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.
Wow, this is the most impressive results I’ve seen from anything in a long time. Would really love to see that list of trained docs when you have the chance admin. Hopefully something in SoCal.
I have messaged them and they don’t have any certified clinic or person which can perform this procedure. I told them please arrange or appoint one because india has the huge market for hair loss and alopecia. We are having thousands of transplants everyday across our country and this number is not exaggeration.
I told them that I would be the first person to get this treatment if your team does this in my country.
How is this different than MMP?
Is this legitimate?
Aw, c’mon… these guys are clearly wearing fibers in the pictures.
Admin, you know that I’m hyper skeptical of most hair transplant docs and what they’ll market to make a buck (anything). Some are far worse than others. I believe Ron Shapiro has a pretty good reputation, what do you say (if you can)?
I see that Shapiro sells his own branded products on Amazon. Not snake oil, appears to be overpriced versions of products that are readily available for less. My transplant doc aggressive marketing senses are tingling, not ready to pronounce his guilt and defacto lack of credibility yet, compared to some of these charlatand its like Jeffrey Dahlmer vs a Jay walker.
I have only ever heard good things about Ron Shapiro. There is also a famous Jerry Shapiro.
Yoda, please do not start posting negative comments about all the surgeons that you dislike in this post.
I will make a list in here at some point, but delete all criticisms of individual surgeons who are not here to defend themselves.
Every single one of the renowned quality surgeons that I know in the US do at least one of the following: advertise online, pay to get on various “best of” lists, pay for press releases, charge high prices versus the rest of the world, sell their own products, overcharge for things such as PRP, stem cell injection, exosomes etc…, pay to be members of associations, have representatives promote them on forums and much more.
If you try to find someone like Gandhi, it is best to go to India… though people do die in India during hair transplant surgeries once every few months.
Hey admin, didn’t post any names, just posted there’s a Shapiro line of products on Amazon, that is a fact. Not an opinion. I have no problem with the marketing techniques you noted, just the peddling of bogus treatments.
You implied that the products are from Ron Shapiro. Would be curious which ones.
The ShapiroMD line are not his if that is what you saw.
As far as bogus treatments go, many people still consider PRP, Exosomes, Secretome etc… to all be bogus. I would prefer surgeons offer all such options.
Could be the other Shapiro on Amazon, I didn’t look that close. I noted in a prior post ” I believe Ron Shapiro has a pretty good reputation, what do you say (if you can)?” Had hear good things about him, could’ve been the other one, however I remember he was in MN like this Shapiro. Also said this treatment looks interesting and I might consider. PRP, Exosomes, Secretome etc are not what I was referring to. Not for me however they have been proven clinically, however not sure how large a population they have any effect on. It’s treatments that are not proven, don’t want to call out the treatments as they will possibly give away the doctors that market them, not wanting to make the Admin more irritated with me. Thanks for all you do, I’ll take a time out and lurk for a while. :-)
No worries Yoda, keep posting any time. You have helped hundreds of people with your summaries of all the treatments that you have tried!
Awww Admin you can’t quit Yoda! Although hundreds seems a bit of a stretch, maybe pissed off more than I helped. Ok, so let’s get down to business. I’ve had terrible scalp itch, inflammation and flaking for probably 10 years. It was bullet proof to topical additives like propylene glycol, tretinoin. Thru trial and error I’ve learned I can no longer tolerate either. I’ll be moving to a new topical (online telemed/RX) later this week with 8% min and .5% Dutasteride with a few other things in a liquid base that I found. Liquid works better than cream for me, hard to find anything without propylene glycol, tretinoin. Like that this one has high min and the highest % of dut I could find. For those that prefer a cream base and want tretinoin I’d recommend Blends (no PG and high % of the important stuff). Even though it didn’t pan out for me, their doc is the best hair telemedicine doc I’ve experienced, he’s the owner (a transplant doc Admin!) and gives personal attention. Most of these online compounded minoxidil docs know nothing about hair loss, are just approving people to get their consultation fee, including the new topical I’m moving on to. While I’m not in Frank’s camp that all docs are questionable, most telemed docs leave a lot to be desired.
Do you have a name of the doctors he trained in France? I have been trying to get myself some dut and minox for years and found no one. Thanks.
No, but I will update this post with a list at some point.
I messaged the doc on insta and there is one doing it in paris, but that is weird as we have no regulation for meso dut or min. But I will contact them and maybe try.
Hello Louis,
I come from Paris too. If you manage to get the contact details, could you let me know? Thanks a lot.
Would love to know if anyone in CA is doing this!
Does anyone have information on Amplifica hairy Nevis treatment for AGA?
The last update almost a month ago was that Dr. Rassman said they hope to begin trials for 303 in the next 12 months. With the pace they are progressing in, even 5 years is a pretty optimistic guess. Seems like they’ll take more than that (funny 5 yrs ago, Dr. Rassman replied to a reddit comment at the time asking how long before amplifica finishes trials and said, “in 5 yrs” and now it’s the same again).
Anyone under the auspices of the American Medical Association will gaslight you as long as you allow them. All of them.
That was pretty frank, Frank! Do you still use leeches and have a medicine man treat you for any afflictions?
I think it’s great that your foster home gives you free internet.
In my case nursing home would’ve been a better come back, I’ll throw you a bone. Must suck going thru life being a ray of sunshine Franky! XOXO Yoda
Great post. I am definitely going to try this if a decent dermatologist offers it in my state.
Anyone in this field using low-res images alone tells the story.
Who knows how effective this will actually be, but if you go to the “results” section on his website, he has videos where he is combing through people’s hair. I always get my hopes up so easily:), but the results look kind of impressive.
Yeah tons of videos on his site, on his Instagram, and on the Instagrams of people he trained.
Make sure to check the links I have in the “training sessions” section towards the bottom of the post.
The delivery system, kitchen sink medication approach, micro-wounding, growth factor release etc…all combined into one. Dr. Shapiro said that he can use a bunch of products in small doses in this way, and he still also recommends that people continue taking oral finasteride or oral dutasteride (if they were already doing so).
How often is it done?
See my comments above the Spex video. I only watched the video once yesterday. If you watch it, add any interesting details you hear in a comment.
Not sure if I can re-watch it today.
Who’s offering this in America?
A number of doctors are offering CRT in the US now. I will list the names as they come.
I just got off the phone with Dr. Ron Shapiro and he is doing it and is quite excited about the prospects. This method allows for a lot more microdose delivery throughout the scalp (and it is relatively low-cost per Dr. Shapiro). He also said that the once-a-month-for-6-months initial strategy seems more logical than the once every 6 months or once every 12 months approach for PRP, exosomes, mesotherapy etc…
Dr. Shapiro also agreed that there might be a microneedling type effect.
This looks pretty cool, imagine US docs will be much more than $500 a session, guessing like PRP around $1K, possibly a break if you sign up for six sessions. I’d probably give this a shot if it comes a little closer to home.