Skin & Medical Treatments
Scalp micropigmentation
Scalp micropigmentation, or SMP, places thousands of fine dots of pigment into the skin of the scalp to recreate the look of hair. On a closely shaved head it reads as stubble. Under longer hair it fills in the pale scalp that shows through where hair has thinned, which is usually what makes thinning noticeable in the first place.
It is a tattoo. It does not grow hair, stop hair falling out, or do anything to the follicles. What it changes is how much scalp you can see. Supporting the hair you still have is a different job, and a different treatment: hair filler.
Who it suits, and who should wait
It suits:
- a receding hairline
- thinning on top or at the crown
- male and female pattern baldness
- alopecia that has settled
- hair loss after chemotherapy, once your hair has shown what it will grow back as
- thinning along the hairline from years of extensions
- and hair that has not recovered after pregnancy, or has thinned through the menopause.
It is the wrong choice, at least for now:
- while hair loss with no known cause is still progressing
- during chemotherapy, or soon after it
- in the first months after having a baby, when shedding usually settles on its own
- while alopecia is still changing, because the pigment stays where it was put
- over broken, inflamed or infected skin, or a flare of a scalp condition such as psoriasis
- if you form raised or keloid scars
- and for anyone under 18, because it is a tattoo and the law does not allow it.
If your hair is thinning and nobody has told you why, see your GP before anything cosmetic, and ask for blood tests including ferritin, thyroid function and vitamin D. SMP hides thinning. It does not explain it, and it will not stop a treatable cause from carrying on.
What separates good SMP from obvious SMP
The commonest mistake is the hairline: too low, too straight and too sharp. A real hairline is soft and slightly irregular, and it sits where it would sit on someone your age. We draw it on first, you look at it in the mirror, and no pigment goes in until you are happy with where it is.
The second is the pigment itself. Placed too deep, or in the wrong shade, the dots spread under the skin and heal with a blue or green tinge, and they blur into a solid patch rather than reading as hair. Shade, dot size and depth are matched to your skin and to the hair you still have.
That is also why it takes more than one session. The first is deliberately lighter than the finished result, because it is easy to add density and very hard to take it away.
What happens, session by session
Consultation
We look at the pattern of your hair loss and what is behind it, talk through what SMP can and cannot do, and agree the hairline and the shade.
First session
The hairline is drawn on and checked again, then pigment is placed in fine layers of dots. Each session takes one and a half to three hours, depending on the size of the area.
Second session
At least a week after the first, once it has healed. Density is built up, and any areas that healed lighter are filled in.
Third session
Shade and density are refined. Some people need a fourth session; a few are finished after two.
Top-ups
The pigment softens over the years and needs refreshing from time to time. A top-up is priced when you need one.
What it costs
From £150 per session, depending on the area being treated. A typical course is three sessions, so from £450. Some people need more, and a few need fewer.
Common questions
Will scalp micropigmentation make my hair grow back?
No. SMP is a tattoo in the skin of the scalp. It does nothing to the follicles and does not regrow or protect hair. It changes how much scalp shows, which is what makes thinning noticeable in the first place.
How many sessions will I need?
Usually three, at least a week apart, so each one can heal before the pigment is built up further. Some people need a fourth. A few are finished after two. You will have a realistic estimate after your consultation.
Does SMP work for women?
Yes, though it is used differently. Most women keep their hair long, so the aim is not a shaved look but to fill in the scalp showing through a widening parting or a thinning crown. Reducing the contrast between hair and scalp is often enough to make thinning much less noticeable.
Can I have SMP after chemotherapy?
Yes, once treatment has finished and your hair has had time to show what it will grow back as. Some people regrow most of their hair and some do not, and designing a hairline too early means designing around a loss that may not be permanent. Tell us about your treatment at your consultation. We may ask you to check with your oncology team before booking.
How long does SMP last?
Years rather than months, but not for ever. The pigment softens and lightens gradually, faster with sun exposure and on an oily scalp, and a top-up session brings it back. It does not disappear completely on its own.
Can SMP be removed if I change my mind?
It can be lightened or removed with laser, but it takes several sessions and complete clearance is never certain. Treat it as a long-term decision. That is why the hairline is agreed before any pigment goes in, and why the first session is deliberately light.
Will scalp micropigmentation look fake?
It can, when the hairline is too low, too straight or too dark, or the dots go in too deep. That is why yours is drawn on and agreed in the mirror first, set for your age, and built up over several sessions rather than one.
Can SMP turn blue?
It can, when the wrong pigment is used or it is placed too deep. SMP pigment sits much shallower than a body tattoo, and the shade is matched to your skin and to the hair you still have.
Does scalp micropigmentation hurt?
Most people describe it as uncomfortable rather than painful, and the hairline is the most tender part. You can ask for a break at any point.
Do I have to shave my head?
Only if you want the shaved look. If you are keeping your hair longer, the dots go in underneath it and nothing is shaved.
Who will carry out my SMP?
Alicia Marsland, or a member of her small team. Whoever treats you is fully trained in scalp micropigmentation.