I would have no problem telling my friends the truth if they ever questioned me about my SMP, no problem at all. Would I be so comfortable with that discussion if I’d had a hair transplant, was wearing a wig or had a head full of keratin fibres? No way! But somehow telling my friends about my scalp micropigmentation treatment is just fine with me.

Why is that? Honestly, I don’t know. Perhaps it’s because the other options I mentioned are something of a cliche, or maybe my friends would be really impressed with the realism of the technique itself, and would therefore be less inclined to give me a hard time about it? Instead of thinking it’s a stupid idea, they might instead just think it’s really clever.

Scalp micropigmentation by Scalp Aesthetics
A superb natural-looking camouflage of almost total baldness

I believe this subtle difference is important. Why? Because to some extent it removes the fear factor. If you’re ever cornered by your friends, family or work colleagues and are squeezed for an explanation, you could simply tell them how it works and watch the jaws drop.

Get closure

This is something I talk about a lot on Scalp Guru – the importance of putting your hair loss anxieties behind you and moving on. The best thing about scalp micropigmentation is the fact that it gives you a genuine opportunity to do exactly that.

Scalp Micropigmentation in progress
A scalp micropigmentation technician adds the finishing touches to a clients treatment.

Amen to that, but always remember – the purpose of the procedure is to release yourself from anxieties about your hair loss. After your treatment, you must discipline yourself not to obsess over your pigmentation as a replacement for obsessing over your hair loss.

The issue of quality

The scalp micropigmentation industry is not without its issues. There are around 1200 providers in the world right now, and I can put hand on heart and say that at least half offer treatments that I would consider to be sub-standard, or at least not on par with what a paying customer should reasonably expect.

Despite the number of providers that now exist around the world, all the evidence that I see suggests that more than 70% of all treatments are completed by one of the three leading providers.

Shadow Clinic
Ricky Hancock of Australia’s Shadow Clinic hard at work.

It is also clear that the vast majority of poor quality treatments do not originate from the top three. Sadly, many people think they can make a lot of money quickly in this industry, and fail to realise how much time and money needs to be invested into proper quality control measures, not least a quality training program and (just in case), a way to remove pigments applied.

For this reason, it is rare for a botched treatment to be carried out at one of the top three clinics. It happens of course, but the numbers are disproportionately low.

There is nothing wrong with choosing a smaller provider for your scalp micropigmentation treatment, nothing wrong at all, in fact many of them do exceptional work. Just make sure you do your research and see verifiable examples of their recent clients first.

Treat low prices with caution

As demand has rocketed, close to 500 providers have established themselves in various locations around the world. Standards vary enormously from one provider to the next.

Low quality clinics often have no choice but to compete on price, so if you’re offered a quotation that is significantly lower than the guideline rates above, make sure you’re being offered a genuine discount by a quality clinic.

Why are low prices a problem? After all, what do you care if it makes your treatment a little cheaper? It’s a fair question. If price becomes a leading factor when choosing a provider, consumers will focus less on quality and thousands more men will end up with sub-standard treatments. What if some of those clients cannot afford laser treatments to remove the pigments? They’ll be stuck with poor results that could damage their confidence for a very long time.

I have personally witnessed this scenario a million times before. No service at all is better than a low quality service. Honestly, if you had seen some of the things I’ve seen since I first got into this industry nearly seven years ago, you’d understand why this is such a big issue.

For a rough idea of how much you should expect to pay, see our cost calculator.

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