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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. -
Nizoral Shampoo (Regular Strength) for Hair Loss
While Nizoral 2% shampoo is more effective at inhibiting DHT production and its binding to hair follicles, Nizoral regular strength offers a smoother, gentler approach to treating hair loss while minimizing scalp irritating effects from other topical treatments such as Rogaine 5% liquid.
This product includes 1% of the active ingredient ketoconazole. To view the clinical abstract proving the effectiveness of ketoconazole in the treatment of androgenetic alopecia, view "Ketoconazole as a hair loss treatment". Alternatively, you can obtain a prescription from your medical practitioner for the more concentrated 2%.
Developing Realistic Expectations:
Men and women sometimes suffer from hair loss for different reasons. Thus, diagnosing its cause is necessary to facilitate and promote proper treatment.
Don't expect immediate results. It's recommended to use Nizoral in conjunction with other proven treatments for at least 6 to 12 months before determining its effectiveness. Documenting your progress with bi-monthly photos can help you determine whether or not Nizoral has been successful in helping you maintain existing 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.
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Setting the Highest Standards in Hair Restoration
Why the Coalition?
With hair loss treatments often being marketed without regulation or accountability, hair loss sufferers need credible information about legitimate treatments and the ethical physicians who provide them.
The Coalition of Independent Hair Restoration Physicians is a carefully selected group of skilled and ethical physicians who are united in providing patients with outstanding education and results.
Physician Accountability
Membership in the Coalition requires members to maintain a high degree of patient satisfaction. Members care for their patients knowing that their patients are free to post their experiences on the popular Hair Restoration Discussion Forum. On this open forum patients are free to critique physicians and to hold them accountable for their actions. This forum is run and moderated by hair restoration patients.
In such a transparent environment our members are held publicly accountable for their actions and results. Members who fail to meet the high technical and ethical membership standards set by the Coalition are removed from the group.
However, we ask that patients first give their physician the opportunity to satisfy their concerns privately before posting any public criticisms on the discussion forum.
If the issue is not resolved to the patient’s satisfaction they are encouraged to contact the Coalition by email to service at hairtransplantnetwork dot com
Member clinics also agree to open their clinics up to inspection. Many of these inspections have been reported on the Hair Restoration Discussion Forum. View some of these clinic visits.
Membership Standards
The skill, technique and talent of hair restoration physicians vary widely, as do the end results. Only a minority of leading physicians provide truly state of the art hair restoration.
Coalition members are carefully reviewed and granted membership based strictly on their high level of integrity, skill, experience and ability to perform ultra refined follicular unit transplantation.
All Coalition members have made the investment in time and resources to perform a highly refined and difficult to perform state of the art procedure called “Ultra Refined Follicular Unit Hair Transplantation”.
While many surgeons now perform standard follicular unit grafting, only a minority have risen to the challenge of using very tiny incisions and grafts to achieve ultra refined results. This ultra refined procedure, while very demanding on the physician and staff, produces excellent results for the patient with optimal density and rapid healing. It also allows the patient to achieve their goal for fullness and density with a minimal number of surgical sessions.
To learn more about Ultra Refined Follicular Unit Hair Transplantation
Membership Criteria
A physician must meet the following requirements before being granted membership in the Coalition of Independent Hair Restoration Physicians:
- A demonstrated capability to successfully perform large sessions of ultra refined follicular unit grafting using tiny incisions and grafts that are microscopically prepared.
- The ability to dense pack tiny follicular unit grafts in a given area when appropriate.
- Mastery and control of the orientation and direction of the transplanted grafts to achieve a completely natural appearance.
- Dedication to doing state of the art hair restoration exclusively or at least as the main specialty of the clinic.
- Excellent patient results demonstrating a high level of artistry and naturalness throughout, as well as excellent growth rates.
- An excellent reputation of the physician amongst colleagues and former patients.
- Several years experience in performing hair restoration surgery.
- Medical training, depth of background, board certifications, honors, credentials, lectures, and published articles and books.
Note - All members contribute dues to support our joint educational resources and services.
We are open to reviewing experienced surgeons for possible membership. Apply for membership as a physician.
Membership Selection Process
Physicians with a proven track record of providing excellent ultra refined follicular unit hair transplantation and who meet the Coalition’s membership criteria will be considered for membership.
In addition to reviewing the applicant physician’s credentials, technique and results, input from patients and current members of the Coalition will be considered prior to membership being granted.
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Viviscal Hair Loss Treatment Product Review - Can it Really Promote New Hair Growth?
Viviscal's hair growth vitamin and dietary supplement taken twice daily promises to "reverse hair loss" and grow thicker hair in both men and women experiencing balding and thinning hair. Its primary activeingredient, AminoMar C™ Marine Complex, is said to be a proprietary blend of ingredients and proteins that "provides the essential nutrients needed to nourish thinning hair and promote existing hair growth".
The entire Viviscal product line includes an "all natural" dietary supplement, a shampoo and conditioner, and a scalp lotion. Viviscal is promoted as being 100% natural, drug-free, gluten-free and safe from harmful side effects. But can Viviscal deliver on its promises to reverse hair loss and grow new hair?
In 2011, Viviscal advertisement was banned in the United Kingdom by the Advertising Standard Authority (ASA) who deemed that its claims to maintain optimum hair health were unproven. The ASA concluded:
"Because the evidence sent did not show that the ingredients in Viviscal had been shown to have a positive effect on hair health, we concluded the claims that the product could 'nourish hair follicles' had not been substantiated' and ruled the advert cannot be broadcast until it is changed."
However, as with many similar products promising to grow hair, substantiating their hair growth claims may not be a simple task.
Viviscal’s manufacturer does reference a number of studies that seem to support their claims of growing thicker hair. For example, the results of "Scientific Pilot Study #1" on 40 hair loss suffering females with an average age of 35 concluded, "Viviscal was well received by test subjects and the analysis of hair counts showed a mean reduction in hair loss of 46% in only 10 weeks." Additional studies are cited on Viviscal’s website.
Recently, we learned that Dr. Glenn Charleshas publicly endorsed Viviscal. Dr. Charles has an outstanding reputation for performing state of the art hair transplant surgery and is a highly esteemed member of the Coalition of Independent Hair Restoration Physicians.When asked to comment on his public endorsement of Viviscal, Dr. Charles stated:
"I have never had any hair loss patients display any negative effects. I describe it to my patients as a natural supplement that can promote a healthier scalp and hair. It may also, in turn, slow down the hair loss process. I tell all my patients that there are no guarantees with this product. Although most patients believe that they did have improvement after using this product, I admit that some patients do not see any noticeable changes that either they or I can identify."
Other hair loss experts are not as optimistic regarding Viviscal’s hair growth potential. Coalition member Dr. Bill Rassmanof Los Angeles states:
"I am skeptical of the photographs (results) and the changes shown make me doubt what the Viviscal marketing department wants me to see. Viviscal reportedly contains ‘special marine extracts and a silica compound’ - and yet I’m to believe this will regrow hair? If these photos were real, the product would have taken over the market years ago."
It's also important to note that Viviscal does notmake any claims on their website that their products can reverse the effects of genetic hair loss. Instead, it simply states, "Viviscal works to reverse hair loss due to stress, poor nutrition, and many health related ailments".
So is Viviscal an effective hair loss treatment? More research may be needed before this question can be effectively answered.
While there may be no harm (potential side effects) in trying it, at an average cost of $600 per year there are certainly more affordable and proven treatments available. The only clinically proven and FDA approved medical hair loss treatments currently available are Rogaine (minoxidil) and Propecia (finasteride). While Rogaine may be used by both male and female patients, Propecia is safe and approved only for male hair loss sufferers. Always consult your physician before adding any treatment to your hair loss regimen.
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Stemcelex – A Revolutionary Stem Cell Hair Loss Treatment?
Stemcelex is the newest product in a long line of hair restoration therapies claiming to “cure” hair loss via stem cell therapy. Given the recent onslaught of news regarding stem cell based hair loss treatments, injectable baldness cures, and research breakthroughs, it’s not surprising to see new therapies claiming to aggressively fight hair loss through these same mechanisms. However, is Stemcelex truly a stem cell based, regenerative hair loss cure, or is it another therapy simply riding the recent wave of interest in these types of non-invasive, revolutionary treatments?
At first glance, Stemcelex seems quite impressive. The product website is filled with scientific explanations, graphs, charts, and diagrams explaining the science behind stem cell based hair restoration. Stemcelex even states its affiliation with Dr. George Cotsarelis, a researcher at the University of Pennsylvania Medical Center who, along with a talented research team, recently discovered that the bald scalp does not suffer from a lack of stem cells, but rather a dysfunction in the pathway to properly activating stem cells to produce hair. The finding was significant and Dr. Cotsarelis’ involvement and the seemingly detailed science look promising, but what about Stemcelex itself? Does it utilize these scientific breakthroughs and offer an effective treatment for hair loss?
Unfortunately, despite the impressive name recognition and detailed explanations, Stemcelex doesn’t appear to live up to its lofty hair restoration claims. Despite claiming to “activate” the dormant stem cells described by Dr. Cotsarelis, Stemcelex does not offer any sort of feasible molecular/stem cell based therapy. The website cleverly explains the science behind stem cell inactivation and the promise of reversing the dysfunctional pathway, but instead of reinforcing Dr. Cotsarelis’ view that cures for reversing the inactivation pathway are not yet understood, Stemcelex claims to actually fix the stem cell inactivation through a series of unproven homeopathic and herbal treatments for hair loss.
So, what is actually inStemcelex? The treatment involves a three day cycle of different lotions and topical treatments for baldness applied twice a day.
Day1: On the first day of the hair restoration cycle, a topical lotion made from Jaborandi Pilocarpus is applied twice after washing and thoroughly drying one’s hair. According to Stemcelex, Jaborandi Pilocarpus is a parasympathetic activator (it excites the nerves that cause the body to “rest and digest” during periods of relaxation) that rids the scalp of excess oils and dandruff that impede healthy follicular hair growth. Furthermore, Stemcelex claims that Pilocarpus naturally darkens and thickens existing, native hairs. According to the experts, Pilocarpus has no reproducible pharmacological applications and any evidence that it actually thickens and darkens hair is anecdotal.
Day 2: The second day of the cycle involves Veratrum Lobelianum, a family of herbs commonly used in Chinese medicine. Stemcelex claims these herbs can penetrate the scalp and activate the necessary molecular signaling to “regenerate” the hair follicle stem cells. Furthermore, Veratrum allegedly down-regulates or prevents the production of Dihydrotestosterone (DHT), the hormone directly responsible for male pattern baldness. According to the research, members of the Veratrum family have been used in everything from a Native American poison to a drug researched in human blood pressure. Currently, they are used in cancer treatments. Although the science behind cancer therapies indicates that the drug could have some molecular benefit in signaling cell activation and inactivation, there has been no research or evidence suggesting that Veratrum is useful in fighting, reversing, or preventing the effects of male or female hair loss.
Day 3: During the third day of the Stemcelex cycle, a kelp based topical extract is applied twice daily to provide nutrients to the “new hair growth” and also ensure that the scalp remains clean and healthy. This step of the treatment doesn’t claim to be more than a simple dose of nutrients useful in good scalp hygiene.
After reviewing the active ingredients behind Stemcelex, there is no evidence to suggest that Stemcelex is an effective hair loss treatment at this point in time. The idea of activating the dormant stem cells is important to finding a molecular cure to hair loss, but despite understanding this importance, Stemcelex doesn’t offer any concrete stem cell reactivation agents. It’s possible that Veratrum may prove useful in cell signaling and reactivating dormant cells, but the current research and evidence simply don’t support its use at this time. Furthermore, Stemcelex charges a hefty $99.85 for a month supply of the treatment which may keep even the most curious and enthusiastic hair loss suffering men and women away.
Altogether, the idea of reversing dormant hair follicle stem cells is important, but therapies for effectively stopping and rewiring this pathway do not seem to exist at this point in time. Unfortunately, this seems to nullify the claims made by Stemcelex and prevent it from becoming a stem cell hair loss cure.
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Bijan Feriduni, MD
Dr. Bijan Feriduni
Dr. Bijan Feriduni has been dedicated exclusively to advanced hair restoration since 1995 and now performs large sessions of ultra refined strip and FUE hair transplantation with outstanding results. -
Nizoral 2% Shampoo (Extra Strength) for Hair Loss
Nizoral 2% is magnificent shampoo and a significant part of what's referred to commonly as the Big 3. The other two are the FDA approved and proven treatments Propecia (finasteride)and Rogaine (minoxidil). To date, Nizoral is the only shampoo on the market that can make the unique claim that it's proven to stop the formation of DHT. Its active ingredient ketoconazoleat 2% concentration has proven to be a moderate DHT inhibitor and has growth stimulating properties about as effective as Rogaine 2%.
This product includes 2%, the highest concentration of the active ingredient ketoconazole. To view the clinical abstract proving the effectiveness of ketoconazole in the treatment of androgenetic alopecia, view "Ketoconazole as a hair loss treatment". There is also a less concentrated 1% of Nizoral. To learn more, visit Nizoral regular shampoo.
We strongly suggest using Nizoral shampoo in addition to other proven treatments. Nizoral should be used 2 or 3 times a week to avoid dry hair and a flakey scalp.
On the off days, you may want to consider rotating Nizoral with other excellent shampoos designed specifically for thinning hair. See the recommended treatments section below for other shampoos we recommend.
Developing Realistic Expectations:
Men and women sometimes suffer from hair loss for different reasons. Thus, diagnosing its cause is necessary to facilitate and promote proper treatment.
Don't expect immediate results. It's recommended to use Nizoral in conjunction with other proven treatments for at least 6 to 12 months before determining its effectiveness. Documenting your progress with bi-monthly photos can help you determine whether or not Nizoral has been successful in helping you maintain existing 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.
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The Psychology of Hair Loss
Long ago, a full head of hair was valued as a means of protection, heat retention, and camouflage.
Today we value hair for other reasons. Whether we admit it or not, good hair still is associated with power, virility and youth.
Such associations date back to ancient times. Remember the story of Samson and Delilah? When Delilah cut Samson’s long hair he lost his power.

"And Delilah made him sleep on her knees; and she called for a man, and she caused him to shave off the seven locks of Samson’s head. . . and his strength went from him."(Judges 16:19)
As “enlightened” as we are today, stereotypes associated with hair loss persist. The bald or balding are sometimes passed over and teased at work, in the media, and in the social scene. The media idolizes the young and the attractive and often lampoons the bald or balding.Of course, it’s not fair. But at least losing your hair is not health threatening. However, it can result in various psychological and emotional issues. These include insecurity, isolation, panic, a sense of loss, and even depression. But let’s first look at the role of hair (and the lack of it) in our society.How is Hair Loss seen by Society? So why does something as superficial as hair seem so important to so many men and women? Studies have shown that hair is a symbol of social, professional, cultural, and/or religious affiliations. Good hair implies power, virility, strength and youth.
Studies reveal how baldness is perceived.In a study done in 1971, a picture of one person was distributed to 60 people. But each picture had been altered by a commercial artist to reflect a non bald, balding, or bald condition. The results revealed some negative stereotypes.

When the person was shown with a balding head of hair he was rated as weak, dull, and inactive. This same person with a bald head of hair was rated as unkind, bad, and ugly. Yet this same person with a full head of hair was rated as handsome, virile, strong, active, and sharp.
Today, more than 30 years later, it is hard to know if things have really changed. But maybe some of these tired negative stereotypes about being bald are starting to change, at least in the media.

Today, bald NYPD Blue's -Dennis Franz, a multiple Emmy Award-winner, is considered a sex symbol.

As is Tony Soprano of the popular HBO TV show the Sopranos.

And, of course, let’s not forget Telly Savalas of the 70’s TV show Kojak who was once voted by People magazine as the “sexiest man alive.”
Studies about Baldness and Self Esteem
Those who are bald or balding are generally thought of as older, weaker, and more ineffectual, both in the work world and on the social scene.
According to a 1995 article in the “British Journal of Psychology,” balding men have been found to have lower levels of self-esteem than their peers, are less sociable, suffer more from depression,and are less likely to succeed in life.
Hair loss, especially when first occurring, can lead to rash decisions. So it is important to slow down and look at the many viable options that are available for dealing successfully with hair loss.
Our Hair Treatments section offers in-depth information on many viable treatments.
1992, researchers from the Old Dominion University in Norfolk, Virginia surveyed 145 balding men and found that 84% were preoccupied with baldness.
Their responses showed that they were filled with self-consciousness and helplessness. They were also envious of men with full heads of hair.
Additional research indicated that single men and woman who had begun losing hair in their early twenties were more likely to suffer from extremely low self-esteem.
Hair loss often creates emotional distress.
Loosing your hair can be disturbing, especially if you're a young man or woman. This unwanted loss forces those afflicted to face new issues, such as the perceived loss of youth and sexual attractiveness.
It's common for young people who are balding to have feelings of isolation. They may feel uncomfortable among their peers and in public. Young people with hair loss often lose their confidence and may also become less productive at work.
For older people hair loss is often just one more sign that they're reaching middle or old age. It may prompt them to question the direction of their lives or fear that their lives are closer to the end than the beginning. This can result in a sense of loss, insecurity, or even depression.
And as bad as men have it, hair loss can be even worse for women. Balding women must deal not only with the thought of aging, but also that they may not be considered attractive.
Coming to terms with hair loss.
Yes, hair loss can be disturbing. But there are many effective options available to you, ranging from hair loss drugs that often halt thinning to restoring the hair you’ve lost with surgical hair restoration.
However, prior to choosing a hair loss treatment, it is wise to deal with the psychological effects of hair loss.
Hair loss at any age, while not painful or dangerous, can cause emotional damage and distress.
Finding support and advice to cope with hair loss.
You can find support and share ideas and advice privately with other hair loss sufferers by reading and posting on our popular hair loss discussion forum.
By sharing with others you will realize that others share your same concerns and feelings about going bald. You will also learn about what hair loss treatments actually work or not from those who have already tried them.
Find a "Hair Loss Mentor" for - one on one - support and guidance.
In addition to our discussion forum, you can also view Hair Loss Weblogs created by actual hair restoration patients. These blogs contain photos journals documenting the person's hair restoration. Often you can correspond with these blog authors by email.
If you have a hair loss question please post it on our Hair Loss Q & A Blog. This blog can also be searched for dozens of answers on many hair restoration topics.
Empowering yourself with information and sharing your feelings and concerns will also make you feel much more in control of your hair loss. Then, if and when you finally do choose a hair loss treatment option, you will feel much more confident in your decision.
Many who once were preoccupied by their hair loss find a solution and move on in life, sometimes with a "new lease on life". While others choose to remain bald and simply accept it.
The choice is yours to make. This site is dedicated to helping you successfully resolve your hair loss issue on the inside as well as on the outside.
The disturbing truth about hair loss
In 1999, the psychological impact of hair loss, as well as its leading treatments, was the subject of the American Academy of Dermatology's summer scientific meeting in New York. At this meeting it was revealed that there were direct links between androgenetic alopecia (male and female pattern baldness) and personality disorders in those afflicted.
In one study of 116 subjects with hair loss it was determined that 76.3% of the participants had at least one actual personality disorder. This was an extremely high rate of disorder compared to the much lower rate of 10% of the general public suffering from personality disorders.
Another study showed that twice as many women than men with hair loss rated themselves as “very” or “extremely” upset about their hair loss.
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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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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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