In 2024, I wrote a post on the subdermal scalp infusion of drugs by tattooing to induce hair growth. The process of skin microinfusion of medications (MMP®) was first outlined in 2013 by Brazilian dermatologist Dr. Samir Arbache. But Dr. Pablo Cirino (Brazil) started using the tattoo machine in his own way with his own protocol for the purposes of scalp hair growth. He originally called his process “combined regenerative technique” and published a paper on it in September 2025.
Cirino Regenerative Technique (aka Combined Regenerative Technique)
As of 2026, Dr. Cirino now calls his process the Cirino Regenerative Technique (CRTTM). He has made a number of modifications to the original version insofar as what drugs, peptides, growth factors and micronutrients to use.
The delivery mechanism via precision microinfusion technology using a tattooing machine type device remains the same. It creates thousands of microscopic channels across the scalp at a controlled depth. This allows the various hair growth customized medications to be delivered directly to the hair follicle at the dermal papilla level. This is superior in comparison to your typical topical gels, serums, liquids, creams and lotions. In addition, this method stimulates natural growth factors and regenerative processes. I think there is a microneedling type effect, but I am not sure.
CRT is now becoming especially popular in the hair loss world so I decided to write this post. Moreover, a number of renowned hair transplant surgeons are being trained to use CRT at their clinics (see the end of this post). Also check out Spex’s new interview with Dr. Cirino further below.
In a response to me in 2025, Dr. Cirino said that he delivers the below combination of topical drugs with a tattoo machine for transcutaneous delivery:
- Arginine 200 µg. This is an amino acid.
- Biotin (Vitamin B7) 50 µg.
- Copper Sulfate 2 µg.
- Chromium 0.2 µg.
- Dexpanthenol 20 µg.
- Riboflavin (Vitamin B2) 10 µg.
- Vitamin B6 6 µg.
In addition, for males with androgenetic alopecia (AGA), he adds the following:
- Minoxidil 0.5%.
- Finasteride 0.05%.
- Dutasteride 0.1%
For females with AGA (i.e., female pattern hair loss), he adds the following:
- Minoxidil 0.5%.
- Bicalutamide 0.5%.
This week, Dr. Cirino told me that he now also uses some growth factors from PRP. Moreover, after studying the main hair growth pathways, he has also added some “home treatments” to patients to boost the results. I presume one can also use exosomes, even though he did not mention it.
He never prescribes oral finasteride or oral dutasteride, preferring to apply both topically via his scalp microinfusion via tattooing technique. He does prescribe oral minoxidil.
In a January 2026 article, Dr. Cirinho mentions that the combined regenerative technique:
“Integrates tattoo machine-assisted infusion of minoxidil sulfate, dutasteride, copper peptides, and platelet-rich plasma with concurrent oral minoxidil and topical finasteride.”
All of this reminds me of the kitchen skin approach to tackling hair loss that we have discussed numerous times on this blog. Except that in this case, it is via a superior delivery mechanism of topical medications directly to the scalp. And from a doctor who has been experimenting with various regimens for a number of years.
On a related note, make sure to read my 2019 post on creating the ultimate hair loss drug cocktail. Most online vendors of topical finasteride these days also offer a mix of molecules in one serum.
Dr. Pablo Cirino Interview: Non-Surgical Hair Growth via CRT
Earlier this month, Dr. Pablo Cirino gave a lengthy interesting interview to Spencer (“Spex”) Stevenson that I have embedded below. Among the highlights:
- His CRT method has led to 40% of his patients ultimately not needing a hair transplant.
- The cost is just $500 at his Brazil clinic.
- 1 million micro-perforations per treatment.
- He is training many surgeons from around the world via his Tricho Surgery Academy.
- Most people need one 30-minute treatment session each month for 6 months total. Thereafter, maintenance options are based on individual needs and preferences.
- He recommends Chemistry Rx in the US for compounding unique hair loss drugs. I have talked about this company in the past too.
Cirino Regenerative Technique Training Sessions
In 2026, Dr. Cirino has started training many other doctors and hair transplant surgeons in regards to his CRT technique. Check out his Tricho Surgery Academy for more information as well as numerous photos and training session videos.
A number of globally renowned hair transplant surgeons are now proponents of this unique method of delivering multiple hair loss drugs to the scalp subcutaneously. Note that some of them are using existing scalp micropigmentation (SMP) devices to make the holes or incisions.
Videos
- Training session at Dr. Maxim Chumak’s clinic in Florida.
- Closeup of Dr. Max getting treated.
- Training session in Paris, France.
Other Drug Delivery Mechanisms to the Scalp
Over the years, I have discussed many different ways of delivering drugs directly to the scalp. Among these include:
- Dutasteride injections.
- Finasteride injections.
- Alma TED ultrasound,
- Topical finasteride deivery systems.
Hopefully the CRT method turns out to be the best of these options, although it is still too early to tell.
