Scalp micropigmentation – or scalp tattooing – is a cosmetic procedure for hair loss. If you’ve ever heard of microblading (eyebrow tattooing), it’s a similar procedure, whereby a physician or tattoo artist uses a tattoo gun to fill in sparse areas of the hair with permanent or semi-permanent micropigments. As a result, there is less contrast in color between the hair and the scalp, causing hair to appear fuller and denser – even without any restoration of hair growth.

Studies report high patient satisfaction scores with the procedure and, as such, the industry is expected to expand rapidly – with some clinics having already treated over 10,000 patients (1). And with such a large profit margin for scalp micropigmentation providers, there’s no doubt that this service will soon have widespread availability.

But, for you, the consumer, we need to uncover whether or not this hair loss pseudo-treatment really lives up to its hype (and provides a return of investment). To better understand this, we’ll weigh up patient satisfaction versus cost, quantify tattoo fading (if any), and address long-term concerns with tattooing, all extracted from clinical research.

We’ll also get into the nitty-gritty of what to expect from a procedure and what things you need to keep in mind before investing. Read on to learn more.

Scalp micropigmentation: what is it and who is it for?

Scalp micropigmentation is a procedure by which a practitioner or tattoo artist tattoos micropigments into the scalp. These micropigments are concentrated in thinning or balding areas.

These areas could be as large as the whole scalp or as small as a balding patch or scarred area. Thinning areas can also be tattooed to give the illusion of more hair follicles and, thereby, fuller hair. So, you really only need to tattoo the areas that need it.

The micropigments give the illusion of hair follicles where there may be no hair-producing follicles really present. As such, it can be a really great option for those who 1) are looking to treat hair loss, but want an immediate solution or 2) have treatment-resistant hair loss.

All types of hair loss (androgenic alopecia, alopecia areata, alopecia universalis patients, scarring alopecia, chronic telogen effluvium, chemotherapy-induced alopecia, or even patchier hair loss as a result of scarring or punch grafts) can make an individual a candidate for scalp micropigmentation. There are no gender or age restrictions.

It can also serve as a means to enhance the appearance of hair density following hair transplantation. (2)

But, you may not be the best candidate for scalp micropigmentation if: 

• You have blonde to light brown hair. The dye pigment is dark, which would make the scalp micropigmentation much more noticeable in contrast to lighter hair.
• You have gray hair or are planning on going gray soon and also don’t plan on shaving your head/dying your hair. The reasoning for this is the same as the former concern, gray hair will contrast with the scalp micropigment, making it clearly noticeable. This isn’t a concern if you plan on or are comfortable with shaving your head or keeping your hair dark using hair dyes, however.
• You change your hair color often. Scalp micropigmentation is not recommended for individuals who change their hair color often, as this will make the pigmentation more noticeable.

You’ll also have to take into account factors like cost, how many sessions you can incorporate into your schedule, and more… all of which we will discuss in the next sections.

The procedure: how does it work?

The scalp micropigmentation procedure is accomplished similar to a standard tattoo: a handheld device with 3 medical-grade needles inserts the dye/micropigment into the scalp at a rate of 140 cycles per second, specifically in the areas of balding and/or thinning. (3) The difference between a traditional tattoo and a scalp micropigmentation procedure (besides the needle size and depth of ink placement) is that the micropigments have to be inserted in such a way that they mimic our natural hair follicles.

In other words, the micropigment has to be so precisely placed that the dye inserted is the exact diameter of a normal hair follicle. It also has to be inserted at the right depth — not too shallow or to deep — as improper depth may cause the ink to bleed out into other areas of the scalp.

The procedure sounds simple enough, however, the ability of a provider to accomplish this is contingent upon their skill, experience, and ability to control the needle’s depth and length of time in the skin. The practitioner also needs to be able to reproduce this result multiple times over multiple sessions. In fact, this is essential.

Here’s why: the dyes used in the procedure are considered foreign to the body. As such, the body metabolizes some of the dye in each session, producing an incomplete pigmentation. Full results that mimic the natural follicle require multiple sessions, meaning multiple applications of these micropigments in the same areas.

As a result, the time needed to fully complete a scalp micropigmentation procedure may take as much as 20 hours or more total, spread out over multiple sessions. The amount of time needed for one given session will depend on how much surface area you’re looking to cover.

For reference, one full scalp procedure takes about 6-8 hours from start to finish. But, if you have less surface area to cover, there’s going to be significantly less time commitment for each session.

There will also be 2-3 additional follow-ups required over a period of a month to ensure the pigments remain stable. These follow-up sessions typically last for between 3-6 hours and can be performed as often as weekly over the course of the month.

Does it hurt?

Although the needling process is painful and likely similar to the pain of a tattoo on an area with thin skin, the procedure is always performed under local anesthesia. The procedure is generally painless under the anesthesia, but some individuals (likely those with a low pain tolerance) may feel some discomfort.

How long do results last?

The short answer is: it depends.

Some clinics use biodegradable dyes that eventually metabolize over the course of 3-5 years while others use permanent dyes. (1) Regardless, both will require touch-ups over the course of a lifetime to maintain results, as both permanent and temporary biodegradable dyes will fade over time.

The semi-permanence of the biodegradable dyes is not necessarily a downfall, however. Micropigmentation that fully fades with time may be advantageous, should you choose to go fully gray, change your hair color, or opt for an alternative hair loss treatment (and no longer want to utilize scalp micropigmentation). Additionally, any mistakes made by a practitioner will fade without having to use painful laser treatments.

It’s important to note, as well, that just as red blood vessels appear green or blue at the skin surface, so does black pigment. (1) This is not a result of fading ink over time but, instead, due to the way the spectrum of light is absorbed under the skin. This is something that is totally unavoidable, unfortunately.

Nonetheless, you can avoid additional color changes by protecting the micropigmented areas of your scalp from sun exposure. This can be easily accomplished by wearing a hat or using a high SPF sunscreen on exposed areas.

Is the treatment noticeable?

The visibility of the treatment is contingent upon individual features and what you’re willing to do to disguise the treatment, if needed.

The pigmentation only becomes noticeable when the hair surrounding the pigment is light enough to contrast against the treated area. However, this risk is mitigated by shaving your head or dying your hair dark (but, this is also not something everyone is comfortable with).

With that said, so long as you have dark hair or a shaved head/dyed hair in other circumstances, scalp micropigmentation is likely not noticeable. Although, a keen eye may spot a micropigmented scalp.

How much does scalp micropigmentation cost?

Scalp micropigmentation cost can range depending on where you live, how much of your scalp is being micropigmented, and the skill of the provider you’re looking into.

Generally, a complete scalp micropigmentation treatment will require 2-6 sessions, with the number of sessions calculated on a case-by-case basis. Assuming an average cost of $500 per session, one can expect to pay around $1,000-$3,000 in total cost. Necessary touch-ups will also be an additional added cost (between $100-$300 per touch-up session).

Number of Sessions	Average Cost
2	$1,000
3	$1,500
4	$2,000
5	$2,500
6	$3,000

However, treatments may be more or less depending on the skill and experience of the provider you choose to work with and the size of the area you’re looking to cover.

Are there any risks associated with scalp micropigmentation?

As with any procedure there are risks. We also don’t have a crystal-clear idea of how permanent/semi-permanent inks are metabolized in the body — other than that they sometimes end up in lymph nodes. (1) How this may affect the body is unclear, however, studies have generally not identified an increased risk of system-wide issues with tattooing. (4)

Local reactions, however, have been documented. If you have or have had eczema, psoriasis, or pyoderma gangrenosum on the area you’re looking to pigment, the tattooing process may trigger a flare-up or exacerbate a current breakout. (4) General inflammation after the procedure is to be expected (as with any injury to the skin).

Best practices for scalp micropigmentation

Although scalp micropigmentation is a treatment almost anyone can incorporate, there are some best practices you’ll want to implement to ensure you’re getting the best result. We’ve listed them all here.

Dye or shave your hair if you don’t have dark hair

Lighter hair colors (gray, light brown, blonde) contrast against a micropigmented scalp, which defeats the purpose of the treatment. However, if you do decide micropigmentation is for you, you’ll want to 1) dye your hair dark to match the pigment or 2) shave your head.

Opt for biodegradable ink

Biodegradable ink is a much better option compared to its permanent counterpart. If there is an error during the procedure or you think you may not be comfortable with it down the line, biodegradable ink is far less permanent and doesn’t require laser treatments for its removal.

Hair lines have to follow the natural contours of the scalp

Our hairlines naturally fall along the areas where the parietal plate meets the frontal eminences. As such, any scalp microneedling treatment that doesn’t follow this guideline will look both unnatural and be clearly noticeable.

Take, for example, this picture:

The hairline doesn’t follow the natural pattern and is clearly indicative of a scalp microneedling procedure. Which means that it is critical to find someone with a great track record of success for SMP.

Invest in a good practitioner (don’t skip this!)

As detailed earlier, scalp micropigmentation requires a lot of skill to get it perfect. Practitioners have to have full control over needle depth, placement, and diameter of each individual pseudo-follicle. They also have to have knowledge on how to create natural hairlines tailored to each individual scalp.

Even a small error could result in subpar results — pigment bleeding, an unnatural hairline, and/or patchiness.

So, save up a little extra money and opt for a licensed practitioner, preferably one with a scalp micropigmentation certification and lots of before-and-after photos.

The verdict

Scalp micropigmentation is a great option for almost all hair loss sufferers or those looking to increase hair density after a hair transplant, although those with lighter hair will need to dye their hair darker or opt for a full shave.

The cost averages around $1,000-$3,000 or more depending on where you live, the practitioner performing the procedure, and how much surface area you’re looking to cover. As part of best practices for scalp micropigmenting, you’ll want to invest more money in guaranteeing a you get a great practitioner.

All in all, it seems like a great, low-risk option, so long as the practitioner you choose is experienced in the procedure.