Two relatively new modalities, follicular unit extraction (FUE) and scalp micropigmentation have changed the treatment of hair loss, to reduce the number of procedures and the total costs of the hair restoration process. These 2 modalities augment each other when treating patients with thinning hair and balding.
The explosion of FUE procedures (which reflected 52.6% of the hair transplant procedures performed in 2016, up from 48.5%) and the appearance of more and more new physicians offering hair restoration technologies employing FUE have caused a 20% annual growth in this industry over the past few years. This article reviews the use of FUE and scalp micropigmentation when used in combination.
Cosmetic treatment for hair loss is divided into how many categories?
The hair industry reflects a huge industry in products and services. The presence of thinning and genetic balding is present in 50% of men under 50, and 50% of postmenopausal women. This has been a cosmetic problem that impacts almost every family at some point in time.
The cosmetic treatment of hair loss falls into 3 major categories:
- Gels, mousse, and other similar products that thicken the hair by adding moisture to the hair shaft causing the hair shaft to swell, hair attachments and hair systems that add hair bulk to the thinning/balding area with animal or synthetic or human hair make up the largest component of this category;
- The use of concealers that are powered type materials that are applied to the hair and scalp and are used to reduce the contrast between hair and skin color in the balding or thinning areas;
- Various surgical and nonsurgical treatments, usually offered by physicians, such as follicular unit extraction (FUE) transplantation (1 of 2 techniques used in hair transplantation today) and scalp micropigmentation (SMP), which together reflect an almost $3 billion industry. With the advent of FUE, a perceived minimally invasive hair transplant surgery, this procedure has produced a greater awareness and demand for hair transplant services by more and more men.
Hair restoration services by surgeons
What is particularly notable is that hair restoration services are now being offered by many physicians entering the field from primary care and other specialties. These services mainly include FUE rather than the traditional strip surgery.
With newer technologies now available, the skill sets required are not as great for either the surgeon or the staff. This has caused a reduction in referrals for existing hair transplant surgeons as more and more physicians are incorporating these services into their non hair restoration practices to take advantage of the financial opportunities rather than referring patients to existing providers.
SMP for thinning hair
Hair transplantation is less effective for treating thinning hair particularly as the thinning area gets more extensive. Fully 80% of women with post-menopausal/genetic thinning have hair loss that is too diffuse for hair transplantation. Many of these women have significant miniaturization of the hair in the donor area as well, making their donor area less ideal as a source for transplanted hair. Most women today resort to the use of powders, pastes, hair attachments, products that allow the hair to thicken as it takes on water and spray-on concealers to address their thinning hair.
Their goals are to decrease the contrast between their hair and skin color, thereby making their hair look fuller. In our recent publication on SMP we have been using SMP as the sole modality in treating many women with thinning hair. Specially trained SMP technicians produce the highly labor intensive stippled patterns on the scalp to mimic closely cut hair follicles. This imparts a reduction in the contrast between the hair and scalp color. When done in the doctor’s office, local anesthesia allows for a pain-free experience. SMP is an ideal treatment for thinning hair in men and women.
What are the problems of scalp wounds?
Many forms of diseased alopecias including alopecia areata, alopecia totalis, scarring alopecias, most scalp scars from previous hair transplant or neurosurgical surgical procedures, and hair loss from chemotherapy and other wasting diseases, can also be effectively treated with SMP. SMP is a technique that can be deployed by doctors interested in expanding their practices to encompass this cosmetic treatment for almost all forms of alopecia and offered as a permanent cosmetic tattoo.
The authors believe that the market demand will become far more significant as more providers develop the skills for providing these SMP services. For women with diffusely thinning hair (approximately 50% of women who pass-through menopause), there is no effective medical or surgical therapy (including hair transplantation). SMP can address this huge untapped market opportunity for physicians as these techniques can be easily learned and delegated to trained on-site personnel.