Scalp Micropigmentation aka Hair Tattoo: Should You Do it?

scalp micropigmentation hair tattoo

Losing your hair is not fun.

For many men, the moment we realize our follicles are thinning is the beginning of the end for our self-esteem.

The reality is, though, we are far from alone in this struggle: in one study, 42% of men between the age of 18-49 were found to have moderate to extensive hair loss. So while it feels cruel, there is comfort in numbers.

The fact that hair loss is so widespread explains the huge number of preventative methods and solutions now at our disposal: from Minoxidil and specialized shampoos to full hair transplants; the options are numerous.

Growing in popularity in recent years, however, has been Scalp Micropigmentation:

Also known as the ‘Hair Tattoo,’ SMP restores receding hairlines, thickens remaining hair, and hides transplant scarring.

Why is it so popular?

Well, the short answer is it offers a highly realistic-looking solution to the problem of balding with great reliability and relative ease.

And what’s the long answer?

Well, that’s what this article is about.

We’re going to go into great detail about:

  • How SMP works.
  • What the process is like.
  • How to know if it’s the right solution for you.
  • How to find a good, reputable clinic.
  • How it compares to other well-known hair loss treatments and strategies.

But first, let’s get some background questions out of the way.

Why do we lose our hair?

The short answer: It’s genetic. If one or both of your parents are losing their hair, there’s a good chance you will too. This process is called androgenetic alopecia, or pattern baldness. If you’re starting to lose your hair, this is probably the culprit.

There are, fundamentally, a number of reasons men lose their hair. In most men (and women) who suffer this way, the reality is a number of factors are likely working in combination against you.

Hair loss is a natural part of aging for many people. According to the American Academy of Dermatology, roughly 40 percent of men will have noticeable hair loss by age 35, and about 65 percent of men will experience significant hair thinning by the time they are 60. And although it’s often thought that balding is a male problem, women actually make up 40 percent of American hair loss sufferers.

Aging inevitably thins the hair for most men, as well as turning it grey in many cases. But there are numerous other causes, as listed below:


According to the American Hair Loss Association, 95 percent of hair loss in men is caused by androgenetic alopecia – AKA Male Pattern Baldness.

MPB is essentially a hereditary sensitivity to dihydrotestosterone (DHT) – a by-product of testosterone.

Hair follicles that are sensitive to DHT shrink over time, which has the knock-on effect of shortening each hair’s lifespan, and eventually, they just stop growing altogether.

This is why so many men have receding hairlines and get the classic ‘horseshoe’ thinning.

MPB is extremely brutal: around 25% of men who have inherited it start losing their hair before they turn 21. And by 35, around 66% of men will have at least started to lose their hair.


Much less common – though no less brutal – is an autoimmune condition called Alopecia Areata. Essentially, the immune system begins mistakenly taking healthy hair follicles to be a threat and attacking them.

This leads to hair loss. But the cruel part is, it tends to occur in small patches, which are at first unnoticeable. So many men wake up one day to find they suddenly have a bald spot they’d never noticed before.

Stress and trauma

Stress and trauma are bad in a number of ways: they weaken your body and cause all manner of illnesses. But they can also cause your head to start shedding hair.

The fancy term for this is Telogen Effluvium: it’s generally a temporary condition, and the hair usually grows back within 6 months.

But it isn’t unusual to have lasting damage from the condition, leaving many with a need for urgent action.

Telogen Effluvium can also become a chronic condition when excessive hair shedding can last for years.

Poor lifestyle and nutrition

Growing hair requires nutrients – like iron and biotin – as well as plenty of protein and various vitamins (in particular, vitamin D).

An unhealthy diet will stunt the growth of hair, and for many men, as they age, this will exacerbate other hair growth issues quite dramatically.

You also need to exercise to keep the body healthily pumping all that nutrition around. And stay away from smoking and other vices, which will also do no good for your body’s ability to grow healthy, natural hair.

What is Scalp Micropigmentation?

While there is some evidence to suggest similar practices have been used as far back as 1970, Scalp Micropigmentation, as we know it today began in 2002, before being made available to the public in 2006.

SMP is an advanced form of tattooing that involves injecting pigment into your scalp. The process replicates the look of a very short buzz cut, filling in thinning or bald spots by creating the illusion of tiny hair follicles (hence why it’s sometimes called “hair tattoo”).

How does it work?

SMP uses microneedles to ‘tattoo’ pigment into the scalp – they’re sometimes referred to as hair follicle tattoos because they create the appearance of tiny hair follicles.

The idea is to restore the look of a fuller head of hair by ‘filling in’ spaces where thinning has started. The procedure replicates your natural hair follicles while strengthening and adding density to thinning areas.

It is a little bit like Microblading for the eyebrows, but in SMP, an electric tattoo device is needed: the skin on your scalp is thicker, so more power is required to penetrate it properly.

SMP is notable because it is not only good for men with serious Male Pattern Baldness and the like but also men (and women) who just have minor thinning issues and want to give themselves a little aesthetic boost.

How much does it cost?

A standard, multiple-session procedure in the United States generally costs from $2,000 to $4,000.

The cost for a scar treatment only is usually from $1,200 to $2,500.

However, the cost of SMP depends on a variety of factors, including the clinic you choose, what country the clinic is based in, and the type of procedure:

Hair density

From the color which is used and the number of follicles you have to replicate to the style you want to achieve, the density of the SMP will determine not only the price but also the length of the process.

Skin type

Unfortunately, if you have particular skin challenges – very dry or extremely sensitive skin, for example – there will be additional considerations to ensure your skin isn’t damaged during the process.


If you have scar tissue, this will require extra attention too. Light scarring shouldn’t be an issue, but if you have more severe conditions, extra precautions may be required, and the process will likely require more follicles to blend properly.

It is also worth noting that many high-quality clinics will offer financing options, often over very manageable periods.

How long does it last?

Generally speaking, SMP lasts 4-6 years before the patient requires any proper retreatment.

While it does fade, it fades exceptionally slowly, making it an essentially permanent solution.

However, this may be an advantage or a disadvantage, depending on your perspective…

Scalp micropigmentation advantages

  • It’s highly effective for a variety of hair loss issues and conditions, meaning it is unusually versatile as a procedure.
  • It looks highly natural in the vast, vast majority of cases.
  • After the initial recovery period, there is no ongoing cost for maintenance in the majority of cases. When there is maintenance, it is generally simple and relatively cheap.
  • All told, it is probably the most ‘ stress-free’ option in the hair loss solution market.

Scalp micropigmentation disadvantages

  • SMP is an essentially permanent procedure, which some men will view as a disadvantage. Because the hair pattern stats the same – like a tattoo – changing it requires laser removal, which can be time-consuming, costly, and painful.
  • Prolonged exposure to the sun’s ultraviolet rays can increase the rate of fading. This would require the patient to visit an SMP clinic more often for touch-ups.
  • Men need to keep their hair very short to take advantage of the SMP look fully.
  • It is not bank-breakingly expensive, but it is a bigger upfront investment than most other treatments.

Who is Scalp Micropigmentation for?

Ultimately, there are plenty of reasons to resist SMP. But there are also huge benefits to the process; in many instances, it is the only way to manage certain particularly unusual aesthetic issues properly.

If this claim confuses you, it’s probably time that we explain quite how versatile SMP is…

What applications does SMP have?

There is an assumption that SMP is really just for men who are losing their hair and want to improve their ‘freshly-shaved’ look, giving what remains of their hair a little extra texture.

In reality, though, SMP can be used in a variety of different ways and for a variety of different reasons.

For example, it is popularly used to ‘Edge-Up’ receding hairlines:

scalp micropigmentation before after 1
Before and After

But it can also add density to thinning hair:

scalp micropigmentation before after 2
Before and After

Or blending in scars, blemishes, moles and the like:

hiding scars with smp

Before and After

Source: https://www.hairlineink.com/
It also very popular with women, who generally use it to decrease the contrast between their scalp and head:
Before and After

Source: https://crownscalpsolutions.com/

In fact, SMP is used in a whole range of perhaps surprising circumstances:

  • Burn and surgery-related hair loss
  • Managing hair loss after diseases like cancer, lupus, and HIV
  • Concealing hair transplant scars
  • Concealing blemishes or scalp damage
  • Blending birthmarks

Is SMP for me?

The truth is, if you have any of the above needs, there’s a good chance you’ll benefit from Scalp Micropigmentation. Generally speaking, the results are very impressive, and most customers at high-quality clinics tend to report high satisfaction rates.

This procedure is ideal for men and women suffering from thinning hair or balding areas on their head. It works best with people who have very fair skin, as well as those who have dark skin and dark hair. If you have light brown or blonde hair, you may want to consider other solutions such as laser therapy or hair transplants because it will be difficult to find an exact match for your unique pigment color. For people with gray and white hair, you

However, there is no way to be certain SMP is for you without getting a consultation. And before you do that, you should know a little something about what to expect from the process…

What is it like getting Scalp Micropigmentation done?

Like the cost of SMP, what the process of having SMP done is like – how long it takes, how many treatments you need – depends on the specifics of your needs. It does, however, in all cases, take at least a few separate treatments to get a consistent, lasting effect.

Usually, this is split over three separate sessions, although the actual time can vary depending on the extent of your hair loss, the style you require, and other factors.

Why does SMP take multiple treatments?

During the treatments, microneedles are used to layer pigment dots on your scalp – again, like getting a tattoo.

A tiny wound is created in the skin when each dot is applied. A scab heals over the wound and eventually falls away, taking some of the implanted pigment with it. Furthermore, the immune system attacks the pigments, causing them to shrink.

This gradual “fading” of the dots varies from person to person but necessitates the need for multiple sessions to get the required pigment shade.

But regardless, you will have to begin with a consultation.


Before your first SMP treatment, at a consultation, you will meet with the ‘practitioner’ who does the treatment: here, you will discuss your requirements, including the shape of your hairline, its positioning, as well as the density and shade of your pigmentation.

In part, this is to make sure the practitioner has a full understanding of your specific needs and can plan your full treatment schedule.

However, it is also important to have a consultation so that you can know up front how much your treatment is going to cost, and so that you can make sure you are fully comfortable with what the procedure entails.


Each treatment will last – generally speaking – 4-5 hours. This might seem like a lot, but it generally goes by very quickly.

Different treatment sessions include the application of different shades of pigmentation. Different shades are needed to enable some pigment deposits to stand out from among the rest.

Lighter pigments are usually applied during the first session, while subsequent sessions introduce the applications of darker shades.

You should be briefed in full before each treatment, so you’ll know what to expect. And the sessions tend to be several weeks apart, so you’ll have plenty of time to prepare.


Proper preparation for each treatment is fairly minimal: just like getting a tattoo, you will need to prepare yourself for a tiny bit of pain and, of course, make sure you have enough free time to actually meet the appointments.

The most important thing to bear in mind is that you won’t be able to wash your scalp for several days after each treatment, so make sure you get a really good wash in before each appointment.

Does it hurt?

While most patients experience mild discomfort during the procedure – especially in its earlier stages – the discomfort typically becomes more tolerable as the session progresses.

Some areas of the scalp have much more densely packed nerve endings than others, but the majority of patients focus on the benefits of the treatment rather than any discomfort they may experience.

The bottom line, however, is that SMP hurts less than having a regular tattoo and much less than a hair transplant. Anesthetics are usually available to numb the scalp, although many men choose to go without them.


There is no downtime or recovery period following a scalp micropigmentation treatment, although slight redness on the skin from each tattoo session may last between 24-48 hours.

Many patients return to work the next day, and the basic time table between treatments is seven days. However, it is important to take a few simple precautions in the short term:

  • For at least 5 days, you’ll need to avoid heavy exercise or strain, which could cause sweating.
  • After four days, you should start moisturizing the treated area – though it’s important to be gentle!
  • After around 10 days, most men can shave with a razor blade, but you will need to ease yourself back into it to avoid any unwanted pain!
  • For around 28 days, you’ll need to avoid swimming and stay out of the direct sun (after this period, you’ll still need to use strong sunscreen to avoid fading)

How does it compare to other hair treatments?

Scalp micropigmentation is among the newest treatments for hair loss available today and, as mentioned, has grown steadily ever since being introduced to the general public. SMP’s “hair tattoo” approach is unique when compared to other types of hair loss treatments.

The truth is, the best way to understand if SMP is the right solution for you is to compare it to the other options on the table. Treatments include medications, hair loss shampoos, surgery, and even wigs and hairpieces, among other hair growth products.

1. Medications

Men have used drugs to treat hair loss for many years. The most popular types of medication are Minoxidil and Finasteride; both have the Food and Drug Administration’s (FDA) approval, and both have their own benefits and problems.


Also known as Rogaine, Minoxidil is an over-the-counter product that comes in either liquid or foam that you apply to your scalp twice a day.

Minoxidil first was introduced as an oral medication to treat high blood pressure. One of its side effects, however, was that it caused hair growth – and from there, the topical Minoxidil solution to treat hair loss was born.

Minoxidil works by stimulating hair follicles to grow hair on your scalp, but also anywhere on your body. It widens blood vessels, which allows additional oxygen, blood, and nutrient to flow to your hair follicles.

It takes very little time to apply Minoxidil to your head. Users should wait at least eight hours between applications and apply the foam or liquid evenly throughout the scalp.

Results vary for different individuals, but most users report seeing results within two to six months.

There are pros and cons to using Minoxidil:


  • Perhaps the biggest advantages to using Minoxidil are that it’s easy to purchase (you don’t need a prescription) and its relative ease of use. Others have found it useful to use after a hair transplant because it boosts the results of hair restoration.


  • One of Minoxidil’s cons is that it’s not as effective for advanced hair loss. That said, men over 30 may not experience the same results as younger men who have experienced minimal hair loss. As mentioned, Minoxidil patients don’t experience results immediately and may experience “shedding” early in the process as new-growth hair follicles push out old hairs.
  • Only the 2 percent solution of Minoxidil is approved for women. The stronger 5 percent solution puts women at an increased risk for low blood pressure and hypertension. It may also cause unwanted hair growth for women.


Most commonly known as Propecia, Finasteride is available to men only, and only by a prescription from a doctor. It comes in pill form and taken once daily.

Finasteride works to restore hair by converting testosterone to dihydrotestosterone, a hormone that shrinks hair follicles. One (1 milligram) dose of Propecia may lower DHT levels in the scalp by as much as 60% when used daily.

Many users have reported significant hair growth while using Finasteride.


  • Finasteride lowers DHT levels, which many consider the only effective way to slow and stop the hair loss process. It’s also easy to use because it comes in pill form.


  • You need to keep taking Finasteride to retain its benefits. More serious side effects include an increased risk of prostate cancer, as well as a diminished sex drive and sexual function.
  • Also, women who are pregnant or may become pregnant should never handle Propecia tablets because they may cause birth defects.

2. Hair Transplant Surgery

Hair transplant surgery involves moving hair you already have and transplanting it to an area of your scalp where there’s no hair or thinning hair. There are two methods of hair transplant: follicular unit strip surgery (FUSS) or follicular unit extraction (FUE).

During FUSS surgery, your doctor will remove a strip of skin from the back of your head (the area remains hidden by the hair around it). The strip of removed skin is divided into tiny grafts, with each graft consisting of an individual hair or a few hairs.

FUE surgery involves shaving the back of your scalp, and the surgeon extracting individual hairs one by one.

The procedure for transplanting hairs is the same for both methods. Grafts are inserted into individual holes or slits created in your scalp by a scalpel or needle. The typical hair transplant treatment lasts four to eight hours.

Other types of hair transplant procedures include flap surgery, tissue expansion, and scalp reduction. These types of surgeries can be used alone or in combination to provide the best results for each patient.


  • Hair transplant patients typically see long-term results that don’t need follow-up treatments. Transplants also involve the re-growth of natural hair.


  • There are significant disadvantages to hair transplant surgery, including the cost – which can range anywhere from $4,000 to $15,000. Most insurance plans don’t cover the cost of surgery. Also, hair transplant treatment only works if you have (transplantable) hair on other parts of your scalp.
  • Some patients also report irritation after their hair transplant procedure, including itching and bumps, while, in some cases, the transplanted hair had fallen off before it had a chance to grow.

3. Natural Methods

There are plenty of other methods for managing hair loss naturally, including improving your diet and taking supplements.

Nutritionists recommend a diet that includes sufficient amounts of protein – which strengthens hair and is said to promote hair growth – while others claim that supplements such as iron, biotin, zinc help slow hair loss.

This has sprouted a whole industry of products like shampoos, which specifically target hair loss – though the effectiveness tends to be unpredictable.

You shouldn’t take iron supplements unless you have anemia. For the most part, however, there’s not enough evidence to show that supplements promote hair growth.

4. Temporary solutions

Many men opt for very temporary and/or limited solutions to their hair loss – like hiding it under a hat.

Wigs and hairpieces are also sometimes used by people who don’t respond to other types of treatments.

Interestingly, insurance may actually turn out to cover the cost of a wig or hairpiece if your hair loss is due to a medical condition – so that’s definitely worth checking out.

How to find the right SMP clinic for you

Once you’ve decided that SMP is the right solution for your specific hair loss needs, finding the right SMP clinic is vital.

There are a few basic things you should look out for:

  • The clinic should have SMP training certification
  • They should also have other licensing – depending on where you’re looking. There are numerous relevant certificates, and you should look into whatever evidence of expertise they have
  • They should have clear, transparent working, and you should be able to find legitimate reviews – generally, good clinics will have at least some reviews online!

The safest route would be to go with a well-known and respected chain of clinics.

Skalp – the world leader in scalp micropigmentation –would be a fine choice. Founded in the United Kingdom, Skalp has offices in London, Manchester, Edinburgh, and New York.

However, if you don’t have access to a large, well-known clinic, you should still be able to find a reputable practitioner.

The consultation phase will be essential in this case: you need to – whilst remaining polite – really grill your potential practitioner on their background, how many treatments they do a day, and what kind of results they generally produce.


So there you have it: hopefully, you now have a full understanding of how Scalp Micropigmentation works, and a sense of whether it’s for you.

We’d love to hear your thoughts:

Have you given SMP a go? Would you consider it now you’ve heard a little more about it? And what do you think

Let us know in the comments below!

About The Author

Domen Hrovatin
Domen Hrovatin

Domen—a self-confessed facial hair addict—is a grooming professional, style enthusiast, and someone with deep personal experience and knowledge about male pattern baldness. His work was mentioned in countless notable men's grooming and style publications, including Beardbrand and AskMen.

  • Thank you so much for this great and very informative article. I am going to have my first scalp micro pigmentation tomorrow and I am already scared to death :-(… BUT this very useful article has calmed me down a lot and I am starting to get more relaxed about the whole procedure WoW :-)… Thank You sooo…much

  • I had an SMP done myself in Sweden around two months ago, and i’m extremely pleased with the result.

    I was originally planning on getting as second hair transplant, but my donor hair was too weak.

    I found out about SMP a little while later, and I have absolutely zero regrets.

    As long as you’re okay with having keeping your hair short (I set my trimmer to 1mm and then cut it like that around 2x per week, you’ll look great!)

  • Just had a second session of s,m,p,,2 weeks ago top of my scalp is fading very quickly can anyone tell me why so fast

  • I was discussing Scalp micropigmentation with my friend who has a serious bald head and he desire nothing else but a head full of hair. This article explain everything we need to know about it. Thank you!

  • Where could I learn the SMP course ? Is it possible to learn thru internet ? Upon finished the thiery course, Can I practice the treatment using tools and some artficial sulp by myself ?

  • Is there an EU approved certification for scalp micropigmentation? How & where to obtain it? Thank you

  • We at Scalp Culture have been specialising in Scalp Micropigmentation in the UK since 2012. We have a vast amount of knowledge on the SMP treatment and process, if anyone needs advice on Scalp Micropigmentation we are happy to help out.

    • Is there an app (and if not, there ought to be) to show various patterned results on a submitted photo? I know such apps are available to see different hair styles or beard styles with a bald photo. It would be nice to see a projected virtual result beforehand.

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