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Dr. Ruk
Dr. Ruk has years of experience with FUE. He tailors each procedure to individual needs, hair type, and desired outcomes. Dr. Ruk has raving reviews and high-quality before-and-after photos that showcase his exceptional results. -
Scalp Micropigmentation (SMP)
A Cosmetic Tattooing Procedure to Conceal Hair Loss
Scalp Micropigmentation, the process of tattooing thinning or bald areas of the scalp to resemble shortly cropped hair, has been met with high amounts of enthusiasm from patients seeking alternative ways to mask and conceal their hair loss. This artistic and minimally invasive procedure, also referred to as SMP, provides men and women suffering from hair loss with an illusion of fullness or the appearance of thick, shortly cropped hair. SMP results (not the procedure) are often compared to topical concealers such as Toppik, DermMatch and Nanogen, because they also help conceal baldness and make thinning hair appear thicker and fuller.
Although scalp micropigmentation is increasing in popularity, it is still a new and evolving practice and its mystique may leave interested patients asking several important questions.
How does scalp micropigmentation work? What are the benefits, limitations and potential risks associated with the procedure? Who is a suitable candidate? What are the costs associated with SMP? What happens if consumers don't like the results? Is the ink associated with scalp micropigmentation permanent? Are all SMP practitioners equal or do some produce better, more natural looking results?

Scalp Micropigmentation is the artistic application of tattoo-like ink or pigmentation "dots" to bald or thinning areas of the scalp to recreate the appearance of shortly cropped hair (or "stubble") by a trained practitioner. SMP practitioners are typically experienced in the art but often aren't medical professionals or hair restoration physicians. Scalp micropigmentation is typically used for one of three purposes. These include:
- Creating the illusion of fullness or density to thinning hair by applying cropped, hair-like tattoos in between and around thinning hair.
- Creating the appearance of closely cropped or shaved hair on an otherwise bald scalp.
- Camouflaging a pre-existing hair transplant scar. Typically, this is a rare, but stretched, linear scars from follicular unit hair transplantation procedures via strip harvesting (FUT) can sometimes require revision.
Scalp micropigmentation ink is normally placed in the superficial dermis, a layer of skin between the epidermis (the outer layer of the skin) and subcutaneous tissues that consists of connective tissue and cushions the body from stress and strain. However, SMP practitioners often place ink at varying depths. Some practitioners are now beginning to use a “sweeping” technique when tattooing, in order to create a more three-dimensional appearance on the scalp.
Depending on the size of the balding/thinning area and the desired appearance, the procedure can take anywhere from 1-8 hours, and can now be completed with both permanent and temporary SMP ink.
According to Coalition hair transplant surgeon Dr. Robert Bernstein, the key to further achieving a natural result with SMP lies in holding the inking tool at an appropriate angle, controlling the depth at which the ink is placed, monitoring the amount of ink deposited at each site, and selecting appropriate ink tones.
To read more of Dr. Bernstein's input and discussion related to SMP at the 2012 annual ISHRS Scientific Meeting for hair restoration physicians, visit "Scalp Micropigmentation (Scalp Tattooing)at the 2012 ISHRS (International Society of Hair Restoration Surgery) Scientific Meeting".
Permanent Versus Temporary Scalp Micropigmentation (Advantages and Disadvantages)
Defining and understanding the difference between permanent and temporary ink is important for any consumer considering the procedure.
Permanent scalp micropigmentation is performed with micropigmentation ink that is not designed to fade or change over time. The ink is placed slightly deeper in the scalp tissue, and the procedure can be performed with ink containing both colored and black pigment.
Advantages of permanent SMP include the ability to undergo a single SMP treatment without frequent “touch ups" and potentially lower long-term costs.
Disadvantages include the possibility that the ink will eventually fade to a green or blue hue (due mainly to the black pigment used in permanent SMP ink) and the inability to reverse the procedure without laser pigment removal (i.e. “laser tattoo removal”) if the work is unsatisfactory.
Temporary scalp micropigmentation is performed with ink that is specially designed to gradually fade and disappear within 6 to 24 months after the procedure. The ink is placed into a superficial layer of the scalp, which allegedly helps to define the pigmentation and decrease the probability of “blurring” ink. Temporary SMP is performed with ink containing no black pigment. Because black pigmentation can eventually fade into a blue or green tone, it would inevitably produce an unnatural looking result as it gradually fades and disappears, and should be avoided.
Advantages of temporary SMP include: the ability to redesign or discontinue the process (when the ink fades after 6-24 months) if the results are not satisfactory; the decreased rates of ink blurring, running, and definition loss with the superficial placement into the scalp; and the ability to use the three-dimension technique (which was designed by Beauty Medical in Milan, Italy, and is now utilized by several leading clinics recommended by this patient community).
Disadvantages of temporary SMP include ongoing maintenance and costs associated with undergoing subsequent SMP applications every 6 to 24 months, and the possibility of discoloration as the ink fades (though the temporary ink is purposely designed to fade evenly and without discoloration).
To learn more about the advantages and disadvantages of permanent and temporary SMP, visit "Temporary Scalp Micropigmentation: Advantages, Disadvantages, and Clinics Currently Offering the Procedure".
Scalp Micropigmentation Costs
The cost of SMP is variable and depends upon the type of procedure (temporary versus permanent), size of the procedure, and the practitioner/clinic performing the micropigmentation. While rates typically vary and change, permanent SMP can cost anywhere from $800 for a small procedure and $6000 for a large one. The cost of temporary SMP is approximately half the cost of permanent SMP and typically ranges from $500 to $2500 depending on the size of the procedure. Subsequent procedures, which are needed 6 to 24 months after the initial results fade are typically 50% of the original costs.
What Makes a Good SMP Candidate?
Although a wide variety of men and women are interested in scalp micropigmentation, the procedure is actually only ideally suited for a small, select number of hair loss consumers.
SMP is likely best suited for individuals interested in aiding the appearance of density in shortly cropped, diffusely thinned hair, and for patients trying to camouflage a hair transplant scar. It may also be suitable in creating a greater illusion of fullness in those who've already undergone surgical hair restoration.SMP consumers should also consider a naturally asymmetrical hairline design and “fading” effect (from decreased pigmentation in the hairline to denser, increased pigmentation in the middle scalp) if hairline restoration is performed. This approach will likely create a more natural result in eligible candidates.
Creating Realistic Expectations
While scalp micropigmentation may be a useful adjunct therapy for a select group of consumers interested in concealing their hair loss, it should be approached with realistic expectations and performed by a trusted clinic. Individuals considering the procedure must remember that SMP is a two-dimensional process and cannot provide the texture and growth of real hair. Undergoing SMP without respecting its limitations may create unrealistic expectations and disappointing results.
Evolving Procedure or Just a Fad?
Is SMP just a fad or will it continue to evolve and cultivate additional interest from hair loss sufferers and hair restoration physicians?
While some hair loss experts are quickly embracing the procedure, others are more resistant, and liken scalp micropigmentation to less popular "niche" treatments like hair systems, laser caps, and topical concealers. Whether or not it will continue increasing in popularity and retain its momentum is not yet clear.
Hair restoration is a rapidly changing field and new and evolving therapies may eventually render scalp micropigmentation and other hair loss treatments obsolete. Altogether, only time will tell whether SMP is a lasting adjunct therapy or a passing fad.
Clinics Currently Offering Scalp Micropigmentation
As of January 2013, the following hair restoration clinics recommended by this website are offering some form of Scalp Micropigmentation: Hasson and Wong (Drs. Victor Hasson and Jerry Wong), and Shapiro Medical Group (Drs. Ron and Paul Shapiro).
Dr. Feller, Dr. Lindsey, Hasson and Wong, and Shapiro Medical Group trained with Beauty Medical and offer the temporary SMP procedure; Dr. William Rassman performs his own variation of Scalp Micropigmentation with permanent ink.
Note that in many cases, a trained technician and not the physician will be performing scalp micropigmentation.
This website does not currently recommend one SMP clinic over another. Those considering scalp micropigmentation as a tool to conceal hair loss and create an illusion of hair are encouraged to do their own diligence in researching each technique, practitioner and clinic.
To discuss scalp micropigmentation with hair loss sufferers and other interested parties and to view results showing before and after pictures, visit the Scalp Micropigmentation Forum.
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Damkerng Pathomvanich, MD
Dr. Damkerng Pathomvanich
Dr. Damkerng Pathomvanich and his experienced staff regularly perform large densely packed megasessions with outstanding results. -
Finally Hair Loss Medication that works
While hair restoration surgery is now a proven treatment for restoring hair where it has been lost, Hair loss medication such as Rogaine (minoxidil) and Propecia (finasteride), have made real contributions toward stopping and even reversing hair loss.
During the late 70’s and early 80’s it was discovered that minoxidil, used as a heart medication, had hair growing side effects. Minoxidil was tested for use as a topical scalp treatment for hair loss and proved to inhibit hair loss in many test subjects.
It has proven to be effective to some degree in slowing the hair loss process. For a minority of people it can even grow back lost hairs in the crown area (back of the head). However, Rogaine (minoxidil) does not slow or reverse the balding process in the frontal hairline area.
Rogaine is typically applied topically on the scalp twice a day, morning and evening. But once usage is discontinued the hair loss which had been inhibited will resume and the hair that was saved will be lost.
Rogaine originally required a prescription, but in 1995, it became available in 2% strength Rogaine over-the-counter. Today, men and women can buy 5% strength lotion over-the-counter as Rogaine or as generic minoxidil.
To date Rogaine (minoxidil) and Propecia (finasteride)are the only hair loss medications with FDA approval. Propecia’s active ingredient, finasteride, was originally used to treat enlarged prostate glands. It was discovered that, like minoxidil, it had the “side effect” of stopping male pattern baldness and for some even regrowing hair.
Propecia is taken as a pill once daily and acts to inhibit the body’s ability to create dyhydrotestosterone or “DHT”. DHT acts as the active ingredient or catalyst in the balding process.
Rogaine and Propecia
The 90’s brought great advances in hair restoration, both surgical and non surgical. Now most people can realistically halt and reverse their hair loss with truly natural results.
In 1988 minoxidil, Rogaine, became the first hair loss medication to be approved by the FDA for the treatment of hair loss.

In 1998 the FDA approved Propecia for the treatment of hair loss. Propecia (finasteride) should NOT be taken by woman or children for any reason.
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ProTHIK Hair Loss Concealer
Truly "Personal Care Luxury?"
Of all the types of concealers available today, one of the longest lasting may be the "spray on," color-matching aerosol topical. Although many brands and differing types of spray on concealers currently exist, ProTHIK is considered by many to be one of the most trusted. What makes this product so popular in the hair loss community? How does ProTHIK work to conceal hair loss? Is ProTHIK truly a "personal care luxury for men" like their website indicates?
ProTHIK: What is it, and how does it Work?
ProTHIK belongs to the popular "aerosol" variety of spray applications. It is applied properly by spraying an appropriate amount of the aerosolized solution onto balding areas of the scalp. Due to its resin technology and variety of natural color choices, spraying ProTHIK onto areas of the balding scalp or thinning hair eliminates unsightly "bald spots" and reportedly leaves the patient with a realistic looking and undetectable appearance. But what does ProTHIK offer that similar hair loss products do not?
The Benefits of ProTHIK
According to the manufacturers, ProTHIK is superior to similar products for a number of important reasons.
First, ProTHIK allegedly possesses superior rub-resistance, a single component formulation (meaning multiple applications during one sitting is not necessary), superior water resistance, and a greater overall durability.
Second, when applied to the scalp, ProTHIK supposedly creates a natural, undetectable appearance (to both visual and physical inspection) that is resistant to excessive amounts of sweat. What’s more, ProTHIK is proposed to last overnight or between showers, and washes off easily with basic shampoo.
Third, ProTHIK is designed to provide adequate coverage in a variety of hair loss scenarios. For example, ProTHIK is reportedly able to conceal scalp regions with only 10 to 15% remaining hair and "bald patches" as large as 3-4 centimeters in diameter.
ProTHIK Product Reviews
Like other aerosol products, ProTHIK is only recommended for areas of hair loss 1.5 - 1 inches posterior to the frontal hairline however, it's considered especially effective in the vertex (crown) region. Despite the more specific application, ProTHIK remains popular with many consumers because of its overall effective nature, natural appearance, and lasting durability. On the flip side, some ProTHIK users have expressed concerns about messy application and clogging.
Unlike similar products, ProTHIK reports that it requires fewer applications and its resin technology does not create a shiny, thickened, or "sticky" appearance when applied to areas of balding scalp.
Additionally, manufacturers of ProTHIK report that it remains effective in hair thinned up to 85 – 90% of its original density and bald patches as large as 3-4 centimetres in diameter. For these, and many other reasons, ProTHIK remains a popular, trusted choice for individuals seeking a quality aerosol concealer.
What Real Hair Loss Sufferers are Saying About ProTHIK
To learn what hair loss suffering men and women who've used ProTHIK are saying, visit our popular hair loss forum and social community.
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Dr. Felipe Pittella
Dr. Felipe Pittella
Dr. Felipe Pittella performs ultra-dense mega-session and Giga-session FUE procedures on Norwood 6 and 7 patients with excellent density and coverage. Dr. Pittella combines quality and affordability with coverage and density. -
Dr. Taleb Barghouthi
Dr. Taleb Barghouthi
Dr. Barghouthi performs Ultra Refined Follicular Unit Extraction (FUE) and Follicular Unit Strip Surgery (FUSS) with excellent results. He and his staff can perform extensive mega sessions with dense natural results. -
Tricomin Follicle Therapy Spray, Shampoo and Conditioner

Tricomin is an all natural hair loss treatment designed for both men and women with thinning hair to stimulate hair regrowth and improve the appearance of thinning hair. It can also be used in conjunction with with Rogainehair regrowth treatment.
Tricomin Solution Follicle Therapy Spray combines the benefits of the Triamino Copper Nutritional Complex with an exceptional leave-in conditioner. The therapy spray enriches your hair and scalp with a unique blend of mineral and body-building ingredients and essential amino acids. Spraying the therapy spray liberally after shampooing daily will condition and treat your hair and scalp. It's recommended to apply this product to damp or dry hair.
The Tricomin Revitalizing Shampoo stimulates and restores health, structure, and vitality to thinning, fine, and damaged hair. It's recommended to use the Revitalizing Shampoo daily, gently massaging it into moistened hair scalp, leaving on for 3 to 5 minutes before rinsing. A second application may be made if desired.
The Restructuring Conditioner uses a unique moisture and nutrient-rich framework to help restore your hair's natural mineral and protein balance. This conditioner helps to add structure and body onto thinning and/or damaged hair.For best results, use all three Tricomin products in conjunction with one another. All 3 Tricomin products is called the Tricomin TricoPak.
How It Works:
Al three Tricomin products contain the active ingredient copper peptides. Scientific evidence suggests that copper peptides can shorten the shedding (telogen) phase and elongate the growth (anagen) phase of the follicles. Partial FDA trials showed Tricomin products' effectiveness in promoting new hair growth.
Developing Realistic Expectations:
Tricomin copper peptide technology may provide marginal benefit to men and women with thinning hair. To date, only surgical hair restoration is proven to grow hair in completely bald areas. You are invited to have a free virtual consultation with one of our prescreened hair restoration physicians.
Ingredients
Tricomin Follicle Therapy Spray: Purified Water, SD Alcohol 40B, Amodimethicone, Nonoxynol-10, Panthenol, Polyquaternium-11, Polysorbate 60, Tallowtrimonium Chloride, Citric Acid, Dimethyl Lauramine Isostearate, Linoleamidopropyl Ethyl Dimonium Ethosulfate, Triamino Copper Nutritional Complex (Alanine/Histidine/Lysine Polypetide Copper HCl), Methylparaben, Benzethonium Chloride, Menthol, FD&C Blue #1.
Tricomin Revitalizing Shampoo: Purified Water, Sodium Laureth Sulfate, Disodium Cocoamphodiacetate, Cocomidopropyl Betaine, Ceteth-16, Glycerin, Laneth-16, Oleth-16, Steareth-16, PEG-75 Lanolin, Sodium Chloride, Triamino Copper Nutritional Complex (Alanine/Histidine/Lysine Polypetide Copper HCl), Citric Acid, Diazolidinyl Urea, Hydrolyzed Keratin, Panthenol, Methylparaben, Fragrance, Propylparaben, Peppermint Oil, D&C Red #33, FD&C Blue #1.
Tricomin Restructuring Conditioner: Purified Water, Glyceryl Stearate, PEG-100 Stearate, Stearamidopropyl Dimethylamine, Cetyl Alcohol, Propylene Glycol, Stearyl Alcohol, Dimethylamine, Triamino Copper Nutritional Complex (Alanine/Histidine/Lysine Polypetide Copper HCl), Hydroxyethylcellulose, Panthenol, Aloe Vera Gel, Soydimonium Hydroxypropyl Hydroxylyzed Wheat Protein, Hydroxylyzed Keratin, Citric Acid, Methylparaben, Fragrance, Disodium EDTA, Propylparaben, Peppermint Oil, Tocopheryl Acetate, Cholecalciferol, Retinyl Palmitate, Vegetable Oil, FD&C Blue #1, D&C Red #33.
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The Coalition of Independent Hair Restoration Physicians
Chosen by Patients and Peers for meeting the highest standards.
This Learning Center is sponsored by the Coalition of Independent Hair Restoration Physicians.
This elite group of independent surgeons have been carefully selected by patients and leading physicians and are committed to providing Ultra Refined Follicular Unit Hair Transplantation.
This minimally invasive hair restoration procedure enables patients to achieve very natural and dense hair growth after only one surgical session.
Coalition members agree to have their results openly critiqued and reviewed on the world’s most respected online patient based community - the Hair Restoration Network. Learn more about the high standards Coalition physicians must meet for membership.
Find an an elite Coalition Physician in your area and consult for free about how to restore your own natural hair.
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What Causes Hair Loss?
As you see yourself balding, while others retain their hair, you may ask - why me?
The basic answer is – your hair loss is due to your genetic make up. Your thinning hair is not due to anything you have done, whether wearing too many hats, washing your hair too much or too little or any other hair loss myths. Alopecia or hair loss is primarily genetic and is referred to as "Androgenetic Alopecia" in the medical community.
Your hair's future is largely determined before you're even born. Your follicles have been genetically programmed as to when, where and how much baldness (if any), you'll experience in your lifetime. But the fate of your hair can be altered or compensated for with modern hair loss treatments.
So what are the specific causes of hair loss?
Baldness is largely the result of certain hormones interacting over time with those hair follicles that are vulnerable to their effects.
Both men and women produce "male" hormones. The three most common are testosterone, androsteinedione, and dihydrotestosterone (DHT). Hair follicles, as well as the sebaceous glands, contain high levels of an enzyme called 5-alpha-reductase. This enzyme converts testosterone into DHT, via the blood. DHT is the source of most male pattern balding.
In some people, their follicles on the top of the head are genetically vulnerable to baldness. Over time, these genetically vulnerable follicles are acted upon by the hormone DHT. This hormone binds with the receptor sites of these vulnerable follicles and cause the hair follicle to weaken over time. Propecia is a drug that has been shown to slow the creation of DHT and can be helpful in slowing, stopping or in some cases, reversing hair loss when it is used early enough.
Hair grows naturally in cycles of approximately 3 to 8 years. At the end of the growth cycle, the hair shaft is shed from the follicle and a new hair grows. With thinning hair or balding, each successive growth cycle is shorter and the hair produced is thinner and finer. This is called 'miniturization'.
Men and women don't go bald overnight, it is a slow progression of thinning hair and hair loss that eventually produces baldness. In many cases, the balding has progressed to such a stage that hair loss treatment products aren't enough to reverse the balding process.
Few treatments have the dramatic effect of restoring hair like hair restoration surgery. Click here to learn more about hair restoration.
Not all hair loss is permanent. There are many causes of temporary hair loss that can be treated with diet, stress reduction and a visit to your doctor. Click here to learn about other causes of hair loss.
Androgenetic Alopecia
And rogenetic Alopecia, commonly referred to as 'genetic balding', is the main cause of male and female hair loss. This genetic 'programming' accounts for 95% of male hair loss.
For baldness to occur three factors need to be present:
1.The presence of and rogens, or male hormones.
2. A genetic pre-disposition to balding.
3. Time for the DHT to degrade the vulnerable hair follicles.
While they comprise less than ten percent of permanent hair loss, there are several other Causes of Hair Loss like stress, nutrition, health, age and hormones, that can cause temporary as well as permanent hair loss.
There are also several categories of treatments for hair loss which include drugs, topical lotions, hair care products, hair replacement systems and hair restoration surgery. To learn more about each, please visit our Hair Loss Treatment section.
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