By Dr. Cole, FUE Hair Transplant Pioneer

Scalp Micropigmentation (SMP): Overview, Preparation & Aftercare

SMP treatment for hair loss

Scalp micropigmentation (SMP) is a cutting-edge solution for those seeking the appearance of fuller hair. In this article, we will explore who can benefit from SMP and the diverse options available to customize this treatment to individual needs. We’ll delve into the various factors that can affect SMP results, ensuring you understand how it can be tailored to achieve your desired look. Additionally, we’ll provide detailed guidance on how to prepare for your SMP appointment, what to expect during the treatment process, and essential post-operative care tips to ensure optimal results. Whether you’re considering SMP for hair thinning, scar camouflage, or enhancing your overall appearance, this comprehensive guide will help you make an informed decision.

What is SMP?

SMP stands for scalp micro pigmentation.  So, what does SMP mean? Essentially,  SMP is a series of tiny tattoos injected with pigment into the scalp, giving the appearance of increased density.  SMP can target specific areas, such as thinning spots; it can also be performed on a patient’s entire scalp or camouflage any unwanted scars. This procedure is customizable for each patient and ensures their most desirable goal can be obtained.

SMP before and after results

Is SMP Right for You?

SMP is for anyone wanting a minimally invasive solution to give the appearance of having more hair than they have, an illusion.  SMP is suitable for both men and women. It can be used to help conceal scarring in former strip patients or any other scar that would be preferred to be covered up.  It can also be used in alopecia patients who do not want to pursue surgical options. In patients with dark hair and a light scalp, SMP can go a long way in helping to conceal thinning by reducing the shine that can often be seen in harsh, bright lighting.

Options, Variables, and X-factors…

SMP can be done in many colors, such as red, blond, brown, and black.   The color can be diluted to match the existing color. An example is taking fiery red pigment and be softened into a strawberry tent.  Needle depth can be varied to create a shorter or longer-lasting effect lasting anywhere from 3 to 10 years.  For those who aren’t sure that SMP hair treatment is the look they want, a shallower needle depth can be used in a small test area so a customer can decide if the result (color, shade, etc.) will match their expectations. 

As with any cosmetic procedure,  beauty is in the eye of the beholder.  An SMP victory is very subjective.  Some patients will opt for a single pass over the scalp with a dark color, while another patient will want three passes over the scalp with a lighter color.  Some patients choose to wear their head shaven.  A shaven head would likely mean more SMP would be needed since the entire scalp is exposed.

In contrast, someone with a good amount of hair but is thinning may choose to do SMP treatment in their crown only. SMP results vary in different types of patients.  A 70-year-old patient with looser scalp skin will see different SMP performance than a 22-year-old.  A patient with a darker complexion and skin tone may see a different performance than someone with a highly light scalp and dark hair. 

Ok…so there is no “one size fits all. “

Exactly right!  SMP treatment is different for everyone, just like most aspects of hair restoration. This procedure is completely customizable for each person. A common strategy we often suggest is to plan on 2 to 3 passes over the entire head in your desired color and shade.  That will usually get a customer their desired results.

Bald crown male patient

So, What are you to Expect?

When getting prepared for your appointment, there is preparation that will need to be done beforehand. Most of these instructions are imperative for your procedure to receive the best results possible. Let’s start by breaking these instructions down for you:

Preparation for Your SMP Appointment

  • SMP procedure can be done no matter the length of your hair. If you tend to keep your hair short or shaved, please make sure it has been shaved well in advance. The reasons for this can be for several different reasons, such as:
    • Lessing the personal “shock” factor after your first session. Each dot is a tiny scab that also contains SMP pigment. Those dots will look larger and darker during the healing process, but don’t worry; they will get smaller and lighter.
    • Revealing any marks or scars we were unaware of and giving you the time to decide whether to leave them alone or cover the area with SMP.
    • Giving you time to moisturize your scalp if it tends to be dry or flakey before your first session. A dry scalp can hinder the tech from performing the procedure and the results.
    • If you have a tan, give your scalp time to become the same color as the rest of your head and neck, allowing the SMP to blend in perfectly with the current state of your scalp.
  • Moisturizing is the most important step: it is imperative that you start moisturizing 21 days or more prior to your appointment. Dr. Cole recommends 3-4 times per day. There is no need to worry about what kind of moisturizer you use or at what intervals; just use what you have in your daily routine or whatever you have lying around the house.
    • This ensures your scalp is in the best possible condition, prevents dry skin from interfering with the technician’s work, and gets you the best recovery setup.
    • Dr. Cole recommends monkey balm as an excellent moisturizer.

If you plan on using pain relief, it is best to make a decision prior to your appointment. Consider taking Tylenol or Advil before the session. A topical anesthetic is available before your appointment date. Be sure to let the staff know if you have taken any pain relievers or applied topical anesthetic before the session.

Planning Your SMP Design

Think about your frontal hairline and what the best end goal would look like for you. You will want to refer to photos of others who have achieved the type of SMP hairline you’re looking for. These can come from our website or from anywhere on the internet. Another good tool is to draw lines on your head to test out what you think could fit you the best. Please do what you can to get an idea of what you want before your first appointment so we can be prepared for your procedure.

Please bring any reference you will use in the form of photographs, even if they’re just photos of your self-made hairlines. This will help your technician understand what you’re aiming for. If they don’t understand your end goals, they won’t be able to deliver your ideal results.

SMP doctor planning hairline

The Treatment Process

After each treatment session, you need to understand precisely what happens to your head after a scalp micropigmentation session. Your scalp has been pierced a couple of thousand times by a needle, usually of the triple cluster variety, and must be taken care of. Don’t let that scare you at all! Discomfort is minimal!  It does, however, mean that your scalp needs to heal, and that means you must refrain from interfering with it for a few days; in fact, following the aftercare guidelines is most important. Each dot is a tiny scab that also contains SMP pigment. Those dots will look larger and darker during the healing process, but don’t worry; they will get smaller and lighter. As your scalp heals, the scabs come away and take some pigment with them. People refer to this as immediate fading, although it’s not actually fading yet. 

Post-Operative Care Instructions

The post-op instructions are minimal and manageable. You should follow them as closely as possible. Failure to do so could alter your results in unwanted ways.

  • Wait to wash, rub, or touch your head for at least three days after each session.
  • Avoid sweating as much as possible. Those trips to the sauna or gym will have to wait.
  • On day four, you will start washing your head with water only. If you have more SMP sessions to go, this is when you will begin moisturizing your scalp again.
  • You can cleanse your head using a gentle facial cleanser on day seven.
  • For the next 30 days, you must avoid heavy sweating, exfoliating, scalp abrasion, and prolonged exposure to strong UV rays (sunlight). The tanning booth is also included in the list of things to avoid.
  • After 30 days, you can resume all your usual activities.

Long-Term SMP Aftercare and Maintenance

For long-term SPM aftercare, you will want to take sensible precautions to ensure the best long-lasting results. This is not a huge list, but there are factors that could alter your results.

  • Be cautious in the sun. If you would have applied sunscreen before you had SMP, you will do so now. If you’re a sun worshipper who never uses any sort of SPF protection, consider applying at least SPF15 on your head. You know it makes sense. 
  • Reconsider your use of sunbeds. They’re bad for your skin and come with cancer risks. Plus, they accelerate your rate of fading. 
  • Avoid topical products that contain high concentrations of alcohol. Be aware that most cosmetic creams, lotions, and moisturizers contain some alcohol, but these are generally fine. I’m talking about high concentrations like what you’d find in minoxidil lotion. 
  • Moisturize at least once a day. Keeping your scalp in good condition will benefit your overall appearance and pigments. 

Patient with hair loss

In conclusion, SMP is an excellent cosmetic option that is not permanent to address any unwanted imperfections your scalp may hold. This procedure is customizable to every patient by creating the perfect pigment color to match your hair, choosing what areas you want to be treated, the density-determined goals, and several sessions. The preparation for SMP procedure will want to be followed as closely as possible to ensure the best outcome. To recap: if shaving your head, do it well before the appointment, moisturize, plan for pain relief, and bring in references. The aftercare of SMP is very manageable but still significant. By following our post-op, avoiding the sun, watching what you put on your scalp, and moisturizing, your outcome will maintain its desired integrity and last longer.


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