SMP for female hair loss

Concealment of female hair loss using scalp micropigmentation

Anouska Cassano of London-based HAIR Ink on HPT micropigmentation as an alternative camouflaging solution for female hair loss.

Hair loss affects an estimated eight million women in the UK. Androgenetic alopecia or female pattern hair loss accounts for about 95% of cases. Other types of hair loss which effect women include telogen effluvium, anagen effluvium and traction alopecia.

The psychological damage caused by hair loss can cause emotional stress that directly affects their physical health. Research carried out by Charité – Universitätsmediz in Berlin found that hair loss could even lead to exaggerated feelings of ugliness and, in extreme cases, lead to body dysmorphic disorder. It is therefore unsurprising, that 60% of hair loss sufferers said they would rather have more hair than money or friends.

Hair transplants

According to the ISHRS 2013 Practice Census it is estimated that 310,000 surgical hair restoration procedures were performed worldwide in 2012 worth $1.9 billion (USD). Additionally, this has also encouraged more women to consider the option of investing in a transplant, with one London clinic claiming to have witnessed an 82% increase in the number of women undergoing hair transplants in the first eight months of 2013, compared with the same period in 2011.

Since hair transplantation is a good option for nearly 90% of male hair loss suffers many women think they are good candidates for hair transplant surgery, but this is usually not the case. It is estimated that approximately only 2-5% of women will benefit from this type of procedure, due to the fact that most women have diffuse hair loss. In female pattern baldness these donor areas are usually unstable. This means that if the hair and accompanying follicles are removed from these donor areas in women and transplanted to another area on the scalp they are just going to fall out.

HPT: An alternative

One alternative camouflaging solution for female hair loss is Hair microPigmentation Treatment (HPT). More commonly known as scalp micro-pigmentation or scalp tattooing, HPT is a revolutionary semi-permanent micro-pigmenting technique that offers an alternative option for both men and women suffering from hair loss who are not appropriate candidates for hair transplant surgery or who do not want it.

HPT involves the use of a digitally controlled needle that applies medical grade hypoallergenic colour pigment into the scalp. Unlike a traditional tattoo that would use ‘ink’, HPT is performed using specially designed pigments that will not have the colour change or migration that are commonly seen with a body art tattoo. Although it may appear to be a similar technique, the needles and treatment depth into the skin are very different. Both use needles to implant colour, but that is where the similarity ends. Traditional body art tattoos do have the tendency to change colour and very often they will turn blue as a result of migration due to the type of ink used and the tissue level the tattoo was implanted. HPT is not implanted at a deep level on the scalp and the simulated hair follicles are implanted in the very top layers of the epidermis.

The quality of consultation for this treatment is of vital importance. To this end our approach is endorsed by Glenn M. Callaghan PhD, professor of psychology and director of clinical training at the Department of Psychology, San Jose State University. We strongly believe that the more time you invest with your patient really listening to and understanding their hair loss situation and history at the consultation stage, the more likely they are to be satisfied with the final result.

If a patient has emotional or psychological issues, the likely outcome is that they will not be satisfied or happy with any scalp micro-pigmentation treatment you perform. To understand if a potential patient has body image disorders we recommend the use of the Body Image Psychological Inflexibility Scale (BIPIS) to ascertain a patient’s suitability for treatment.

HPT is designed to last a number of years and typically we would expect this treatment to last between one to three years with some minor maintenance or touch ups. The pigments used are designed to fade over time as this makes it possible to adjust the tone and change the hairline to be more ‘age appropriate’ for patients as they mature.

HPT has immediate results and will create the illusion of thicker hair, taking the focus away from the scalp or bare patches and reduces the time and pressure on the patient of having to hide these thinning or bare patches under headwear or ensuring their hairstyle is always ‘exact’ to cover these areas. Additionally, the illusion of ‘hair’ follicles from HPT far surpasses the results achievable from any concealer product on close inspection. There is no need for daily application and the fear factor of being ‘found out’ is reduced giving the patient the freedom to engage with physical and social activities with confidence.

We always stress that although the treatment can create the illusion of hair or hair density, it is not actual hair. If a patient is a suitable candidate for hair restoration surgery and can afford it, we would recommend that this is the route they should take. Hair loss suffers, if they could turn back the clock, would always choose the time in their life when they had a full head of natural hair.

It is in the area of working with hair restoration clinics that we are starting to see the greatest synergy when promoting the benefits of HPT as a combination treatment. One of the most common complaints that patients have after hair transplant surgery is that the density of their transplant was less than they expected, with 64.1% highlighting this factor. An increasing number of our patients are referrals from hair transplantation clinics. Either where the patient is looking to create the illusion of additional density and enhance the overall result of their surgical procedure or both male and female hair loss patients who were unsuitable candidates for hair restoration surgery.

By improving the quality of scalp micro-pigmentation, raising standards and making the treatment more accessible to patients through hair restoration clinics we hope that in the future industry bodies, such as the ISHRS, BAD and hair loss charities will start to acknowledge and promote scalp micro-pigmentation alongside other more established hair loss solutions as an option for both men, and especially women, suffering from hair loss.


Please note: This article was was written by Anouska Cassano of HAIR Ink, to be published in Aesthetic Medicine magazine. Anouska has very kindly supplied this article for dual-publishing on SMPDebate.com. HAIR Ink is a scalp micropigmentation clinic specialising in the treatment of women, and of men who wish to benefit from SMP without shaving their hair.


Anouska Cassano is a specialist micro-pigmentation practitioner. She is a member of BABTAC (British Association of Beauty Therapists and Cosmetology) and SPCP (Society of Cosmetic Professionals). Anouska works with a number of the UK’s leading surgeons in the fields of medical and reconstructive surgery and was recently invited by the Royal College of Surgeons to share her techniques and work in the area of areola restoration and tattooing with a number of their breast and reconstructive surgeons. She has also worked with some of the leading hair transplantation clinics and surgeons in both the UK and Europe.

Laurie Downing

/* ]]> */