Frequently Asked Questions

Is it Permanent?

Yes, Scalp MicroPigmentation is a permanent medical-grade tattoo similar to permanent makeup or a traditional tattoo.

Fading: Just like traditional tattoos, the pigment will fade over time. To avoid premature fading, we recommend that you use sunscreen and avoid prolonged periods of exposure to the sun. If you need to be exposed to the sun for a long time, wear a hat if possible. Doing so will not only preserve you SMP but it will also protect your skin from sunburns.

Is it a Tattoo?

Scalp MicroPigmentation is a medically refined tattoo.  In other words, it’s a medical-grade tattoo.

What’s the difference between a Tattoo and SMP?

To understand the difference between a tattoo and SMP, you need to understand how a traditional tattoo is applied to the skin and the skin layers that are affected by the pigment.

Human skin has three layers: the epidermis, the dermis and the hypodermis. The dermis is the outer layer. It’s the layer you wash in the shower and the one that produces flakes from dry skin. The epidermis is the second layer of skin and it can be up to up to 4 millimeters thick. It’s this layer that will absorb the pigment during a tattoo or SMP procedure.

During a regular tattoo session, the tattoo machine is set to penetrate the epidermis all the way into the dermis to a depth of up to 3 ½ millimeters. The needles used in a tattoo are very thick and carry a lot of pigment into the skin.

During SMP, the dermis is penetrated to a depth of ¼ millimeter to ½ millimeter. The needles we use are extremely fine medical-grade needles designed to leave a very small dot of pigment in the skin. Thousands of these small dots on the scalp give the appearance of a full head of shaved hair on a bald patient.

Are your doctors and medical technicians tattooists?

No, we are not tattooists. Jae Pak, M.D. is a medical doctor and works with medical technicians who specialize in surgical hair transplants in Los Angeles. For over 15 years, we have successfully performed hair restoration surgery on thousands of patients. When we design a hairline for a patient during Scalp MicroPigmentation, we know what a hairline should look like because we’ve recreated so many of them during surgical hair transplants. We can duplicate a variety of hairline designs to match your ethnic background, your balding pattern and age.

The doctor will discuss the hairline with you and make recommendations. He will use a grease pen or a surgical pen to draw the outline of the proposed hairline on your head. He will make the changes you want until you are satisfied with how it looks. This process helps to visualize the end result of your procedure and eliminates any unwanted surprises.

Who Came Up with the Term ‘Scalp MicroPigmentation’ or ‘SMP’?

Alvaro Traquina, M.D. used the term “micropigmentation of the scalp” in an article published in the Dermatologic Surgery medical publication back in 2001 (see Micropigmentation as an Adjuvant in Cosmetic Surgery of the Scalp). His title, text, and pictures clearly define the use of the pigment as a concealer.

We started using the term “Scalp MicroPigmentation” and “SMP” around 2010 and started referring to it as “SMP” and purchased the Internet domain names since the terminology was not being used. Since then the term “SMP” and “Scalp MicroPigmentation” caught on all over the world. We did apply for the SMP trademark and the (R) symbol with the U.S. Patent office but were denied trademarking a common merely descriptive term. SMP is merely describing the service offered almost literally (which did not rise to the level of trademark protection).

Thus no one can claim TM or (R) symbols.

Is this a medical procedure?

SMP is not a medical procedure. Although it is performed in a medical hair restoration clinic by hair transplant surgeons and specially trained staff, it is technically not a medical procedure. Our technicians have years of experience performing SMP and hair transplant surgery. Our surgeons are pioneers in the field of medical hair restoration and they have perfected the techniques used in Scalp MicroPigmentation to ensure a successful procedure every time.

Is it safe?

Our SMP procedure is completely safe. We use pre-packaged one-time-use sterile needles. Our clinic adheres to surgical center rules to maintain the highest level of sterility and cleanliness. Your procedure is done in a private treatment room. This greatly reduces the possibility of cross contamination from patients receiving other treatments at the clinic such as hair, beard or eyebrow transplants.

Does it hurt?

Scalp MicroPigmentation is far less painful than a traditional tattoo but you will still feel some discomfort depending on your pain tolerance. Patients say the tender spots are at the front hairline and around the ears.

To make you as confortable as possible, we offer local anesthetic that is similar in nature to the anesthetic used by dentists. We also offer light sedation for the duration of your procedure.

What if I want to grow out my hair?

Depending on your balding pattern this may be possible. Consultation between a prospective patient and an experienced hair restoration doctor before undergoing SMP is invaluable.

What if I am not bald, but I want to make my hair look fuller using a concealer (Toppik and DermMatch)?

SMP is used to decrease the contrast between your scalp color and hair color, giving an illusion of fullness. You can think of SMP as a “permanent” cosmetic concealer such as Toppik or DermMatch. Unlike some concealers, with SMP you will not have to worry if your scalp is showing from the uneven application of concealers. Unlike some cosmetic concealers, SMP does not put a stain on your clothing, pillow, or on your significant other’s fingertips.

What if my hair turns gray?

Believe it or not, the stubble from white hair (and most colors of hair) is GRAY when you shave close to the skin. Just look at blond men with a close shave and you will see the gray shade where the hair exits the scalp. We try to match the shade of pigment based on your skin and hair color. If you have dark hair now and it turns gray later on in life, the underlying shade will blend despite the hair color change, because SMP covers the entire scalp (not just the bald areas).

If I continue to bald after doing the procedure, will it look natural?

As we are physicians specializing in hair loss and its treatment, we can plan for a worst case balding situation to develop. Whatever is done, it must be designed to plan for the worst case balding scenario or the possibility that some day you may decide to have a hair transplant or another type of hair loss procedure in the future.

What if it fades?

The SMP process requires two to three treatments spaced out at least two weeks apart to get the color and shading just right. This time interval is needed so that your skin can exfoliate. Each individual absorbs some pigment at different rates. For the first year we offer free touch ups if there is any fading. Your finished SMP process should last years before needing a touch up, but everyone is different.

What if I want a hair transplant later on?

You can always have a hair transplant in combination with the SMP process, but not on the same day.

Can I ease into the decision to have this done?

Yes. We have done test areas (about 1cm square area) in scars so that the person gets comfortable with the way it looks, and we have done test areas where the balding scalp meets the side hair. This approach has been very helpful to the person who is ‘on the fence’ in deciding whether SMP is right for them. Remember, we are doctors first and we want anyone considering this procedure to be comfortable with their decision.

Does it look real?

Yes. Although there is nothing in this world that is “perfect”, with the artistry and technique we use, you should not be able to tell that someone has had SMP even up close. SMP gives you the look of a permanent 5 o’clock shadow. SMP blends in with the genetically resistant-to-balding hair around the sides of your head.

Don’t tattoos or pigment dots just look like a big blob over time?

Traditional tattoos may discolor, but this is highly dependent on the type of ink used, the depth the pigment was placed into the scalp, and the amount of sun exposure you get. The key to minimizing this effect is to use a specialty pigment like we do and either wear a hat when in the sun or use a good sun blocker (with a high SPF factor). SMP dots will lose definition over time, but unlike regular tattoos, the ‘blob’ look is greatly minimized due to the special technique and the instruments used.

Don’t tattoos or pigment look green or blue?

There is always a potential change in the color of pigment over time. The pigment used for SMP is chosen to match the color and tone of shaved hair underneath one’s skin. Despite variations in hair color, most patients have a grayish (and greenish) tint after the hair is shaved from the dark roots of the hair showing through the layers of the dermis and epidermis. Much like how blood vessels appear green under the skin, the increased absorption of the red spectrum of light gives rise to this phenomenon explained by the trichromatic theory of color vision (i.e. if red is absorbed, you will perceive green). The light propagation through human tissue has also been modeled to show the greater decrease of red spectrum remission. In short, there is NO TRUE perception of black when the pigment is deposited beneath the skin. The greater depth of pigment deposit, the greater the potential change in color perception.

I heard there are other techniques or colors that will not turn green or blue.

Over time, there will always be a slight change in the perception of color. Some patients never feel the need for a touch up and others come back after several years if they see slight changes. (See the answer from the previous question for more information.)

Can you make a soft natural hairline?

Dr. Pak is an expert at creating natural looking hairlines. Most clients want a soft and natural fading frontal hairline, while others prefer a more distinct and linear look. We advise and work with our patients individually to obtain the look they want.

I saw this technique on other websites called something else, what makes you different?

The difference between SMP with Jae Pak, M.D. and other businesses offering similar services is that Dr. Pak is ABMS Board Certified physicians with over 15 years in the hair restoration business. We’ve been offering hair restoration since 1992. We are a medical group offering SMP in a medical facility. Our physicians offer anesthesia to ensure a pain-free procedure. We are experts in the creation of natural looking hairlines and can combine SMP with hair transplant surgery for a comprehensive hair restoration solution.

What will I look like immediately after SMP is done?

Immediately after the procedure, your scalp will look slightly pink, somewhat similar to a sunburn. This pink color will fade out over the course of 24 to 48 hours. This is more pronounced in patients with a light skin color. You will appear to have a full head of hair that has a closely shaved look. The pigment may also appear more pronounced until you wash your scalp and remove the excess pigment three days later. Depending on each patient and the type of skin, the pigment may fade as it settles in. This is the reason why you may need more touch-ups, so that the shade and color is just right. Although we recommend at least 2 weeks between SMP sessions, you can wait weeks or months depending on your schedule and geographic location.

I am a woman with thinning hair. Can SMP help me appear to have thicker hair?

Yes, we have performed SMP on women, but we are cautious when it comes to women because we want to know the cause of the hair loss or hair thinning. With men, 99% have hair loss or hair thinning from genetic causes in a typical balding pattern (MPB), but women may have balding due to many medical conditions and we would want to diagnose them prior to offering SMP. As ethical physicians, we want to be sure that we do not perform this process on women who have potentially reversible baldness from hormonal causes, thyroid, or autoimmune diseases.

Can my tattooist do what you do?

No. SMP is unique in its application as we use specialized instruments, needles, and pigments. A tattooist may be an expert at what they do (creating wearable art) and their clients are proud to show off their tattoo, but a successful SMP application should be virtually undetectable. You also have the option to have the SMP performed under a local anesthesia – a tattooist cannot deliver anesthesia to ensure a painless procedure.