Scalp Micropigmentation 101 / Hair Tattoo

Depending upon the balding or hair loss extent, a regular client will take 2-3 treatments to achieve their final appearance. The first treatment often places a very light application on the scalp to assess fading and density levels.

The normal reaction for many clients is to assume that the SMP® is too light and to be a bit nervous. However, this is a normal part of the treatment, as the 2nd and 3rd layers of pigmentation will give it the 3d natural looking scalp. The 2nd treatment adds most of the density to the scalp.

The 3rd treatment is usually for completing the look, addressing darkness matching or to even the density across the scalp.
How will my scalp look immediately after a treatment?

The area of the scalp that has been treated will have some redness for around 2-3 days after treatment. For darker skin clients, the redness is not too noticeable. The pigmentation will appear darker for up to 7 days after treatment, depending on your skin tone. Therefore, the pigmentation will become lighter and softer as the tiny pigment-filled scabs flake away.

SMP hair is applied to the scalp by means of a pigmentation machine that carries pigment into the dermis by a rapidly moving needle. When the epidermis and upper dermis is punctured, the skin begins its normal healing and clotting process. After the treatment, your scalp will be covered by hundreds of tiny pigment-filled scabs, which is seen in many after photos. These scabs are often 400 to 800 micrometers across and far larger than the eventual SMP® dot after the healing process.
These tiny scabs will flake away in the first 3-10 days and your body’s immune system also removes any excess pigment caught in the healing wounds during the first 3 weeks. As this happens, it appears to the observer that the SMP hair dots are shrinking. When the healing process finishes, the final dots are often 90 to 170 Um in diameter and blend seamlessly into any natural hair.

If you show your scalp within the first 2- or 3-days post treatment, the scalp may still be a little red, and may be noticeable. After the initial redness goes away and you have shaved your scalp by day 4-10, you scalp would only be noticeable if you’ve made a major change from your previous hairline. The SMP® treatment allows you to design any hairline you like. If your friend or family have never seen you with a new hairline, they will notice. The vast majority of SMP® clients often choose a slightly receding look to account for the future ageing process and this allows the them to fit into their social scene often without being noticed.

Working with a very small shaft comprised of 3 needles on the end of the pigmentation machine, stable chromophore pigment is injected into the 2nd dermal layer of the skin on the scalp. Pigments are delivered dot by dot over the scalp and the entire process scales with the Norwood level of the client.
The dot size is dependent upon the practitioners hand pressure and is in the range of 80 to 170 micrometers at the frontal hairline and 120 to 250 micrometers at the back apex of the scalp.
The needle is known as a standard 3 round needle and it is 3 steel needles soldered to a base in a circular pattern. This is the smallest standard size needle that is used in large quantities by pigmentation specialists.

The 3 round needle tip is sent downwards into the skin by an electromagnetically inductive circuit. The 3 round needle ends will bend together as backwards pressure is applied from the resistive skin and pigment will flow to this tip. The needle will break the epidermis and travel about 0.25 to 0.55 millimeters through the epidermis and into the top layer of the dermis.
As the needle reaches the upper dermis, tiny capillaries and blood vessels will be broken by the path of the needle and the wound would bleed a small amount. The path of the needle will leave a ‘V’ shaped micro-incision. This V shaped micro-wound will appear as a tiny incision about 400 micrometers wide at the top. Blood and clotting factors will swell up in the wound and some of the pigment will be pushed back up out of the wound.

The skin is comprised of three layers, the epidermis on top, the dermis in the middle and the sub-dermis below. The epidermis sheds itself every 45 to 50 days and, therefore, placing any pigment there would be futile and it would slough off. The middle dermal layer contains many micro-collagen fibers that is comprised of strands with spaces (lumen) between them. These open spaces are the areas where the pigment is deposited.
Once the client’s immune system responds to the site of the wound and cleans up the loosely held pigment, the more tightly packed pigment molecules in smaller lumen will not be touched by roving macrophages, or the rate of removal becomes so low to not be measurable.

Yes. Although some bleeding is normal, there are some clients that may bleed more than average. If clients bleed above the average rate, pigment will be trapped in the blood and move upward with the clotting factors and some pigment will be pushed out of the wound. This is the exact opposite from the goal of retaining as much pigment as possible in the dermis. Additional treatments may be required for clients that bleed above normal levels to achieve the appropriate SMP® darkness shades on the scalp. Although bleeding is dependent on genetic and blood pressure, some clients have found that eating certain legumes or spinach for 10 days before treatment, can lower bleeding rates significantly.

A small scab is formed at the incision site within 30 minutes and this is hardened by additional fibrin over the next several hours. This scab will then remain as fibroblasts fill in weakened areas under the scab within 48 hours and endothelial cells migrate to the site in a complex cascade. As this process completes, the scab falls away, usually within three to seven days.

Right after the treatment, the scalp will be covered in hundreds of small pigment filled scabs, which are seen in many of our after photos. These scabs are often 400 to 800 micrometers across and far larger than the eventual SMP® dot. The dot may appear to shrink but it is the scab falling off that makes the dot smaller. When the process is complete, the final dots are around 80 to 170 micrometers in diameter and blend seamlessly into any natural hair.
At an average size of 80 to 170 micrometers, the pigmentation dots need to be large enough not to be removed by roving macrophages and large enough to show through the epidermis as distinct dark dots that mimic actual shaved hair follicles.
Be weary of competitors who promise proprietary needle sizes that can lay down dots smaller than 80 micrometers. This may indeed be true, but by the time the immune response has finished, the dot may be reduced in size to 30 to 40 micrometers, which is then very difficult for anyone to see. This is the exact reason why we aim to place dots that are ideally 150 micrometers in diameter and are then reduced by the immune and would healing responses to about 110 micrometers. In comparison, the average human hair diameter is between 66 to 120 micrometers.

The 3 most important are 1. Long-term immune responses and 2. Individual dermal collagen micro-structure and 3. Ultraviolet radiation exposure (sunlight).

1. Long -term immune responses

The immune response manifests itself at the micro-level through macrophages and phagocytic cells whose job is to remove foreign debris, particulate and antigens.  SMP® pigment molecules are seen by these defender cells as foreign material and removed from larger lumen within the dermis.  In some clients, this immune response is very strong, the result is that there is a large apparent fading.  In other clients, this response is much less, and a larger percentage of the SMP® pigment is retained in the collagen micro-structure of the dermis. Long-term immune response is entirely dependent upon the unique biochemistry endowed to everyone. Some people heal from a wound in 2 to 3 days while others take weeks or longer to heal from a minor scab. 

2. Individual dermal collagen micro-structure

Individual dermal collagen micro-structure is also a major factor in SMP® pigment retention and fade resistance.  Some clients simply have ‘loose’ skin. That means their internal lumen spaces are larger, the collagen micro-structure is not as tight and any pigment deposited will diffuse out and be more easily removed by the immune system. 

3. Ultraviolet radiation exposure

Although 1 and 2 are different for everyone, we can control the amount of UV radiation that hits your scalp each day.  SMP® is a pigment molecule (chromophore) which if subjected to long-term UV radiation exposure will eventually breakdown.  That’s what in the aftercare it is very important to wear a good quality sunscreen to protect your scalp from UV radiation whenever you go outdoors.  A client who is mostly indoors can expect to not require any touchup for about 20 years whereas client who is always outdoors and don’t wear any sunscreen could require a touchup as little as 2 to 3 years.  On an average client, a touch up may be required by 8 to 15 years.

The nature and alignment of the chemical bonds in a pigment’s three-dimensional structure determine its ability to undergo chemical reactions or degrade under UV radiation. The perfect pigment for a hair simulation application is one that is inert, chemically unreactive under most biochemical changes and heavily resistant to UV radiation.
While SMP® pigments are not perfect and do in fact degrade over time (SMP® will fade as the decades past), but it does not change colour like tattoo ink.