Scalp MicroPigmentation - Case 1

by Andrea Darby - Master Medical Tattooist & Industry Educator
SMP - Case 1 - Before

In this BEFORE photo the client had investigated a wide variety of options for his hair loss and decided that Scalp Micropigmentation was his preferred solution to camouflage his hair loss. ...
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Scalp MicroPigmentation (Case 1)

Client Information

Intro: Our case studies are the perfect way to gain a deeper insight into the products required to provide a particular type of service.

This client in his early thirties had not had any prior hair transplant surgery and had previously explored all other hair restoration options, a new SMP hairline was selected based upon the age of the client and residual sparse hair pattern.

Quite a wide variation in hair follicle diameter was discovered after conducting a trichogram therefore a complimentary sizing was matched during Scalp Hair Follicle Simulation Tattooing™ to provide a random size pattern that matched natural hair distribution on associated regions of the scalp, the client had a small pre-existing scar on the right hand side of the frontal scalp following a small surgical procedure and we discussed the pros and cons of camouflaging the scar with tattooing.

Androgenic Alopecia/Surgical Status Grading:  Hamilton-Norwood VI / No Transplant Surgery
Fitzpatrick Skin Type: II
Hair Colour: Black
Grey Light Blond Blond Strawberry Blond Red Light Brown Medium Brown Dark Brown Black

Before Photo

After Photo - (healed 6 weeks after first procedure)

Click for Larger Image

Comments: Collagen Induction Therapy (CIT) is an optional service to increase natural skin colour within scar tissue donor sites following Follicular Unit Strip Surgery FUSS or Punch Grafts, CIT is sometimes performed at the choice of the client prior to Hair Follicle Simulation Tattooing in an attempt to stimulate the production of melanin in scars that are pale in colour in comparison to the surrounding skin colour. Scars can also be peppered with random tattoo pointillism's or pigment mosaic to help camouflage the scar and blend back into the surrounding scalp.

However in this particular clients case the client and I decided together that the pre-existing small scar on the right hand side near his new frontal SMP hairline actually improved the overall natural appearance of his new SMP hairline by providing a random feature on the scalp, many of our regular clients tell us that they are often able to detect SMP work performed on others elsewhere due to excessive uniformity, overly hard hair lines, hairlines that are too angular or too far forward and an overall lack of randomness in the finished result.

We see a lot of examples of unnatural looking SMP frontal hair lines and hair lines that are brought too far forward relative to the age of the client this can result in the clients SMP work becoming far more noticeable to others, often this is due to lack of guidance on SMP hairline design during training programs and as a consequence a lack of guidance to the clients on their new SMP hair lines, our SHFST Course covers this topic to assist Scalp Tattooing technicians to provide more natural looking SMP hairlines for their clients which are more difficult for others to detect.

Multi Spectra Examination

We have always taken a science based approach to client services.

Multi-Spectral examination is a routine part of our initial follow up appointment which provides a more precise indication of the exact needle depth for the individual client and is used in conjunction with our own proprietary analysis software which also provides guidance on the best needle type relative to the individual client hair follicle sizes and distribution.

Further information on these topics can be found during our Course; CT-AIVEP Training - Scalp Hair Follicle Simulation Tattooing

Equipment & Products

 Procedural Consumables

Often technicians claim to be using 'sterile technique' or 'aseptic technique' for a cosmetic tattoo service when in fact the products being use are not of those standards. Aseptic technique involves the compliance with specific standards, the use of a particular grade of consumable supplies and the use of hygiene barriers wherever possible. For example a procedure can hardly be claimed to be 'aseptic technique' if un-sterile gloves or un-sterile gauze are used during a service to wipe tattooed skin or if food handling protective equipment is used instead of the appropriate use of Personal Protective Equipment (PPE) as recommended by health authorities.

If a cosmetic tattoo store is offering food handling mouth shields for sale it is a fair indication that they do not understand the difference between the kind of PPE required for Cosmetic Tattooing to protect the client and the technician vs. those used in the food industry.

For this reason I recommend that technicians are not misled into purchasing products that are inappropriate for use during a skin penetration service by suppliers who do not hold the necessary qualifications to make these kinds of recommendations, ideally this kind of advice is provided by a supervising Registered Health Professional.

 Amiea Microprocessor Controlled Digital Machines

Any serious full time cosmetic tattooist will have 2-3 or more devices to choose from when providing client services and at least 2 hand pieces for each device, leading technicians and educators such as myself will often have 5-10 devices that are all used for different purposes. Most of us will have a go-to device that is our day to day workhorse for the majority of procedures and mine is the Amiea Linelle Supreme I have used them all at one time or another over the years and the Linelle Supreme always comes out at top of the list.

Needle Profiles:

 Creatips for Amiea Digital Machine
  • Amiea 3 Micro
  • Amiea 1 Micro

    CIT (if required)
  • Amiea Vytal
  • Amiea Creatip Meso


 Amiea Pigments

Utilising the correct pigment mixtures for Scalp Tattooing is crucial in achieving the best outcome for the client, we provide detailed guidance on pigment blends during our SHFST Course so SMP technicians do not need to subject their clients to trial and error

  • Amiea Derma Safe - Slate
  • Amiea Derma Safe - Deep Black

For the vast majority of Cosmetic Tattoo procedures I advise against mixing pigment colours together as there is a risk of creating a 'mud mix' this is a muddy brown/blue/grey colour that can result from mixing colours unnecessarily, however for some specialised procedures such as this particular case the blending of a range of colours is required for an optimal result.

Many Cosmetic Tattoo Technicians seem completely unaware of the legal requirements related to manufacturing or importation of pigments into Australia, a recent survey by our Chemical Regulator the Australian Industrial Chemicals Introduction Scheme "AICIS" formerly known as "NICNAS" highlighted that many pigments currently on the market may not be compliant.

Before purchasing any cosmetic tattoo pigment always insist that the supplier provides written confirmation that they are registered with AICIS and that they have audited their pigment for compliance with Australian Regulations and they hold product liability insurance, if not you may be taking an enormous risk.

The European Commission have tasked their chemicals advisory body ECHA with recommending restrictions on the use of a wide range of chemicals that are currently in use by tattoo pigment manufacturers and the European Community are due to vote on the proposed restrictions in 2019. Some of the Medical Professional Associations have publicly stated that even these proposed new restrictions do not go far enough. Our expert opinion is that much stricter regulations will occur in the EU and these standards will eventually be adopted in many other countries.

Some pigment suppliers seem to be totally oblivious to their obligations under the law or the changes that are taking place around the world related to the health and safety of tattoo pigments. In addition to the strict manufacturing standards followed by the PhD chemists at Amiea we independently audit the pigments that we supply for compliance and I recommend that our customers consider carefully the differences between Amiea and alternative brands before making any pigment purchases.

You may find our Amiea Pigment Colour Selection Interactive  & User Tips are helpful for learning about the Amiea pigment range and for choosing pigments for your client.


Specialised needle techniques were utilised for this service which are described in detail during our Scalp Hair Follicle Simulation Tattooing training course.

Training is the most important investment that a cosmetic tattoo technician can make for the future of their career, it often puzzles me why anyone would think that they can offer services to members of the public for hundreds of dollars without spending an adequate amount of money on their own training in the first instance, the more training and experience the better. For medical tattoo training I generally suggest that the technician has at least 2 years full time cosmetic tattoo experience or they have a health service qualification.

Associated Training Courses, Materials & Supplies

  • CT-AIVEP Training - Scalp Hair Follicle Simulation Tattooing (SHFST™)
  • SHFST Tricho Analyser
    (for selecting needles and accurately estimating procedure times relative to scalp size and individual technicians workflow rate)

Whilst I am prepared to provide information about equipment and products used for our Case studies free of charge, information about specific techniques are taught during our training sessions and sometimes contained within our various publications that are available for purchase. If you would like to learn a particular technique or if you are struggling with your technique then we suggest that you book a training session with Andrea.


 Cosmetic Tattoo Training by Andrea Darby

Training is the most important investment that a cosmetic tattoo technician can make for the future of their career, it often puzzles me why anyone would think that they can offer services to members of the public for hundreds of dollars without spending an adequate amount of money on their own training in the first instance, the more training and experience the better.

On a strictly limited basis I sometimes offer boutique one on one and small class training with an honest desire to provide accurate educational information based upon evidence based practice, and I have conducted rigorous research of the medical and scientific literature related to cosmetic tattooing on an ongoing basis and we have published authoritative articles on a wide range of topics and published them here for our clients and customers. Our articles have been plagiarised by others so often that we had to publish an another article explaining why it is unethical to plagiarise.

I have previously trained some of the leading technicians in Australia and internationally, training is based upon the core principles of ethics and best practice together with a genuine desire to assist students with their education with reliable well researched information, click here for further information on training.

Private Client Bookings:

 Cosmetic Tattoo Services by Andrea Darby

To make a booking for Cosmetic / Medical Tattoo client services contact Andrea by email.

Copyright: © 2019 All Rights Reserved. No copying, transmission or reproduction of any of the above content is permitted without our prior written consent.

Disclaimer: The content of this case study should be regarded as general information & is provided solely for the purpose of discussion & is not intended to replace cosmetic tattoo training or medical advice in any instance, always check with a qualified cosmetic tattoo educator and or a qualified medical practitioner before acting on any information regarding cosmetic tattooing or in relation to any medical condition or medical circumstance.

This information is not intended to be a 'how to guide' nor to replace recommended comprehensive Training by Andrea Darby it is merely an overview of the kinds of results that can be achieved and the types of equipment and products that were utilized.

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