Standardization of SMP procedure and its impact on outcome

by on 09/02/2018 - 05:10 pm

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Title: Standardization of SMP procedure and its impact on outcome.
Abstract: Background: Cosmetic deformities can result from various types of alopecia or even post hair transplantation procedures. Patients with such deformities seek aesthetically appealing longer-lasting options. Scalp concealers are commonly used by men and women to camouflage these deformities. Scalp micropigmentation (SMP) is one of the concealers recently gaining popularity.

Objectives: SMP is a novel technique wherein microdot tattoos are placed in a stippling pattern to mimic hair follicles that are cut close to the scalp and various variables affecting its outcome were evaluated.

Methods: Forty-five subjects were recruited for the study. The various factors affecting outcome of SMP-angle of needle against the scalp, depth of needle into the scalp, time of the needle contact in scalp, speed of the rotor, resistance of scalp, color of pigment, viscosity of dye, needle number, needle thickness, and pattern of dot placement-were systematically studied in 15 patients through clinical photographs and trichoscopy. ....
Industry Significance Rating: Informative - General industry awareness.
Publication: Journal of Cutaneous and Aesthetic Surgery 2017 Jul-Sep;10(3):145-149.
Authors: Dhurat RS, Shanshanwal SJS, Dandale AL.
Links:  Article Link Link to Publisher Search Google
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Dhurat et al. describe their attempts to standardise a medical approach to SMP via evaluation of needle depth, needle configuration, machine speed, pigment colour and viscosity and needle dwell duration.

The authors mention their machine was adjusted in cycles for standardisation purposes, it is worth mentioning that machine speed cycles do not necessarily equate to a standardised number of skin penetrations per second (PPS) particularly with reciprocated coils and standard rotary devices or other forms of equipment that do not specify a reliable PPS. High end devices that provide PPS settings may provide a more reliable indication of standardisation of needle penetrations at skin level as opposed to machine cycles which can differ significantly from device to device and even on successive use of the same device due to a variety of factors such as skin resistance.

Patients with cicatricial alopecia were included in this study, however it is important to stress that contemporary advice provided by well trained scalp tattooing/micropigmentation experts should include that patients with scarring alopecia's should not undergo scalp tattoo services without medical advice/consent due to the risk of exacerbating the underlying condition.

The findings of the study are broadly in line with the existing empirical knowledge of the scalp tattoo/micropigmentation industry in relation to implantation depth, hand piece angle and the resulting pointillism's therefore this information should be quite familiar to those who have undergone a comprehensive training program in scalp tattooing/micropigmentation.


Scalp Tattoo/Micropigmentation services should only be provided by those who have undergone an appropriate training course that provides comprehensive instruction in the methodology and underlying health conditions associated with alopecia.

For obvious reasons course evaluation/supervision by a registered health professional is advisable for any form of cosmetic tattoo service that is provided for those with underlying medical complaints.


Medical Report, scalp micropigmentation, SMP, scalp tattooing, alopecia, medical tattooing


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