Scalp Micropigmentation (SMP) in Cleveland

Scalp Micropigmentaion (SMP) is a permanent cosmetic ‘tattoo’ that mimics the very short hairs of a closely shaved scalp. It is a new and innovative technique that offers an alternative styling option for individuals who do not want or are not candidates for hair transplant surgery, or for those who wish to hide scars.

SMP is a non- surgical procedure carried out by experienced hair restoration surgeons and qualified staff.

With the entire head shaved, SMP is a look that is a bold statement of confidence. It looks natural even under close scrutiny. It creates the appearance of a close shave or a short buzz cut over the entire scalp and we expertly create a natural looking hair line, something that we have been doing with hair transplants for more than two decades.

Thousands of men and women who are trapped with their thinning hair or a botched hair transplant scar will testify that Scalp Micropigmentation is a life-changing experience.

There are three different conditions where Scalp MicroPigmentation can help:

  1. A Bold, Shaved look– You don’t have to hide under your hat! A clean, shaved, or buzzed haircut can help you look and feel younger. SMP mimics a five o’clock shadow, so the horseshoe-shaped bald pattern can be covered.
  2. Thinning Hair– You don’t have to worry about the wind, getting your hair wet in the pool, or standing under a bright light! SMP can work as a permanent concealer for thinning hair. SMP can diminish the contrast between hair and skin. Many temporary topical powders or fiber concealers such as Dermmatch, Toppik, and Caboki work well, but they can be messy. You cannot sweat or get your hair wet because the product will come off. Just as your hair always looks better in dim evening shade, SMP creates a permanent shade effect on your scalp.
  3. Scalp Scars– You don’t have to worry about standing in front of the line or sitting in the front row because you are concerned someone will see your hair transplant scar. SMP can work to disguise the pale scar on the back of your head from a strip surgery, or hide the blotchy dots from an FUE surgery. You can wear your hair shorter without worrying about someone noticing your scar.

SMP is like a tattoo in that the pigment is deposited under your skin surface in the dermal layer of skin. The dermal layer of skin is the permanent layer. However, unlike a traditional tattoo, SMP is deposited in the upper dermal layer (just deep enough to make it permanent). A traditional tattoo is deposited deep into the dermal layer. The shallow application is what makes the SMP appear more like a hair follicle (5 o’clock shadow) and not a blob of tattoo ink. Unfortunately, the shallow depth can also push the SMP pigment up to the skin surface and can result in fading over time. Some patients may want a touch up after a few years.

SMP is obviously not real hair, but it can closely mimic the 5 o’clock shadow of a shaved scalp. If you keep your scalp shaved, SMP can look undetectable even up close. Of course, the quality of work depends on the skills of the physician and their surgical staff as well as the pigment. It is an art form as much as it is a technical specialty.

The answer is not so simple. We realize you may want to have the SMP procedure so you can wear your hair short without worrying about your hair transplant scar showing through. SMP can disguise your linear hair transplant scar or patchy FUE scars, but there is an important limitation. You cannot keep your hair too short or the shape of the scar will show through like a line or a step in the contour of your hair. In addition, in certain lighting conditions and angles, the scar will be apparent to the discerning eye.

Keep in mind that you are seeing the SMP pigment under a layer of translucent skin, so you cannot expect it to replace the feeling of a hair shaft as it grows. In other words, SMP is not a substitute for real hair. When your scalp is shaved or your hair is very short (1mm), SMP will blend in and disguise the scar. However, as your hair grows out past 1mm, the texture of your hair will not match with the flat SMP layer. You will notice a gap.

SMP can fade over time. There are many factors that can cause SMP to fade. The type of fading can be divided into two categories:

  1. Extrinsic fading (You can take steps to minimize this type of fading.)
    • Sun (ultraviolet light) exposure (limit sun exposure or use sunscreen)
    • Topical products that contain alcohol (Rogaine, hairspray, etc).
    • Poor quality of the SMP pigment (choose the best SMP provider)
    • Untrained SMP technician (choose the best SMP provider)
    • Washing your scalp in the first 3 days with soap/shampoo
    • Using a hot sauna or steam room in the first 3 days (light exercise and sweating is ok)
  1. Intrinsic fading: About 10% of our patients have this issue. Unfortunately, you cannot do much to avoid this type of fading.
    • Natural exfoliation of the skin. Everyone naturally exfoliates. Your body’s immune system will always try to remove foreign particles such as SMP pigment.
    • Some parts of the scalp fade faster than other parts (even without any scarring).
    • Patients have different experiences with the degree of fading due to the reasons listed above. In rare cases, the SMP seems to fade much faster than the average patient. When this happens, touch-ups are required more frequently.

To avoid extrinsic fading, you should find the best SMP provider using quality pigments and avoid sun and products containing alcohol.

You cannot completely avoid intrinsic fading. To address intrinsic fading, you may need more SMP sessions or touch-ups than the typical SMP patient. Most patients do not need a full touch-up for several years. About 10% of patients may need a touch up every year due to the fading. In rare cases, we may have to try different brand pigments, or apply the SMP much deeper (like a regular tattoo), which may cause it to look blotchy.

SMP is like a tattoo in that the pigment is deposited under your skin surface in the dermal layer of skin. The dermal layer of skin is the permanent layer. However, unlike a traditional tattoo, SMP is deposited in the upper dermal layer, so it is deep enough in the skin to make it permanent. The shallow application is what makes the SMP appear more like a hair follicle (or 5 o’clock shadow) and not a blob of tattoo ink. A traditional tattoo, on the other hand, is deposited deep into the dermal layer.

As Scalp Micropigmentation has gained popularity over the years, it is also synonymously known as a hair tattoo.

Yes, SMP can be used to define the hairline. Some of our patients request a natural, soft hairline while others ask for a linear hairline. Each and every patient’s preference is different, and we try our best to accommodate their goals. If your goals and expectations are unreasonable, our doctor will let you know.

Yes, we offer SMP for the beard to achieve a fuller and thicker look or to conceal a scar. We can even create a permanent 5 o’clock shadow.

Our physicians use SMP pigment to create a shadow effect much like a 5 o’clock shadow. We do not match your skin or hair color. This will ultimately work in your favor as your SMP result will not be affected when your hair turns grey or if you change your hair color.

Yes. Our physicians have performed numerous SMP procedures in combination with hair transplants. However, they cannot be on the same day. When you combine SMP with a hair transplant, you can achieve the look of fullness with the SMP while having the real texture of a hair transplant.

No, you do not need to shave your head before each SMP session. We recommend you wear your hair at your desired styling length so our physicians and technicians can blend the SMP into your hair.

Each session can last between 4 and 8 hours. You can resume normal daily activities after your SMP session. 

We recommend that our patients wait a minimum of two weeks between sessions. This allows enough time for the skin to exfoliate. The interval between each session will be custom tailored to your scheduling needs. There is no issue with waiting longer than two weeks in between sessions.

Scalp Micropigmentation is like a tattoo, and it should be lifelong. But just as a tattoo fades over time, so may SMP. Each patient will experience some degree of fading. In our experience, after a 5-year follow-up, 4 out of 5 patients are satisfied with their results and do not need or want a touch-up. However, there are discerning patients who request a touch up after 1-2 years.


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“I, like many other men over the years, have dealt with hair loss. There is a myriad of reasons men lose their hair. Generational male pattered baldness, sickness or stress are just some of the causes. I was in one of those categories and for almost 30 years I suffered with this stigma to my image. For many years I wore a hair replacement unit. 

I did my research I came upon a process called scalp micropigmentation or SMP. Some refer to it as head tattooing. Like tattooing, ink is placed just under the scalp in the bald areas. This is much different than a standard tattooing. This process has special needles for scalp as well as special ink. Do not go to the corner tattoo shop as the results may be disastrous. The process must be administered by a specially trained person with technical and artistic talents. This option really intrigued me.

I sat down and my Technician Leonard reviewed my scalp informing me how he would address each area. I was motivated and wanted to hear all the details. He explained the process was implemented over three appointments, 4 to 6 hours each, spaced at least two weeks apart. This would allow the ink to be phased into my scalp gradually. Also, each area of my scalp was sectioned and addressed in a certain way. I felt very relaxed and comfortable with Len and his abilities. I decided to take the plunge and move forward to be inked.

Within a couple of weeks and a few appointments, I was looking at my new hairline. It still amazed by the new look, and I find myself stopping to marvel at what I see in the mirror. Please allow me to make suggestion. Taking a few minutes each day stand about five feet from a mirror and just look at your new you. Try on different clothes for a wide range of looks. This will help reprogram your brain to your new you. Your goal is to always see the new image in your mind’s eye, and I guarantee it will definitely give you more confidence. Trust me, I know!”

“It has now been year one after micropigmentation procedure. I have had some new and unexpected events since my new look was done. I started hearing compliments from friends. Several told me they like my new haircut; the short, buzz cut look. The amazing thing is no-one was aware I had micropigmentation done. I became more and more confident that I was no longer seen as bald, but rather more mainstream or normal. This continues to give me a tremendous boost to my overall image and yes, my ego.

It is amazing how when you see yourself in a new way, your attitude becomes more positive, and life seems more upbeat. I wanted to go more places and do things to show off my new look. I think the best form of endorsement I had was when my mother and sister both told me they liked the short haircut or shaded look as they referred to it.  Wow, they didn’t know I had anything done! That is really saying something about my new look. Hopefully, you can understand why I am very supportive of this process and the outcome. Best wishes to all who choose to go this route. I believe it’s worth the investment.”

“I wanted to send you a quick note to thank you for the time you and Len provided me at my appointment the other day.  It was a great experience and I sincerely appreciate all of your assistance leading up to and during the appointment.  Len seemed to really know his stuff and I am thankful you have such a great team member to learn from as your group ramps up this service.”

“Awesome experience! I was taken seriously and their results were more than I could imagine. There is no better team on the planet! I can’t thank them enough for all the time they spend with me. I couldn’t be happier! This is a great alternative when transplants are not an option.”

“I wanted to thicken up my hair a bit but did not want to use the surgical route. I used the Scalp Micropigmentation (smp) alternative procedure. Worked out very well; thickened up my hair and no medical use. Felt very comfortable while at his office. I would recommend Dr. Haber, but also his staff was above expectations. Thank you.”

Before I jumped into SMP, I did my research. I educated myself about what to expect, how to find a good technician, the type and color of ink used, cost and pain level. I even viewed YouTube testimonials of regrets (the majority of regrets stemmed from choosing the wrong technician- at tattoo artist is not necessarily skilled in SMP- and going with ink that is too dark). I read and viewed everything I could on SMP over a year before I found Len Kausing at Haber Dermatology.

I began by scheduling a consultation with Len. I was immediately impressed with Len’s knowledge and his command of the art. I sensed Len was not only a true SMP artist but also a perfectionist. He knew what I needed as we talked about my expectations, and he explained the process. After that first consultation I knew that if I was going forward with SMP, it would definitely be Len.

I later requested a second consultation because I had some additional questions dealing with my unique situation. Len gladly met me a second time and afterwards I was ready for SMP. We scheduled a total of four sessions, each about two weeks apart. I couldn’t wait to begin!

When I arrived at Haber Dermatology for the first treatment, Len was ready and we promptly began at 9 am. We again reviewed my goal and began the SMP. Len explained every step as he went along, including aftercare. During the procedure he frequently asked how I was doing and if I needed a break. Each session lasted between for and five hours. Haber Dermatology even served lunch!

What was the pain level during the procedure? I saw on the internet that most people put it at between 1 and a 2 on a 10-scale. I would put it at a 0 to 1. I am not the one who is fond of needles, but wow, after the first fifteen for twenty minutes, it didn’t bother me at all. In fact, during the procedure I became totally relaxed and didn’t feel anything remotely close to pain. Dr. Haber told me SMP has been described by some as “feeling like a scalp massage” and that is exactly how it felt.

The end result truly meg my expectations. I cannot believe the different my appearance and how quickly I am ready for the day. No more fussing with strands of hair and constantly checking the mirror. I feel confident. I feel free. I look better than I ever expected. I could not be happier with my SMP by Len Kausing at Haber Dermatology.

Everyone at Haber Dermatology was welcoming, helpful and very friendly. Thank you for making my experience a completely positive one!

Robert W.