Tricopigmentation: A Temporary Form of Scalp Micropigmentation

During the past year, I have received a few requests to write a detailed blog post on scalp micropigmentation (SMP), sometimes also termed as scalp hair tattooing. Earlier this year, I told several blog commentators who asked that I would try to do so by fall. However, I had to keep delaying this post due to other more pressing developments in the hair loss world as well as some laziness on my part in researching a topic in which I had very limited interest. In general, SMP is used to give a look of a shaven head that still has all its hair follicles (shadow) intact, although increasingly, people are also getting SMP to enhance the appearance of a hair transplant.

Because scalp micropigmentation procedures have become extremely popular during the past several years, I could not delay this post any longer. Moreover, one of the world’s most respected hair transplant surgeons e-mailed me several months ago and told me that I should write something about this subject matter as soon as possible because their was a lot of confusion in the field. He said that clinics were hiding their proprietary methods from competitors and their is no official regulatory governing body when it comes to the SMP world. i.e., the still nascent world of SMP is not at all transparent at present to the detriment of consumers. It should be noted that despite some bad work out there, numerous people have been very pleased with their SMP procedures and I have seen some superb before and after photos online. Just like with hair transplants and hairpieces, for some people, tattooed hair on their scalps is almost as good as a cure for hair loss. I think head shape and facial skin type/condition also impacts the final satisaction when it comes to SMP.

Tricopigmentation Versus Scalp Micropigmentation (SMP)

Immediately after I started researching this post, I realized that I might have to write at least two posts on scalp hair pigmentation/ tattooing procedures: one on tricopigmentation and one (or maybe even two) on scalp micropigmentation. This particular post will focus on tricopigmentation.

At a bare bones level of understanding, tricopigmentation is just a “temporary” form of “permanent” scalp micropigmentation. However, the definition of “temporary” and “permanent” varies depending on clinic and method being utilized. It seems like “temporary” tricopigmentation ink marks can last anywhere from 6 months to 2-3 years. At the same time, some (but not all) of the so-called “permanent” ink marks in SMP can fade or even disappear within 5 years and often require further touch-up procedures. However, I will save the details of the SMP discussion for another post.

Milena Lardi, Beauty Medical and Tricopigmentation

The person that is most widely associated with tricopigmentation is Italian Milena Lardi, the founder, teacher and technical director at Beauty Medical (Italy). While I am not sure if Ms. Lardi is the inventor of temporary forms of scalp hair tattooing (surely many people must have tried in the past?), she has nowadays become synonymous with the term “tricopigmentation”. Her reputation in the industry seems to be unmatched and stellar. However, it does not seem like she has any kind of registered trademark or copyright to the name “tricopigmentation”. As a side note, HIS Hair Clinic claims to be the world’s first company that offered SMP, 14 years ago. However, even they do not seem to have the rights to the term “scalp micropigmentation”.

According to Ms. Lardi’s Beauty Medical website, tricopigmentation is performed in the upper layer of the dermis. Note that the dermis is the second layer of human skin beneath the epidermis first layer. Skin damage to the epidermis can often be reversed, but skin damage to the dermis is much harder to reverse. It is therefore crucial to do thorough research before embarking on a scalp tricopigmentation procedure. According to Beauty Medical, “tricopigmentation is reversible, non-allergenic and bio-compatible thanks to the use of specific pigments which can be absorbed by the body”. The pigments are microscopic and in the shape of dots. Most patients will require at least one touch-up procedure within the first year after the initial tricopigmentation procedure.

Is Temporary the Superior Choice?

According to numerous online opinions, temporary hair tattooing (aka tricopigmentation) is the way to go while permanent hair tattooing (aka SMP) is too dangerous. At first glance this seems obvious, just like with any form of body tattooing. However, permanent SMP does offer its own advantages that I will discuss in an upcoming post, and there are numerous clinics around the world that offer SMP. If there were hundreds of customers having major regrets several years after getting SMP procedures, we would be seeing far more online negativity as well as lawsuits against clinics by now. At the same time, SMP is far too recent a procedure to know for sure what people will feel like 10-20 years down the road (when the complaints might really proliferate), and for now I would definitely go for temporary over permanent if I had to choose. But I am always very conservative in such matters. In 2014, Dr. Arvind Poswal (India) who got training from Milena Lardi started an excellent thread on Hairsite about this subject and Ms. Lardi also posted a detailed response in there towards the bottom. Both of these two professionals seem to prefer temporary tricopigmentation to permanent SMP.

Having said all that, please stay tuned for my future post on SMP since it is probably a bit biased on my part to favor temporary over permanent without as yet having even completed my research on SMP.

Tricopigmentation in Combination with a Hair Transplant

Numerous hair transplant surgeons have now started to offer tricopigmentation in tandem with a hair transplant in order to make the final results even better, especially in those with extensive areas of baldness that can not entirely be covered with a hair transplant. It seems like most hair transplant surgeons prefer tricopigmentation over SMP. One surgeon e-mailed me that his clinic offers procedures that can last 1-2 years, or 3-4 years, but anything permanent is not good. I will add more here if I get feedback on details regarding when ink lasts 1-2 years versus 3-4 years. Of course some of that will depend on the biology of individual patients and their scalps as well as their lifestyle. Rain will not remove the ink, but too much direct sunlight can potentially impact the duration of results it seems.

One blog reader e-mailed me in the past that he was curious if a scalp micropigmentation procedure could cover his bad linear scar at the back of his scalp from a strip (FUT) hair transplant procedure. That is an interesting idea and Dr. Poswal has a good video on the viability of such a procedure.

Tricopigmentation Technique Variations

Tricopigmentation techniques vary depending on clinic and practitioner. The two main differences are probably in the type of ink/pigment used and in the type of tools used. I doubt that the depth of treatment varies too much between experienced practitioners when it comes to temporary scalp hair tattooing, but I will refrain from making any conclusions here. It is imperative that one goes to a highly reputable and experienced person or clinic for this treatment in order to get a quality hairline design and ensure a natural looking appearance. Some clinics claim to use software and computers (which reminds me of the ARTAS hair transplant robot, although that is much more sophisticated and expensive). Beauty Medical has proprietary “Trico Skin Care” machines and 0.2 milimeter diameter “Tricoinjector” needles which it sells to practitioners that it has trained and licensed. It seems like the machines are set to inject at precisely 0.5 millimeter depth each time with no room for variation (as would be the case with purely human hands and no machine assistance).

Here is a a good overview of what is involved in the tricopigmentation procedure.

I will add more details to this section and the one(s) below as I get more responses from clinics.

Type of Ink used in Tricopigmentation

According to Milena Lardi from the earlier link that I posted in red:

The pigment is composed of a powder part and a liquid part:

Powder part = iron oxide and titanium bioxide.
Liquid part = water, alcohol, isopropyl and glycerine (coming from soya).

Cost of Tricopigmentation

The cost of tricopigmentation varies depending on area that needs to be covered. Online estimates seem to generally range from $1,000 to $4,000 per session.

PRP Free Treatment Session(s) Winner Selection

Please post thoughts unrelated to this subject matter in the comments section of the prior blog post.

After the second and final random number generation, the winner and runner-up are as follows:

Winner = “Robb”

Runner-up = “Emperor Alopecia”

Ironically, the person who is located furthest away from Dr. Rapaport’s New Jersey office won! In the event that Robb does not make it or if Dr. Rapaport has issues with scheduling and decides against accepting someone from outside the US (unlikely), Emperor Alopecia will take Robb’s place.

I hate rejecting people who are in the final five, but unfortunately I have to do the prize drawings in this manner for now.  I need to get a few names in the second round drawing in the event that one or more are suspicious entries, change their mind, do not e-mail me back, or if we need a backup winner in cases such as this unusual multiple session PRP treatment prize drawing.

Robb, I will send your contact information to Dr. Rapaport’s office. If you do not hear from them by early next week, please let me know.

I was surprised to get around 60 participants in the free PRP treatment prize drawing contest despite my discouraging people who reside far away from New Jersey from participating.

Instead of explaining the prize drawing winner selection procedure yet again, I prefer contest participants reading the winner selection post from the last time I ran such a contest. If you are lazy to do that or do not care about the details, I have pasted the main instructions paragraph from the above at the end of this post.

The 5 people that the random generation resulted in this time are as follows in alphabetical order (another random draw will be used to select the final winner from the below 5 once they respond):

Emperor Alopecia (from NJ)

Kana (from Canada — please confirm that you can make it for at least two sessions, months apart from each other)

Michele99 (from NY)

— Robb (from the UK — please confirm that you can make it for at least two sessions, months apart from each other)

Tom (from PA)

All 5 of you please post at least one comment in this thread using the same email you used last time and the same IP address/ computer/location that you used last time to post your comment. Also email me your full name and physical address from the same email address that you used for commenting. I will wait for two days for responses.

Brief Items of Interest, November 2016

Hair loss news first:

— A very busy month for Aclaris Therapeutics. First the company updated its product pipeline page and added photos for each dermatological condition that the company’s various products are supposed to treat. Then they filed for Investigational New Drug Application (IND) for their oral alopecia areata product ATI-50001 with the US FDA. Then, on November 15th the company announced positive results for its topical seborrheic keratosis product (A-101) phase 3 clinical trials (webcast here); and finally, on November 16th the company announced a public offering of its common stock. If successful, the funds raised from this offering will partly be used towards research and trials for Aclaris’ JAK inhibitor products.

— In the past month, HairClone has added the well known Dr. Russell Knudsen, Dr. Robert Leonard and others to their clinic partner team.

— More good news for alopecia areata/totalis/ universalis sufferers. This time its two patients from Brazil who were taking JAK inhibitor toafacitinib.

— Dr. Christophe Guillemat updated his blog a week ago. I am still skeptical about his work, but there is a huge amount of interest. Someone commented in the past that he is not a doctor, but I am not sure. Also see my initial post on him.

— Sharp (Japan)’s plasmacluster ion technology promotes hair growth. Sounds hard to believe. The ending of the article about reduced dandruff and itching is more believable.

Cellmid (Australia) raises sufficient funds to start selling its Evolis line of FGF-5 inhibiting hair loss products in the US.

— Hairdresser Chad Gunter is very pleased with his PRP results from Dr. Laura Bennack. According to Dr. Bennack, “the most dramatic results are on men and women who are at the early stages of hair loss”.

— Yet another growth factor (human hepatocyte growth factor) linked to promoting hair growth. Also see my recent post on the various growth factors that benefit hair growth.

— Kerastem has more US clinics participating in its clinical trials.

— Missed an important study’s findings last month: BPH drugs such as finasteride and dutasteride (both are also used to combat hair loss) do not raise the risk of erectile dysfunction.

Wen hair care product lawsuit concludes in favor of customers.

And now on to medical items of interest:

Gene therapy in a box courtesy of the Fred Hutchinson cancer research center.

CRISPR gene editing tested in a person for the first time in China.

“Any idiot” can now create mutant CRISPR engineered mice.

Gene therapy to reverse certain types of genetically inherited blindness could be approved for use as soon as next year.

—  And thereafter, bionic superhuman eyes.

— Amazon’s Jeff Bezos partners with the Mayo Clinic and others to enter the anti-aging industry.

— Terminally ill 14 year old in the UK allowed to be cryogenically preserved. Also, a reality check.

— Samantha Payne’s Open Bionics allows anyone in the world to download and 3D print their own bionic limbs.

Brain implants allow paralyzed monkeys to walk. The Swiss scientist goes to China to conduct this work due to friendlier regulations. More here.

— First at-home brain implant allows paralyzed woman to communicate.

Genetically modified pig’s heart transplanted into a monkey in South Korea breaks prior world record. The monkey survives for 51 days. Pig’s hearts are thought to be a close match to the human heart. Very cruel animal experiments, but hopefully they help humans in future.

— Dr. Anthony Atala is still optimistic about printed organ replacements.

A Hair Loss Blog