Scalp Micropigmentation (SMP)

Scalp Micropigmentation (SMP) is a life-changing treatment where natural pigments are applied at the epidermal level of the scalp to replicate the natural appearance of real hair follicles. SMP creates the look of a shaved scalp or newly emerging hairs coming through the scalp by strategically placing pigments in areas of alopecia. Dr. Williams and SMP practitioners are skilled artists. Dr. Williams is the founding hair surgeon at Orange County Hair Restoration and is intimately involved in all SMP procedures. We are an advance hair restoration surgical facility possessing specialized training and knowledge of SMP that can’t be duplicated in other non-physician based facilities.

SMP is an excellent outpatient office procedure to increase the appearance of hair density for patients with strip scars, low visual hair density, thinning of the hairlines and scalp, and for balding patient who keep their scalp shaved. SMP imparts an optical hair camouflaging effect. Each pigmented mark on the scalp creates the appearance of a newly emerging hair follicle. Results vary from patient to patient, but it typically provides immediate aesthetic and psychological improvement.


How is Dr Williams and staff different than other hair tattoo clinic?

Dr. Ken Williams and Orange County Hair Restoration are medical and surgical professionals and leaders in the hair restoration industry. We follow high standards of medical and surgical care that is not found in tattoo clinics which otherwise have no medical training in hair loss disorders and aesthetics of hair restoration surgery.

The tattoo industry is not regulated by any government agency like the state medical licensing board. Thus many new “clinics” with medically and surgically untrained individuals have entered into SMP without the knowledge and expertise of understanding hair restoration and natural age appropriate balding patterns.

What are Common Mistakes Observed in Patients who Received Improper Treatment?

We often observe poor cosmetic results with unrealistic low hairlines or too deep insertion of the pigment into the dermis. These low hairlines are often observed in patients in their 20s and early 30s who desire the immediate satisfaction of a younger appearing hairline. As skilled hair loss specialist, Dr. Williams and his SMP practitioner design hairlines that are age appropriate, look natural and aesthetically consistent with the person’s facial features.

What are Reasonable Expectations?

We counsel patients to expect that your SMP procedure will over staged or several procedures and will give you aesthetic density. It is reasonable to expect that the pigment deposited into the upper dermis will fade over time. It may even take on a blue appearance.

How Does SMP Work?

The procedure uses needles inserting micro droplets of pigment through the skin and into the upper dermis. The SMP process requires a small needle that creates a hole in the upper portion of the dermis. The ink or pigment then is dispersed and absorbed in the treated area. The needle(s) must perforate the epidermis to get to the upper dermis. The depth of needle insertion varies by the clinical senses and visual judgments of the operator. If the pigment is placed only in the epidermis, the procedure will fail because the pigment will be lost after the procedure is completed. If the pigment is placed deep in the dermis, the cosmetic outcome will not be appreciated as the pigment diffuses our of the area of insertion.

What are the general and specific characteristics of SMP?

Traditional tattoos are not the same as SMP created effects. SMP does not deposit the ink pigments into the deeper portion of the dermis where such pigments are permanent. SMP ink pigments may contain titanium dioxide, lead, chromium, nickel, iron oxides, ash, carbon black, and other ingredients. Once deposited in the upper dermis by the SMP technique, the pigments are digested by the macrophages of the immune system as the body recognizes these metals as foreign substances as it attempts to “clean up” the skin. This is a reason why pigments may change over time.

What Happens to Pigment over time?

All tattoos and ink changes over time. Permanency of SMP ink does not occur for many reasons. Sometimes the ink pigments are removed by the immune system macrophages and moved into lymph nodes. Pigment does collect in the lymph nodes and the long term health effects of the pigments are not known.

What are Indications for SMP?

SMP can be performed on any healthy scalp that requires the appearance of greater density. The procedure is best for patients with advance balding patterns who choose to shave their scalp. Patients who suffer from burns, scars or birthmarks are eligible for this outpatient procedure. Patients can have this procedure if they are not candidates for hair transplantation and who want to shave their scalp. For patient with less advanced hair patterns, SMP can add greater density to the existing part of scalp with hair density.

How Much Does it Cost?

It depends upon the thinning or balding pattern, the area of the scalp to be covered and if any scars are present. The price range for SMP is $1500 to $5000 (US dollars).

Procedure Type Sessions 1 & 2 (Estimated$USD)
Scar Treatment Only $1500 – 2500
Norwood 2-3 (hairline or crown work only) $2000 – 3500
Standard Procedure NW 6 (Benchmark Price) $5500
Standard Procedure with Scars $6000 – 7000

Can Women Have SMP?

Absolutely. Women who don’t want hair transplant surgery are great candidates for SMP, and respond well to adding pigmentation to existing thinning hair densities.

Are there Differences in Pigment Types?

Yes. Pigments vary from manufacturer to manufacturer. Dr. Williams utilizes ink pigments that are considered to be superior to other tattoo clinics performing SMP. Black pigments vary from manufacturer to manufacturer. They have a potential to turn blue over time if placed too deep in the dermis. No one can predict the final outcome of the SMP procedure.

What Type Of Medical Conditions Will Respond To SMP?

Patients with autoimmune diseases such as alopecia areata or alopecia totalis are excellent candidates and typically received benefit from SMP. Neurosurgical patients who suffered head and cranial traumas with resulting scars may be considered candidates. Patients with scars have a reduced response to SMP as scar tissue absorbs pigments differently than health normal skin.

Can I have SMP if I have Chemotherapy?

Yes. If the patient feels well enough to have the procedure it can be performed

Is Healthy Skin Required for SMP?

Yes. Healthy skin is required to carry out SMP. Dry, red, or peeling skin disorders will not tolerate the procedure well. Active scalp or medical skin disorders may be worsened by the procedure, or increases the risk of procedure failure by limiting ink absorption into the skin structures.

If any active skin disorder such as Psoriasis or Seborrhea Dermatitis is present, then the procedure can NOT be performed until your Dermatologist treats your active skin condition and gives you clearance to have the SMP procedure performed.

Will I need Maintenance Sessions?

Yes. It is difficult to predict the total number of sessions necessary to create the visual hair density our patient’s want. Typically, the number of treatment sessions varies from one (1) to four (4) in the first year. A physiologic phenomenon observed in SMP is the pigments used in the procedure may be absorbed into deeper layers of the skin and engulfed by the immune system. This process results in fading of the pigment over time or a bluish appearance of the scalp.