Learn more about our revised in-office safety policies in response to the COVID-19 pandemic.

Schedule Consultation
Flagship 110 E. 55th St., NY, NY
About Header Image

Note: This page is for educational purposes. Bernstein Medical does not currently offer Scalp Micro-Pigmentation services.


What is SMP?

SMP stands for Scalp Micro-Pigmentation. SMP is a medical-grade tattoo of the scalp that creates the appearance of more hair in the area you wish to appear fuller. SMP is performed over a series of sessions, spaced between 2-4 weeks apart. Once the skin has healed and the tattoo pigment has settled, we assess the results and where more pigment and density can and should be added. The SMP pigment will gradually fade and touch up sessions will eventually be needed.


Does it hurt?

Everyone experiences SMP differently. Some patients fall asleep during the procedure while others experience modest discomfort. The sensation is commonly described as a “nagging” feeling that is around a 3 on a pain scale of 1-10. At Bernstein Medical, we offer medications to relax you, as well as the option of local anesthesia to make your SMP procedure as comfortable as possible.


How many sessions will it take to see the final outcome?

The final results are usually visible after the third or fourth session. This can vary from person to person.


Why can’t it be done in one session? Isn’t it a tattoo?

The skin is the largest organ in the body. Its many surfaces have different textures, thicknesses, and pH levels. The skin is unpredictable in how it heals; therefore, it is necessary to use the first session to create a framework for the following sessions. Pigment absorbs more easily in some skin types than in others, so follow-up sessions help determine where pigment needs to be reinforced and where extra density needs to be added to create an even look.


How long do I need to wait between sessions?

Between 2-4 weeks. Since the epidermal layer of the skin regenerates about every 28 days, waiting for this period between procedures ensures adequate time for healing and allows for a more accurate assessment of pigment retention at follow-up visits. Typically the first and second sessions will be done two weeks apart, and we will wait four weeks between the second and third.


How long does each session take?

The procedure time varies depending on the size of the area of coverage. The procedure can be as short as 30 minutes or take as long as 8 hours.


How long does it last?

The results can last anywhere between two to ten years. Skin type, sun exposure, and chemicals impact the retention.


Is it going to turn blue or green over time like some tattoos do?

The pigments we use at Bernstein Medical are of the highest quality, are proven to retain well over time and are designed to resist discoloration.

Some inks used for traditional tattoos could be combined with several different colors to achieve the final shade you see. Over time, these pigments break down in the skin and may result in the blue or green hues seen in traditional tattoos. These pigments should not be used in SMP.


Will SMP damage my hair follicles or interfere with future hair growth?

The needle and pigment used in SMP do not penetrate deep enough to reach, or damage, the hair follicle. SMP can be used after a hair transplant to add the appearance of density in regions where the hair is still thin.


Why can’t I exercise for three days after I get SMP?

To have the best outcome, you should avoid sweating during this healing process. Excessive exercise can lead to sweating in the region of fresh ink and may disturb the pigment before it is able to completely settle and seal in place. Sweat can also promote the growth of bacteria in the newly treated area.


Will I be able to stop using topical concealers after SMP?

Toppik is a compound of keratin fibers that gets electrostatically charged so that the fibers in the powder anchor to the hair, thus increasing density. SMP provides a similar effect to products like Toppik and Dermatch in that it reduces the contrast between the scalp skin and the hair, but it adds no physical volume on the hair like these products do.

Although SMP may not provide as dark a coverage as Toppik or Dermatch, it eliminates the need for daily application. It also gives the patient the freedom to engage with physical and social activities with greater confidence.


What are some common unrealistic expectations?

SMP mimics individual hair follicles to create the appearance of coverage and/or density. The SMP dots mimic and enhance the appearance of hair in regions that are thinning. SMP will not achieve the darkness that a heavily coated head of concealer would achieve as it is designed to look more natural.


What if my hair goes gray or white in the future? Will dark SMP look funny?

The pigments used in SMP are designed to naturally soften over the years. Even with white hair, dark SMP dots on your scalp provide an element of dimension within your hair. When all hair exits the scalp, even white hair, it appears to have a darker color underneath the skin surface. This is the reason darker dots are still able to blend within white hair naturally.


Why does my SMP look slightly cloudy and not as sharp as right after I had the procedure done?

SMP is performed by inserting pigment through the epidermis and into the upper dermal layer of the skin. The epidermis naturally sheds and regenerates approximately every 28 days. Immediately after the procedure, the implanted pigment is seen in both the upper dermis and epidermis, which is why it looks so dark and crisp. Over the course of the 28 days, as your skin goes through its natural exfoliation process, the residual pigment that is in the epidermis sheds as well. When the cells regenerate, the layer of epidermis no longer has pigment in it, but sits on top of the upper dermal layer where your permanent pigment resides. This results in a slightly less sharp pigment dot, since there is now a layer of skin on top of the permanent pigment.


Do more men or women get SMP?

At Bernstein Medical, our patients are about 50% female and 50% male. Men and women who suffer from hair thinning, who would like more coverage following their surgery, or who are not candidates for surgery can opt to have the procedure. Hair loss does not discriminate and neither does SMP!


When is SMP not a good option?

SMP may not be the best option for a patient with a completely bald area surrounded by hair longer than 1/4 of an inch. They should not have SMP done on the bald patch unless they are planning to shave down the surrounding hair. Otherwise, the bald spot will have a shaved appearance that will not match the longer hair around it.

More information on SMP:

Updated: 2020-09-03 | Published: 2020-02-11