There are millions of men and women who have cosmetic problems with their scalps and hair resulting from dermatologic and/or genetic conditions, such as intractable alopecia areata or female genetic balding. There are also iatrogenic deformities in millions of men from hair restoration procedures done between the 1950s and 1990s, reflecting crude techniques of that period and scars from strip harvesting. Since hair loss is frequently a progressive process, genetic and iatrogenic conditions often become more pronounced over time. Scalp micropigmentation (SMP) uses a tattoo in a stippling pattern that mimics hair follicles that are cut close to the scalp.This relatively new technique can significantly address the cosmetic problems derived from the conditions noted above.
How Scalp Micropigmentation process help people?
The tattoo industry is in the midst of a cultural expansion, growing from 14 percent in 2008 to 21 percent in 2012, making SMP a more socially acceptable cosmetic solution for covering appropriate scalp and hair problems.
This article discusses how the Scalp Micropigmentation process is used, demonstrates a variety of clinical applications, identifies challenges created by the technique, discusses the anatomy and histology of the tattoo pigment interactions with human physiology, and identifies some of the safety issues known today. The authors will show how SMP will have a great impact on people who, heretofore, have had no acceptable long-term solutions for hiding deformities created by a broad variety of diseases and traumas.
The Skin of the Scalp
The skin of the scalp has an intricate anatomy. The normal thickness of the scalp has a significant supporting infrastructure for hair (i.e., glands, blood vessels, nerves, muscles, and fat) in much greater abundance than other areas of body skin because of the higher hair densities of terminal hairs. In androgenetic alopecia (AGA), the large terminal hairs become miniaturized over time, as the hair cycles between catagen and anagen phases. When hair bulk is lost through miniaturization or apoptosis, the supporting infrastructure is reduced in proportion to the loss of the hair.
Diseases and scalp surgeries also alter scalp anatomy, resulting in regional microscopic variations in the manner that each individual reacts to Scalp Micropigmentation. The atrophic scalp of a bald man, with its reduction of blood flow and dermal fat, will respond differently to the introduction and retention of scalp pigments than would a normal hair-bearing scalp. Many incurable scalp diseases produce skin deformities that persist despite treatment. The SMP process offers a good, creative, cosmetic solution to these deformities.
The use of small follicular units was introduced in the early 1990s and, when these smaller follicular units were artistically blended to camouflage large grafts, many of the surgical deformities from prior procedures were corrected. These “surgically corrected patients” frequently became donor hair depleted as the number of surgical corrective procedures increased, creating problems of coverage and scarring in the back and side of the head, The authors estimate that patients living with a see- through donor area, donor area hair depletion, and/or severe donor area scarring number in the hundreds of thousands.
Which medical and surgical problems are solved through Scalp Micropigmentation?
The medical and surgical problems that can be addressed by Scalp Micropigmentation concealment include:
- Scalp scars from scarring alopecias
- People with autoimmune diseases such as refractory alopecia areata or alopecia totalis.
- Women who are balding or thinning who are not responsive to minoxidil or other medical treatments and do not qualify for hair transplantation
- Neurosurgery scars and scars from head trauma, surgeries, and/or hair restoration procedures
- Chemotherapy patients, who do not grow back significant amounts of their hair after treatment
- Deformities in hair restoration patients resulting from unplanned progressive hair loss in men, whose hair transplants have failed to achieve the amount of “fullness” they expected
- People with wide or obvious scars from donor strip harvesting techniques
- People who have open donor scars, as a complication of hair transplant surgery from harvesting techniques between the 1950s and the early 1990s, from strip harvesting surgeries, or from the more modern follicular unit extraction techniques that create punctate scars
- Patients who have the old pluggy or corn-row look with or without donor site depletion and a see-through donor area
- People who dislike using topical concealers or wigs
- Hair thinning or regional balding, where the patient desires to appear to have a fuller head of hair, with or without a shaved scalp.