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  • Writer's pictureEvan Lee

An In-Depth Look at the Scalp Micropigmentation Process

Updated: Jun 24, 2020

Yes, it is basically a hair tattoo. No, you're not going to lose more hair because of it.

These are just a few of the many questions people ask immediately after the initial what-the-hell-is-a-hair-tattoo remarks. One of these days, I'll do another blog entry and put down some more interesting questions and comments I've encountered about micropigmentation. But today is not that day. Today, we will look at the process of SMP itself, from beginning to end, and how it affects both men and women suffering from hair loss.

Scalp micropigmentation has been around as early as 2001 and you can Google its history and find a large array of articles from a wide array of people claiming they invented the technique or they were the first to perform it. What is known is that it originated in Europe and has been adapted by many practitioners and still continue to evolve to this day. Tattoos have been around since the Egyptians built the pyramids, but who would have thought that it would make such an impact on the cosmetic and hair loss industry today?

You've seen the horror stories of people having blue-colored heads after they went to their tattoo parlor asking to get hair tattooed on (or worse yet, a nail salon that offers the service). The truth is, there is little to no regulation in this industry right now and you can get a 4-day training crash course by someone currently performing SMP, pay the $4,000+ training fee, and be certified with a home-made certificate they Googled. What other industry do you know where you can read a 3 page training print out, stab some needles into a grapefruit and then be "certified" to work on people? Yes, it's pretty sad.

For those of us who do care about our clients and their well-being, safety is always first. We establish life-long relationships by making sure we understand their health conditions, emotional state, and what they truly want out of the experience - all of which goes beyond just the transaction. It's not hard finding a good practitioner. You just have to talk to them and see if they're more interested in your needs or wants versus trying to make the sale.


I can't stress enough about the consultation. It's completely free. Anyone who tries to charge you a fee for a consultation - RUN! Consultations are just that - it's a way for your doctor, provider or practitioner to talk with you to know and understand your goals and formulate a plan to get there. It's not the other way around. If you want an "estimate" to gauge pricing, that's just an estimate and a phone call will do just fine if you want a ballpark price. A good practitioner will spend time to understand your goals and find the best solution to help you reach that goal.

A good practitioner will look at his client's situation and assess what the best approach is - regardless of what the procedure costs are (whether low or high) - because the goal is to benefit the client, not the practitioner.

Many times, I would suggest clients with slight hair loss to look at alternatives such as Rogaine to try and grow the hair back, or confide them to wait if they can because it's not needed. Think of a dentist - I won't pull out any teeth if you don't need it and will not recommend it even if you want to. Good practitioners care for their clients.


In my example above, that is seldom the case because most clients who come to see me have already reached a point of deciding what they want done. And just like the dentist example, most clients don't come to see me until they have a toothache and are in pain. In this case, it's usually complete hair loss or they are heavily thinning and have already looked at other alternatives and want a different approach. Most people will find that SMP is the better alternative to hair transplants in most situations. Once you start losing hair, you will continue to lose hair and transplants doesn't really grow hair back. You're just moving hair from one area to another and staving off the inevitable.

Designing the hairline is absolutely crucial for scalp micropigmentation. The client usually knows what he or she wants, but it's up to the practitioner to recommend what he or she thinks may be the best approach. Factors include the client's age, head shape, natural scalp line, health, as well as current hair density, all play a role in what the hairline should look like.

It's unnatural for a 55-year-old man to have the hair line of a 20-year-old. Or, a woman in her 60's to have absolutely no thinning areas whatsoever. Our goal is to look good, but to also look natural and not have you look like you slapped some paint on your head.


The average adult head has between 120,000 to 150,000 hair follicles. Replicating those hair follicles is a true test in patience. Take a blank sheet of paper and a pen and time yourself. Draw out 100,000 little dots. There are only two rules: 1) the dots must be fairly universal in size and darkness in color and; 2) it has to look natural like actual hair follicles and not some random guy trying to dot random dots quickly on a sheet of paper. Not easy is it? Now try it with a needle 1/5 of the size of a pen tip and specialized micropigments that you have to load every minute. Now you have an idea of why it takes a specialist to do something like this.

Each follicle is carefully replicated, one at a time. Every client has a distinctive hair pattern and density pattern. Some areas of the head have more density than others and the pattern must be replicated to have a more natural look.

Depending on the amount of hair loss, each treatment typically consists of 3 to 4 sessions and each session is usually about 3 to 4 hours each. So you're looking at 12 to 16 hours total on average.


All tattoos fade. All inks fade. Unless there is some new alien technology that was just discovered in the last 24 hours, anyone who tells you otherwise has no idea what they are talking about. Humans have looked for non-fading inks since the cave men started drawing on rocks. Whether we use it to paint cars, print signs for restaurant windows or use it for homework - and now in our bodies for tattoos, all inks fade over time and the number one enemy to ink is (you guessed it): SUNLIGHT. Taking good care of your treatment is a part of the education and care you will receive from a good practitioner.

In the picture to the right, this is immediately taken right after the first session. It's taken in black and white so you can see the detail, but there is some slight redness and swelling during the procedure, but it lasts only a few hours and subsides by the end of the day.

The area begins to scab around day 4 to 5 and by day 7, it's completely healed. That's when session number 2 happens.

The best thing to do is DO NOTHING. No vaseline, no ointments, no nothing. Let it heal naturally and wash your head at least 2 full days after the session.


Paydirt! All the time spent sitting in that chair and getting stabbed with tiny little needles for 16+ hours is well worth it. Unlike hair transplants where you sit through 8 hours of surgery and endure 3 weeks of unholy pain, the pain is mild and only lasts during the procedure and subsides almost immediately after the procedure.

Once the last session is complete, and with proper care, a typical scalp micropigmentation lasts 2-3 years with normal care and 4-5 years with good care. Avoiding sunlight and not using any harsh shampoos or lotions will help. Clients typically come in for a touch up in about their third year. Touch-ups refresh the ink and gives the scalp a freshly shaven head look again and the cost is no where near the initial procedure.

In looking for a good practitioner or provider, one thing people must understand is that, especially in this industry, experience does not equal talent. If you're not good at something and you do it for longer, it just means you're doing it terribly for longer than the other guy. Someone who is gifted and have never painted professionally doesn't mean their work can't be good. You just have to look at the work itself and the artist before you make that judgment call. Don't go solely on experience. Sure it helps and no one wants to be the guinea pig, but I've seen (and corrected) terrible botched jobs from so-called "professionals" one too many times to know that experience means absolutely nothing. Do your due-diligence by looking at other client photos, talk to their clients, talk to the practitioner and see how much they care about their work and clients.

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