• Scalp Micropigmentation (SMP)

    micro pigmentation

    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?

    How Scalp Micropigmentation Works

    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.

  • Hair Loss Shampoos & Conditioners

    Hair Loss shampoos and conditioners

    There are a variety of shampoos and conditioners that can be used to slow down the progression of male and female pattern baldness. It should be noted that no shampoo nor conditioner is proven to regrow hair.  Thus, for best results, any shampoo and conditioner product should be used in conjunction with other proven hair loss treatments such as Propecia (finasteride)and Rogaine (minoxidil).

    Shampoo and conditioner can also help to "volumize" the hair, making hair appear thicker and fuller.  Ingredients found in many of these treatments are designed to promote healthy hair growth and nourish the follicles.  Thus, for a healthy scalp and hair, using one or more of these dedicated shampoos and conditioners can be the perfect addition to any hair loss treatment regimen.  To learn more about each product, click a link below:

    Nioxin
    Nizoral 2% Shampoo - Extra Strength
    Nizoral Shampoo - Regular
    Revita Shampoo
    Revivogen
    Tricomin

    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.

  • Dr. Özlem Biçer MD

    Dr. Ozlem Bicer
    Dr. Ozlem Bicer
    Dr. Biçer provides ultra-refined follicular unit extraction (FUE) at an exceptionally low-price. Dr. Biçer's practice combines quality with affordability with a patient-centered focus and attention to detail.

  • Diffuse Unpatterned Alopecia (DUPA)

    Diffuse Unpatterned Alopecia

    What Is DUPA?

    Diffuse Unpatterned Alopecia (DUPA) is a form of genetic hair loss characterized by diffuse thinning over the entire scalp. Unlike Diffuse Patterned Alopecia (DPA), DUPA lacks the stable permanent zone associated with other forms of alopecia.

    Dr. O'tar Norwood defined DUPA in his 1975 seminole publication "Male Pattern Baldness: Classification and Incidence" as:

    Diffuse, Unpatterened Alopecia (DUPA). In this type, there is a general decrease in the density of hair without any definite pattern, although it is usually more marked over the top and front. This type is common in women.

    Identifying DUPA

    Diffuse Unpatterned Alopecia patients have a similar pattern of hair loss to DPA patients but the balding tends to occur more rapidly. DUPA patients are also more likely to achieve the “horseshoe” pattern commonly associated with Norwood class VII baldness. However, unlike other forms of alopecia hair loss, the DUPA “horseshoe” takes on a thin and transparent appearance.

    It is important that patients suffering from diffuse hair loss are properly diagnosed. While DPA patients are often good candidates for surgical hair restoration, DUPA patients typically make poor hair transplant patients due to the lack of a stable zone in which to harvest donor grafts.

    Treatment for Diffuse Unpatterned Alopecia

    Not a lot is known about the cause and treatment of DUPA. However, about half of males who suffer from this form of balding benefit from Propecia (finasteride). Unfortunately, DUPA is about 10 times more common in females for whom Propecia is not a treatment option.

    Conclusion

    Anyone suffering from diffuse hair loss should consult with a dermatologist or hair restoration physician for a proper diagnosis. This is especially true for balding men and women considering hair transplant surgery.

  • Diffuse Patterned Alopecia (DPA)

    Diffuse Patterned Alopecia (DPA)

    Diffuse Hair Loss and How to Treat It

    Unlike male pattern baldness (MPB) and female pattern hair loss (FPHL), which tends to follow one of the hair loss patterns defined by the NorwoodScale and the LudwigScale, Diffuse Patterned Alopecia (DPA) is characterized by diffuse thinning throughout the front, crown and vertex(crown) with no distinct pattern evident. However, like male and female pattern balding,Diffuse Patterned Alopecia patients typically preserve the stable "permanent zone" on the sides and back of the scalp and may sometimes retain a well-defined hairline. DPA is also a type of hereditary balding condition like and rogenetic alopecia (genetic hair loss).

    Diffuse Patterned Alopecia (DPA) can be difficult to diagnose and, particularly in its early stages, may be confused with a similar condition known as Diffused Unpatterned Alopecia (DUPA). While both conditions are characterized by diffuse thinning, DUPA sufferers lack the stable permanent zone necessary for surgical hair restoration.

    Treatment for Diffuse Patterned Alopecia

    DPA often responds well to medical hair loss treatments like Propecia (finasteride) and Rogaine(minoxidil) and, due to the preservation of the permanent donor region, many DPA sufferers are candidates for hairrestoration surgery.

    Conclusion

    It’s essential that hair loss suffering men and women seeking medical and/or surgical treatment for diffuse thinning consult with a skilled and experienced hair restoration physician. Differentiating between DPA and DUPA is critical because Diffuse Patterned Alopecia patients frequently make good hair transplant candidates, whereas DUPA patients rarely do.

  • Menopause and Female Hair Loss

    Many cases of female hair lossare caused by hormonal fluctuations or changes in the body including those who have PCOS (polycystic ovarian syndrome), birth control pillside effects, a recent pregnancy,postmenopausal trauma, or menopause. Women with hair loss experience varying balding patterns These patterns can help determine the type of alopecia you have along with a thorough examination by a physician.

    Because of an imbalance between estrogen and testosterone due to declining estrogen levels, thinning hair and accelerated hair loss is common in women during menopause. Hair on certain areas of the head that is more sensitive to androgen hormones like DHT(associated with male pattern baldness) may thin or fall out. Similarly, declining estrogen levels may result in unwanted facial hair growth.

    In some cases, polycystic ovarian syndrome(PCOS), may accompany menopause and hair loss.

    Be sure to speak with your doctor on the most effective ways to cope with menopause and minimize hair loss during this transitional time.

  • Female Hair Loss - Treatment and Restoration

    Female hair loss

    Female hair loss, otherwise known as Female Pattern Baldness (FPB), affects 1 out of every 4 women in the United States. Recent findings have found that the incidence of FPB has been reported to be as low as 8% and as high as 87%. And, it does appear to be as common for women as for men. Most often, menopause is the most frequent time for hair loss in women to become apparent.

    For a woman to lose her hair can be even more troubling than for men. A woman with thinning hair is not generally accepted as part of the normal aging process. Society has come to expect a thick, luxurious head of hair as part of the attractiveness in women.

    While males and females can both experience thinning hair, they typically do not lose their hair in the same order or appearance.

    Women with thinning hair compared to Men

    Typically men observe their hair loss earlier, whereas women will first notice it in their late 20's through their early 40's. Female Pattern Baldness (FPB) is often seen during hormonal changes. These include the use of birth control pills, following childbirth, or during or after the time of menopause.

    Top view of patient
    Top view of patient, showing excellent growth of transplanted hair.

    In addition, men typically have localized areas (patterns) of thinning, whilein women this usually occurs as thinning across the top, or over an even wider area. When women have very diffuse thinning over much of their scalp they are generally not good candidates for hair restoration surgery. However, women with localized hair loss, similar to the typical male pattern baldness, can successfully undergo hair restoration surgery.

    Thinning hair in females is also characterized by an increase in the combination of normal thick hairs mixed in with finer, smaller hairs. This results in decreased density, and not total hair loss.

    A woman's hair has also been proven to be more sensitive to the effects of stress than men's hair. Stress can result in hair loss in women and men. But this type of loss is not female pattern baldness. Rather, it is known as “telogen effluvium.” This type of hair loss is the shedding of hair in the resting phase when the body senses that it needs to divert its energies elsewhere. Therefore stress can temporarily changes the amount of hair that is shed. But the lost hair is likely to grow back.

    The production of the hair loss-inducing androgens is also different among men and women. A woman produces a small quantity of androgens in the adrenal glands and the ovaries. The ovaries also produce pre-hormones, which are then converted to androgens on the outside of the ovaries or adrenal glands.

    Generally speaking, a woman with hair loss will probably not experience total balding in a given area. But if there is total hair loss, this is most likely a sign of a previously hidden disease. For this reason, it’s important for females to have their hormone levels checked by a physician if they are experiencing heavy hair loss.

    Finally, men and women react differently to various hair loss treatment options. In men, hair loss may be halted or even reversed by finasteride (brand named "Propecia"). However, Propecia is not safe for females or children. Minoxidil (Rogaine) can be effective for both men and women in treating hair loss.

    However, for some women the causes of their hair loss are much more complex than the classic "male pattern baldness". Thus proper diagnosis of the underlying cause is vital before any hair loss treatments are attempted.

    The following physicians are nationally well known experts in female hair loss. Feel free to contact them.

    David Whiting in Dallas, Texas - 214 824-2087

    Vera Price in San Francisco, California 415 353-4163

    Maria Hordinsky in Minneapolis, Minnesota 612 625-1493

    Wilma Bergfeld in Cleveland, Ohio 216 444-5722

    For a web community that is dedicated to female hair loss visit HerAlopecia.com

  • Dr. Emil George

    Dr. Emil George
    Emil George
    Dr. Emil George performs refined follicular unit grafting, creating natural hairlines that showcase his artistic eye. He can dense-pack and create soft and natural results.

  • Scalp Med Hair Loss Treatment for Men and Women

    Scalp Med hair loss

    Scalp Med TV infomercials, like many hair loss products, claim to sell FDA approved hair loss products. Pictures, videos, and testimonies on television show hair loss sufferers regrowing hair even when men and women were completely bald. Is this really what balding people can expect from Scalp Med? Below we examine Scalp Med and unlock the mystery ingredients and whether or not any clinical proof exists that this hair loss solution can treat baldness.

    Scalp Med includes 3 distinct products including topical Vitadil-5A for men or Vitadil-2A for women, topical NutriSol-RM, and Cortex Enlarger hair thickening spray.

    Vitadil-5A for men or Vitadil-2A for women is a topical solution that contains the proven hair regrowth solution minoxidil, also found in Rogaine and Xandrox. It's also said to include a unique delivery agent formulated to increase the absorption of 5% minoxidil for men, 2% for women.

    Scalp Med is a bit more vague as to the ingredients found in the NutriSol-RM topical and the Cortex Enlarger thickening spray. While NutriSol-RM topical is designed to add essential nutrients to the scalp for healthier hair, the Cortex Enlarger hair thickening spray's primary purpose is to temporarily fatten the hair follicles making hair appear thicker.

    Scalp Med is upfront that the ingredients found in the NutriSol-RM shampoo and Cortex Enlarger hair thickener will not stop hair loss or cause hair regrowth.

    Scalp Med also offers a detoxifying cleanser kit which includes a detoxifying shampoo called Panthenol-DX Scalp Detoxifier. This shampoo is designed to deeply cleanse the scalp without stripping the hair of its natural oils and nutrients. Unless your thinning hair is due to pollutants or toxins affecting natural hair growth, Panthenol-DX Scalp Detoxifier won't stimulate new hair growth. Scalp Med's Panthenol-DX does nothing to stop the natural progression of genetic female hair loss and male pattern baldness.

    To supplement Scalp Med's hair loss treatment program, Scalp Med offers a Mega-Multi Vitamin to increase overall body health.

    Scalp Med can legally claim that it's product contains an FDA approved ingredient since Scalp Med does contain minoxidil, which is a FDA approved topical treatment for hair loss. However, Scalp Med its self has not been granted FDA approval. Though Scalp Med's other products may work to promote healthy hair, it's the minoxidil that gives balding men and women any hope of restoring their hair.

    scalp med resultsUnfortunately, Scalp Med's marketing infomercials makes it appear that completely bald men and women have hope of regrowing a full head of thick and healthy hair. However, the words “Results seen are not typical” can be seen in small fine print at the bottom of your television.  Additionally, Scalp Med's website FAQ makes it clear that no non-surgical hair loss solution is proven to grow hair in completely bald areas.

    There are several proven success stories that minoxidil can stimulate hair regrowth in areas of thinning hair. Therefore, Scalp Med's Vitadil-5A should be as effective as 5% minoxidil just as Vitadil-2A should be as effective as the 2% solution.

    Scalp Med is about 3 times the cost of minoxidil. A two month supply of Scalp Med is approximately $160.00. Discounts are available if you buy in bulk. However, even in bulk, the net cost ends up around $64 per month as opposed to the $20 per month cost of Rogaine. Generic minoxidil costs even less.

  • Trichotillomania and Treating Hair Loss

    Trichotillomania and Treating Hair Loss

    Men and women who have the impulse to pull their own hair out may be suffering from trichotillomania. Trichotillomania is an impulse control disorder characterized by the repeated urge to and behavior of pulling out one's own hair. Impulse control disorders resemble substance addictions because the patient feels out of control of his or her own behaviors. Men and women with trichotillomania live relatively normal lives but typically show signs of hair loss, thinning, and bald spots all over the scalp and body from pulling it out.

    Treating trichotillomaniagoes far beyond trying to stimulate hair regrowth.Even if Rogaineor laser therapy for hair losswere to regrow hair, there is a strong possibility that trichotillomania patients will continue to pull their hair out. Patients with trichotillomania therefore, should be treated at the source of the disorder in conjunction with using proven hair loss treatments.

    In addition to medication, Habit Reversal Training (HRT) by a trained counselor has proven to be successful in treating trichotillomania. With Habit Reversal Training, the individual is taught to recognize and redirect their impulse to other more constructive activities. Often times, trichotillomaniapatients are asked to keep a journal of their hair pulling episodes. This can help the counselor and patient to identify and develop strategies to avoid situations that might trigger hair pulling episodes. Journals often include the location of the incident, number of hairs pulled, date, time, and their feelings and thoughts during the episode.

    Treating a trichotillomania patient's baldness may be done simultaneously or after proper treatment of the disorder. Rogaine (minoxidil)can be a helpful aid to HRT by stimulating the follicles underneath the scalp, potentially facilitating or expediting hair growth.Treating a patient’s hair loss while they continue to pull their hair out is not constructive. Since this type of balding is not genetic due to the production of DHT, Propecia (finasteride)won't likely help.

    Patients who've suffered from trichotillomania for awhile may damage or even remove the hair roots by excessive pulling, making non-surgical hair regrowth next to impossible. Surgicalhair restorationmay be an option for trichotillomania patients whose hair roots are too damaged to produce new hair on their own. Hairrestoration surgeryshould be reserved only for patients who've been successfully treated and no longer suffers from trichotillomania.

    Catching and treating trichotillomania early will most likely reduce damage done to the hair follicles and eliminate the need for hair loss treatment, since undamaged hair will return on its own.