Can scalp tattooing (SMP) be a wise alternative to hair loss?

Over the past year or two, I have started receiving new questions from people receiving hair loss treatment. “Director, is it okay if I get a scalp tattoo along the hairline or parting during treatment?” The number of people considering scalp tattoos to cover up empty areas instead of using black powder (powder) is increasing. To conclude, for those with general hair loss, my answer is, “It can be a good supplement if combined with hair loss treatment.” However, we say, “It is not recommended” for patients with alopecia areata, scalp fibrosis, or dermatitis. Scalp tattooing is certainly an attractive alternative, but it is a procedure that must be approached carefully and with an accurate understanding of its principles and limitations.

1. What is scalp tattooing (SMP)?

Scalp tattooing, or SMP (Scalp Micro Pigmentation), is a technique that uses medical pigment to place microscopic dots on the scalp, which appears empty due to hair loss. These dots look like hair roots that have been cut short, visually giving the illusion of thicker hair. This is fundamentally different from a typical tattoo.

• Treatment Depth:SMP injects pigment only into a shallow depth between the epidermis layer and the upper dermis (approximately 0.8 to 1.5 mm) without disturbing the hair follicles where hair grows.
• Pigment used:We use SMP-specific pigments that have a low risk of discoloration and are harmless to the human body.
• techniques:We use a dotting technique with very fine needles to look like real hair roots.

2. Advantages and disadvantages of scalp tattooing

merit:

• Immediate visual effects:You can achieve the effect of visible density immediately after the procedure.
• Non-surgical methods:Unlike hair transplant, it is not a surgery, so there is less burden and recovery is quick.
• Scar Cover:It can effectively cover hair transplant scars or trauma scars.

disadvantage:

• Not real hair:It is a two-dimensional expression with no three-dimensional effect.
• Periodic retouching required:The pigment may fade over time and retouching may be necessary every 3 to 5 years. The cost of the procedure continues to rise every 3 to 5 years.
• Difficulty of removal:If you don't like it, you have to remove it with a laser, which costs a lot of money and time.
• Unnaturalness in future hair loss:This is the most important drawback. If hair loss progresses further in the future, only the treated area may look unnatural.

3. In these cases, scalp tattooing is not recommended

I do not recommend SMP treatment to people with the following scalp conditions.

• Scalp skin diseases (seborrheic dermatitis, eczema, folliculitis, psoriasis, etc.):If you stimulate the scalp with a needle while the scalp is actively inflamed, the existing skin disease may rapidly worsen. Additionally, due to inflammation, the pigment may not be injected evenly and may spread, or the color may not be properly pigmented and may easily fall off, resulting in a mottled result. If you must get a scalp tattoo, you must first completely treat the skin disease and stabilize the scalp before undergoing the procedure.
• Alopecia Areata:Alopecia areata is an ‘autoimmune disease’, or an ‘active inflammatory disease’, in which our body’s immune system attacks hair follicles. If you stimulate the scalp with a needle, it may cause an excessive immune response, which may cause the area of ​​alopecia areata to become larger or cause new alopecia areata. Additionally, since it is impossible to predict when and where hair will regrow or fall out, the procedure itself may become meaningless.
• Scalp Fibrosis:The scalp with advanced fibrosis resembles hard scar tissue rather than normal skin. This type of scalp is difficult for needles to enter and it is very difficult to inject pigment evenly. As a result, unpredictable results can occur, such as the color becoming spotty or easily falling out, and there is also a risk that the stimulation of the procedure may worsen fibrosis. In fact, scalp fibrosis is one of the 'active inflammatory diseases' in which our body's immune system attacks the scalp tissue, so scalp tattoos may actually worsen the immune response. Therefore, scalp tattooing is recommended for small scars that appear after wounds or surgery, but scalp tattooing is not recommended for fibrosis, one of the autoimmune diseases.

4. The most important thing: Combined with hair loss treatment

The biggest blind spot of scalp tattooing is that “if hair loss progresses further in the future, only the treated area may look unnatural.” What would happen if you only get a scalp tattoo without fundamental hair loss treatment? The tattooed area will remain black, but the hair around it will continue to thin and fall out. Ultimately, over time, only the isolated tattoo area will stand out like an island, making the appearance more awkward and unnatural. If you continue to get tattoos on larger areas to cover up your teeth, you will end up in a vicious cycle where your scalp tattoo will continue to cost as much as the cost of hair loss treatment.

Conclusion: Advice for making smart choices

Scalp tattooing (SMP) can be an effective ‘cosmetic treatment’ to cover up hair loss, but it is by no means a ‘treatment’ to stop hair loss. Therefore, I recommend scalp tattooing to the following people:

• People with healthy scalp condition without severe scalp inflammation
• Those whose hair loss has stopped to some extent or is in the early, mild stages
• And most importantly, those who undergo professional hair loss treatment consistently

When we use scalp tattooing as an adjunct while trying to prevent further hair loss and restore hair health through hair loss treatment, we can maximize the effectiveness of the treatment and maintain natural and satisfactory results for a long time.