Tricopigmentation: A Temporary Form of Scalp Micropigmentation

During the past year, I have received a few requests to write a detailed blog post about 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. However, people are increasingly 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 there 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. This is to the detriment of consumers who can get major adverse side effects at the hands of inexperienced practitioners.

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 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” SMP. However, the definition of “temporary” and “permanent” varies depending on clinic and method being utilized. Thanks to Beauty Care Nederland for the above tricopigmentation image.

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 numerous 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) can be a bit dangerous in some instances. 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).

According to Nicole Large from the Shapiro Medical Group in an e-mail to me:

Custom Needles: we have a 1 and a 3pt needle (both are smallest on the market). Big difference is that our needles do not deposit pigment at the bottom of the injection but rather it collects along the injection walls. Therefore it’s not a large pool of pigment sitting at the bottom of the impression – with more chance to spread. Also, we use guarded needles that we set to .05. With permanent SMP they use a method of injection that is based on “feel”. It’s much harder to learn and chances of error are increased.

This was how I learned and literally I remember my first “teacher” telling me “just inject it until you feel it in the upper dermis. You will be able to tell by vibration” I remember thinking “wt%\^?~, how do I know what that feels like”. The perm SMP market standard for needle size is 3pt round. The Beauty Medical needles are smaller. The 1 pt is extremely small compared to the rest of the market which is extremely nice for Caucasian skin whose hair diameter is much smaller in comparison to other ethnicities. But, the 3pt is much better for thickening procedures, and ethnic skin. Permanent SMP also injects from 1-2 mm.

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).

According to Nicole Large:

Trico pigment is brown and not black. Also, trico can give you a full ingredient list and system of manufacturing. No secrets. It is manufactured in the EU, which has the strictest laws in the world for cosmetic pigment manufacturing. The EU has a banned ingredient list 150+ ingredients compared to the US FDA, which has 17. Trico pigment is designed to fade completely over the course of 6-24 months because the pigment particle size is so small it can slip through your cell walls allowing your immune system to sweep it.

When trico pigment is injected during the healing process, the pigment grows slightly. That is why it is very important to let the patient go home and heal between sessions so that we can monitor exactly how everything is healing. In permanent SMP, the dots should shrink down during the healing process. Also, every SMP company is using a different pigment. Some are using “scalp pigments”, which are mostly carbon based pigments which break down to grey as they fade. Some are using permanent cosmetic pigments and or tattoo ink. Both have a high, high probability of pigment discoloration with time.

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. Maintenance session will usually be less costlier.

It should be noted that despite some bad work out there, numerous people have been very pleased with their tricopigmentation 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 satisfaction rate when it comes to micropigmentation.

37 thoughts on “Tricopigmentation: A Temporary Form of Scalp Micropigmentation”

  1. Nice read.

    I have been thinking about getting this done for a while now. I really think this would be a pretty good cover especially if you have a nice head shape. The smp follicles can really frame your face if done correctly to make it look naturally. What I’m worried about is the future side effects

    Could iron oxide and titanium oxide lead to complications later on?

  2. Great post admin. I’ve had SMP done and am very happy with it. Although I wish I knew of trico as I might have gone for that instead. My hopes are for my full head of hair back one day when I can then remove the SMP ink where needed (mainly the hairline and temples which make me look young now but I haven’t had hair there since I was 18). With SMP, I have to use factor 50+ sun cream every day, even on cloudy or winter days. So perhaps reversal may be easy. Also there is the option of laser tattoo removal.

  3. Yeah, i also thought about having this done to enhance my hairs appearance since i have thinning temples and so on. Im worried in a way that if an when i do have a transplant, they will get confused with the tattoos and the shaved down hairs when implanting. Must be hell on their eyes as well when doing the procedure.

  4. Very interesting, didn’t know the ink’s ingredients are natural.
    Wonder if the those ingredients (as brought according to Milena Lardi) are the only ingredients (and there are no others) or only the ones she chose to disclose.

  5. Looks very interesting. Pipeline states clinical trial ready. Any idea where they are in terms of marketing and release?

  6. Off topic, rivertown isnt a godsend in my opinion. Their pics are a little misleading, one has flash on in on and no flash in the other.. and the results arent better than someone just using minoxidil, which is in their product. And to my understanding, cyclosporine does regrow hair, but that is if taken orally. You can already buy topical cyclo and one side effect is actually hair loss. Their results, if any, are most likely due to minoxidil which is sad.

    1. You are right. After I checked out the ingredients, I lost enthusiasm too :/ Probably not too different Minoxidil. Oh well, I guess I will go back to waiting for histogen!

  7. Great post Admin! I wasn’t aware of the temporary option, so I will definitely look into it. Still, if I’m going to spend the time and money, I personally prefer the permanent solution so long as the inks are proven to not change color or migrate. I know of several clinics that make this claim.

    In general, it’s unfortunate that so many young men got caught in a trap of getting an FUT hair transplant scar at an early age. If someone in there teens or early twenties is rapidly losing hair, then chances are they are on their way to extreme NW hair loss, and the insufficient hair transplants will only make it look worse. When you add large strip scars to this, which removes the option of shaving hair short to embrace baldness, many men end up in a very bad situation with no good options to look normal. Large embarrassing scars on the head can greatly affects one’s life.

    The idea that SMP has a chance at covering the scars is the only decent option right now for many, so your informing people about this topic is very helpful. I’m planning to have an SMP procedure this summer for attempting to camouflage scars and make for more youthful shaved look. If successful, it will be truly life changing. As always, I appreciate all that’s done on this site to provide quality information! Great work.

  8. Personally I always thought SMP was stupid but after looking at some advanced pics it’s quite neat. I mean you will have to be happy having a skin buzzed look but if the ink can look similar to hair follicles then it’s a very good option. However, if the ink doesn’t look like natural hair dots then be prepared to be humiliated by people. This could be worse than a detectable hair piece if not done by the brat SMP docs. But the idea of covering up a botched fut scar with smp is an excellent idea. I feel so bad for young guys who get fut. I see them all the time with huge deep linear scars. It’s sad and o feel like telling them why did you not do an fue. Hopefully this 21st century act will allow better treatments to hit the market in 2017 or 18 in the USA. Not many people have the funds for multiple trips to Japan or Mexico to get replicel or histogen.

    1. I’m in that situation and it makes me really depressed. I have coverage for now but the front is getting thinner every year. I really fear the day where I would have to shave because now I have this scar… It really sucks because not a day goes by without having to think about this.

      1. I’m sorry to hear that, but at least your hair might hold out for another few years until the cure arrives. You can supplement with SMP, Couvre, or Toppik. Unfortunately for me, my hair is so thin that I spend huge amounts of time each day covering my scars with Couvre and maintaining fake hair on top to look normal for my career. FUT has messed up my life for the past 15 years, so I always try to warn people whenever I get the excuse. It’s a decision that cannot be fixed (I’ve tried everything but SMP to cover the scars). The only thing that can help me now are possibly SMP or a baldness cure!

        1. What have you tried to improve the scars (how many scars do you have? I thought you only get one). Did you try to get a scar repair. I don’t know if there is already an article on the subject but I think it would make for a nice subject to talk about options for FUT patients (victims). Stuff like scar repairs or even the future of scar tissue repairs. I’m young to be in this situation and it’s hard to see a bright future for me

          1. I have a linear scar in the back in a location that was used 3 times to harvest follicles, each time removing the previous scar. I also have linear scars about two inches above the ears on the sides from a different surgeon who helped at least make the hair transplants on top look somewhat natural. The side scars used acell, so they are less pronounced. This was all around the year 2000 between ages 19 and 22.

            In 2013, I attempted fixing the scars by getting an FUE procedure that was purely focused on filling in the scars with follicles. I’d say this was about 40 percent effective in allowing me to buzz my hair a bit shorter, but I can’t go closer than half inch hair, and I certainly can’t shave it off completely.

            I feel I’ve reached the end of the road as far as surgeries and repairs to look more natural are concerned (I’m out of donor hair). I’m now just basically covering the whole mess each day and hoping for a cure, though this SMP looks like it might give me a good enough result for some freedom. I’m going to visit some clinics soon to get a feel for the potential results. The last thing I want is another failed procedure, so I’m much more cautious these days.

            I hope your situation is more correctable!

  9. I’ve had SMP done (Norwood 6). Looks good but you can see the contrast between the native hair and the treatment area under certain lighting conditions (bright sunlight is the worse). I would recommend the treatment for FUE punctuate scars of FUT linear scars.

    1. Kirkland, what are your thoughts on the SMP hairline? I’ve noticed that most photos show completely straight SMP follicles in a straight line, and this would never happen naturally. Have you given any thought to making it jagged a quarter inch with a few larger bumps to make it look natural? How did you do your hairline? (The good news is you can always add some extra artistry at any time)

      1. Since I’m 49, going for an 18 yr old hairline made no sense to me. Most of the pics of guys with SMP hairlines that are straight across look ridiculous. I went for a slightly receding hairline that was more age appropriate. My SMP provider was fantastic and did a great hairline.

        1. Great to hear! I’m glad you’re happy with the result. I’ll likely request a slightly receding hairline as well with some variations along the front to make it look natural. Let me know if you can think of any other advice. I’ll probably go light with the coloring, since you can always go darker after. What clinic did you go to and how long ago??

          1. My best advice is to go with temporary pigmentation rather than permanent. Milena Lardi (as mentioned in the above article) provides temporary pigments which break down in the dermis over time. My treatment was done in July 2016 and is still going strong which gives me comfort knowing that a) the treatment will last a number of years before doing touch ups and b) that if I decide to forego the look, it will eventually fade. Also, make sure you’re happy with the hairline that is drawn before proceeding with the treatment. I had my treatment done with Ahead Ink out of Long Island. Erik’s a great guy, he trained with Milena Lardi and only uses her products and he really emphasizes the pros of temporary SMP over permanent.

            1. Thanks kirkland,

              I’ll definitely investigate Ahead Ink and that’ll be an option. I appreciate the advice. Again, I’m glad to hear it’s been a good experience for you.

  10. SMP results can look quite good. It is a great option for guys who can pull off a shaved look. The trick is getting a hairline that works for your face. Lots of guys get a very straight and defined SMP hairline, which looks totally fake for tyeir face/age. When done right SMP’d head will always look better than a slick bald head, at least in my opinion.

    For those with a good head shape, it can basically be a pseudo-cure. These are some examples of the good results:

    If the time ever comes where I have to shave my head, I will definitely look into this. The “fullhead” shaved look looks a lot better than thin balding hair IMO.

    1. So let us suppose we burn off our scalps, destroying all those dht plagued follices and then heal it up with that stem cell gun. What would happen? brand new, but still hairless skin ? I guess so, knowing how God and Nature seem to delight themselves with our suffering.

  11. I think SMP could come really well if they were better at drawing the hairline. Most results I see draw a straight hairline half way up their head. IT is the same with HTs. The best ones will focus mainly on giving you a string forelock, rather than drawing an NW1 hairline starting at a nw3 hairline area… Check out romney’s hair transplant– people will deny vehemently that he even has one (he does).

    1. Agreed!.. not sure why they don’t study real shaved heads.. a hairline has a quarter inch jagged variation to it and maybe even a few bigger deviations.

      If they just roughed up the hairline a bit, these things would look very real. The good news is that anyone can get these artistic touches added on afterwards.

      1. Anyone with intel on the health aspects of temporary SMP? I heard its actually worse than permanent from a health standpoint because the temp ink dissipates (fades) and travels to lymph node system where it collects and stays forever, whereas permanent mostly stays in skin where it’s injected so not much at risk of it getting to lymph nodes. Have there been any studies or theories on consequences of her type of ink going to lymph nodes? The pics above look great. You could always get some fue up top to avoid it feeling slick on top but not sides.

    1. It’s a tattoo people… you’re not going to die. I’d be more concerned about stubbing my toe.

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