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.

Learn about all your hair loss treatment options.
 

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.

Today's evolutionary high point - Ultra Refined Follicular Unit Transplantation

By relocating these carefully prepared bald-resistant follicular units, physicians doing "follicular unit hair transplantation" recreate a natural pattern of hair in the balding areas.

To do this properly is a very time consuming and exacting process. It requires a team of meticulous medical technicians working hand-in-hand with the hair transplant surgeon in a very lengthy surgical procedure.

Ultra Refined Grafting - Smaller Blades, Smaller Incisions, Smaller Grafts

Today's micro surgical blades, like the size of hair grafts, have become ever smaller and now enable hair transplant surgeons to safely make more tiny graft incisions in a given area then ever before. Surgeons are then able to "dense pack" select areas with as many as 40 to 60 follicular unit grafts per square centimeter. This graft density is as much as twice that of the standard follicular unit hair transplant procedure.

Such high densities of transplanted hair typically produce the appearance of fullness even after only one surgical session. Patients also experience rapid healing and no visible skin distortions due to the tiny size of these incisions.

Ultra Refined Follicular Unit Grafting - Hard on the clinic but easy on the patient.

Ultra refined follicular unit grafting raises the bar for physicians and their staff. This delicate and demanding hair transplant procedure requires more skill and careful attention to be performed properly. The smaller and more tightly packed incisions require more closely dissected follicular unit grafts that are carefully trimmed under microscopes. These small and densely packed incisions are also more difficult to place the grafts into.

This procedure also requires more careful patient selection, as "dense packing" of grafts is not appropriate for all patients.

Ultra Refined Follicular Unit Transplantation - the new "Gold Standard"

In the hands of a highly skilled physician and staff the Ultra refined follicular unit hair transplant procedure can achieve excellent new hair growth that is so natural that it is undetectable even under close scrutiny.

While the standard micro "follicular unit" hair transplant does produce natural looking results, its ability to achieve high density in only one surgical session is limited. Thus patients may have to do subsequent surgical sessions in a transplanted area to achieve a full look.

The many patient benefits of this new ultra refined procedure are significant and include:

• The ability to get excellent hair density in only one surgical session.
• Minimal trauma in the graft recipient area with rapid post surgical healing.
• Little or no visible pitting or distortions in the transplanted areas.
• More natural direction and angulation of the transplanted hair.

All physician members of the Coalition perform Ultra Refined Follicular Unit Hair Transplantation.

While many hair transplant physicians perform quality follicular unit hair transplants, only some of them are capable of performing large sessions of ultra refined follicular hair transplantation. However, all members of the Coalition of Independent Hair Restoration Physicians perform ultra refined grafting with excellent results.

The Future of Surgical Hair Restoration

The amount of hair you can transplant is ultimately limited by the amount of hair follicles you can safely relocate from the bald resistant donor area at the back and sides of your head.

Some day it may be possible for physicians to create multiple hair follicles from one original follicle. This process typically called Hair Multiplication or more incorrectly Hair Cloning is currently being investigated by several research scientists and hair restoration physicians.

If and when this process is successfully developed patients would no longer be limited by the finite amount of bald resistant hairs that can be relocated from their donor area. Hair multiplication would result in a virtually limitless supply of hair available for hair transplants.

This would be especially good news for men or women with extensive baldness and a very limited supply of donor hair. Even those with extensive baldness would theoretically be able achieve thick full heads of hair.

However, experts believe that we are at least ten years away from hair multiplication being available, if even then. But perhaps some day scientists will be able to use gene therapy to halt the balding process without drugs or surgery.

Learn about modern hair loss drug treatments that work.

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.

Hair Replacement systems, also known as hairpieces, hair replacements, hair systems or toupees, have improved over the past decade. Quality hair replacement systems are now refined in construction and light weight. For those with extensive baldness who require a full head of hair to be satisfied they offer a quick and nearly instant solution.

Hair systems are constructed of human hair or synthetic fiber. Recent advances have made the synthetic hair much more natural in appearance and texture.

A quality hair replacement system is specially constructed for an individual recipient. These systems are made of real hair, synthetic, or both. They're designed to attach to the head for an extended period ranging from 3-6 weeks, without ever being taken off. Visit Farrell Hair Systems for more information.

Hair systems can work for both men and women. In fact, more and more women are opting for hair systems over wigs, as they can be more comfortable and look more natural.

The process of getting a Hair Replacement System

Typically clients first visit a hair salon for an evaluation. The extent of their hair loss is measured. They are given information including prices, maintenance, and future schedules. Usually, it takes several days for the system to be prepared, based on the client’s preferences.

While a person can get virtually any type of look, you are generally guided towards an option that looks more undetectable and realistic. These studios employ their own hair stylists to achieve ideal looks. Clients can visit these stylists for monthly haircuts or touch-ups.

With these hair systems, a fine mesh foundation is placed on the scalp's balding area and precisely cut to these dimensions. Later, real or synthetic hairs will be inserted into a foundation to create the "Hair System" or hair piece.

The foundations of the past were actually designed to be thicker and more durable. Fortunately, today's foundations are much thinner to make them undetectable. However, this thinness comes at a price, literally. The thinner a system the more delicate it will be and thus it will require being replaced more often.

Once completed, the hair system is attached to the client scalp using clips, weaving, and/or adhesive. The hair system is then styled to match your existing hair.

Maintaining a Hair Replacement System

The stylist in the studios also remove the systems about once a month for maintenance, cleaning, and styling. During these adjustments a person can expect to have their hair system removed, their scalp thoroughly shampooed, and their hair cut. The hair system may also be touched up and or colored if needed.

It's crucial to carefully groom the hair system to maintain a natural appearance. With a quality system, a person can expect to continue doing all normal activities such as running, bicycling, and weightlifting.

However, hair systems typically require time, money, and effort to keep them looking their best. And some clients may feel some discomfort, as well as some insecurity that their hair system may be detected.

Various Methods of Attaching a Hair System

Hair replacement systems can be attached in a variety of ways. They can adhere to the skin, hair, or a combination of both.

When attached to existing hair this method can provide an extra sense of security for clients who enjoy active lifestyles. This type of attachment goes by names such as fusion, weaves, cabling, beading and bonding. Because this type of attachment depends on the rate of the hair's growth, the system must be reattached periodically.

Hair replacement systems can also be applied to bare skin. This can be performed in a variety of ways, such as waterproof and biologically safe glues as well as two-sided tape. However, while these glues and tapes are generally safe for the skin, it's possible to have an adverse reaction. For that reason you should tell the studio stylist of any discomfort.

It's also possible to have a hair system applied surgically. In this case, small skin grafts, known as "tunnel grafts", are taken from a donor site. These tunnel grafts are then formed into tiny loops and placed in the balding areas where the outer edges of the hair system will be attached. The edge of the hair system is then attached to these loops once they have grown into the scalp. Since the hair system is now attached to the scalp, rather than the existing hair that grows out over time, the hair system does not get progressively looser over time.

However, this method of attachment is not recommended due to possible complications such as skin infections.

Finding a Quality Hair Replacement System

If you're considering a hair attachment, you need to be aware of just how to locate the nearest studio, as well as what to look for in one.

Of course you can use the Yellow Pages or the Internet to locate a qualified studio. However, once you do locate one, it may be a good idea to check with the local Better Business Bureau for complaints against the company. It's usually only a problem if there have been multiple complaints against the company.

It's best to consider a hair attachment studio that specializes in non-surgical hair replacement systems. And once you do find an appropriate office, it's best to bring along a photograph showing your ideal look. Plus, try to meet with other clients who are wearing the hair system you may be considering.

It's also important to find out how a company handles potential client problems and complaints. Do they have money-back guarantees or trial periods? These are important questions to ask.

You may also want to check around with the American Hair Loss Council (AHLC), one of the leading groups governing hair loss. The AHLC can't endorse any individual firm. However, this organization supplies clients with a list of local AHLC specialists, known as the American Hair Loss Council Source Book. The specialist and studios on this list are all required to sign a statement that says they honor the group's code of ethics. This code is designed to protect consumers.