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8 Common Scalp Micropigmentation Regrets

Knox Beasley, MD

Reviewed by Knox Beasley, MD

Written by Steph Coelho

Published 05/03/2023

Updated 04/24/2025

There’s no shortage of options for restoring the look of a full head of hair. For example, you might consider a hair tattoo, a process more formally known as scalp micropigmentation (SMP).

While many guys have had great success with SMP, others report less-than-ideal results — often due to their own choices or the work of their hair technician.

Below is a list of some common scalp micropigmentation regrets and a little more about the procedure itself.

Scalp micropigmentation is a cosmetic procedure that mimics the appearance of natural hair follicles and creates the look of fuller hair. Often chosen by guys who rock a shaved head or buzz cut, the technique can fill in bald spots and bring the hairline forward.

A skilled SMP specialist can help address concerns such as thinning hair and male pattern baldness (also known as androgenetic alopecia).

Scalp micropigmentation isn’t a medical procedure (it’s cosmetic). But, as with every type of treatment or procedure — or tattoo, for that matter — it’s still crucial to do your due diligence before making an appointment.

Some of the most common scalp micropigmentation regrets:

  • Not going with an experienced technician

  • Poor scalp micropigmentation technique

  • Undesirable hairline design

  • Incorrect equipment

  • Choosing the wrong pigment

  • Not following aftercare instructions

  • Unrealistic expectations

  • Waiting too long to get scalp micropigmentation

We’ll dig into why you want to avoid these mistakes and what to do to ensure you end up with realistic-looking results. Hopefully, this will prevent you from ending up with a major scalp micropigmentation fail.

1. Not Going With an Experienced Technician

Unlike typical hair loss treatment options or hair transplant surgery, a scalp micropigmentation procedure involves carefully selected pigments, tattoo instruments, and the artistic skills of an SMP provider.

What we recommend: Scalps have a surprisingly intricate anatomy, so prioritize finding an experienced SMP technician and a reputable clinic.

Here’s what to look for in a technician to avoid scalp micropigmentation regrets:

  • Certification of SMP training

  • Body art practitioner license on display (depending on state requirements)

  • County health permit

  • Barrier protection during treatment (nitrile gloves, mask, barrier tape, and guards on SMP treatment device)

  • Clean and sterile environment with a sink

We also strongly recommend reading reviews and testimonials from the provider’s previous customers.

2. Poor Scalp Micropigmentation Technique

Along with proper certification and experience, your SMP technician should be using the appropriate technique to achieve natural-looking hair.

Different people will require different techniques, depending on the look they’re going for.

What we recommend: Ask for photos of your technician’s previous work and talk about how they prepare and perform SMP on each client.

Techniques that tend to provide the best results include:

  • Depositing pigment at the proper depth

  • Inserting the needle at the correct angle to the scalp surface

  • Randomizing the pigmentation dot pattern for a more natural look

  • Performing a patch test to check for skin reactions

Again, if the clinic you’re considering has an online presence, check for customer testimonials to get a sense of what to expect.

3. Poor Hairline Design

If you’re getting scalp micropigmentation, one result you might be looking for is the appearance of a natural hairline with more hair density than you have now. Natural-looking hairlines are essential in SMP, so watch out for an uneven hairline outline before the dots are placed in.

What we recommend: Carefully look at photos of your SMP technician’s previous clients. This will give you an idea of whether they’ve previously achieved natural-looking hairlines.

You can also search for photos of a hairline outline achieved through SMP and ask your technician to use them as inspiration. Another option is to use a photo of your own previous hairline when it was fuller.

4. Incorrect Equipment

Though scalp micropigmentation is similar in some ways to tattooing, the SMP procedure requires different equipment. Specifically, it calls for extremely fine needles that create tiny dots of pigment less than 1 millimeter (mm) in diameter.

A single-pronged needle is good for finer areas on the scalp, such as the hairline. But technicians may use needles with up to six prongs across the rest of the scalp.

What we recommend: Make sure your chosen clinic has all the different types of needles necessary for proper SMP. Feel free to ask about the equipment the clinic uses.

There’s also a chance of bloodborne disease transmission if a technician uses incorrect needles, according to the International Society of Hair Restoration Surgery (ISHRS). So make sure your chosen clinic adheres to safety standards, such as a bloodborne pathogens certification and using packaged needles.

5. Choosing the Wrong Pigment

The wrong pigment color can lead to unnatural-looking results.

A skilled technician should be able to provide insight and recommend the right pigment shade for you based on your natural hair color and skin tone.

It’s also important to understand that pigmentation can fade over time. A qualified technician should be able to give you an idea of how your micropigmentation appearance may evolve and whether you’ll need touch-ups down the road.

What we recommend: Talk to your chosen technician about your shade options. You can also refer to their previous scalp micropigmentation results to get a better idea of what to expect.

6. Not Following Aftercare Instructions

The downtime for SMP isn’t too crazy — it takes about a week or so to heal. As with a tattoo, though, scalp micropigmentation aftercare is vital for optimal results. 

Your technician will likely advise you to avoid the following after the procedure:

  • Scratching any itchy spots (itching is a common side effect of the procedure)

  • Frequently touching your scalp with bare hands

  • Shaving your head

  • Wearing tight-fitting hats

What we recommend: Listen carefully to your aftercare instructions and follow them precisely. If you don’t get many (or any!) instructions, be sure to ask your technician before you leave the clinic. Get a copy in writing if you think that’ll help.

You might also need a touch-up ever so often, as tattoos can fade over time.

7. Unrealistic Expectations

It’s important to have realistic expectations when it comes to SMP results.

Scalp micropigmentation treatment doesn’t provide the same full-head-of-hair look as a hair transplant. But if you already sport a shaved head, it might be the right hair loss solution for you.

Sometimes, people combine SMP with hair transplantation to get their ideal hair restoration outcome. Micropigmentation can help your hairline look fuller as your hair transplants grow in.

What we recommend: Look at several before-and-after photos of SMP clients. Have an honest conversation with your technician before that first needle is inserted. Understand what is and isn’t possible with SMP, and consider all your hair restoration options.

8. Waiting Too Long to Get Scalp Micropigmentation

Some people’s biggest SMP regret is not getting the procedure done sooner!

There’s no shame in getting a cosmetic treatment to restore the look of your hairline. But if you want to be discreet, the sooner you get scalp micropigmentation, the less drastically noticeable the results will be.

What we recommend: As soon as SMP becomes a possibility in your mind, start your research and vet different SMP specialists by booking free consultation visits. Also, don’t be afraid to ask questions about a technician’s previous client results, techniques, certifications, and clinic safety and sanitary standards.

Scalp micropigmentation is a non-surgical procedure that involves tattooing the scalp to create the look of natural hair follicles and reduce the appearance of hair loss.

As with any procedure, some people regret micropigmentation scalp tattoos. But doing your research and making an informed decision can help you avoid scalp micropigmentation regrets.

Here’s what to keep in mind:

  • Experience matters. Going to an inexperienced technician can result in unnatural-looking pigmentation and increase your risk for disease or infection. Thorough research of a technician’s past work can help you gauge their performance and skill level.

  • Consult your technician before committing to the procedure. Make sure you’re going with the correct pigment choice and hairline design. A skilled technician will be comfortable talking through your options.

  • Have realistic expectations. Pigment alone can’t completely solve hair loss issues. Look up photos of SMP results to get a sense of what to expect.

SMP can help make thinning hair look fuller, but it can’t completely fill in bald patches or a receding hairline. Consider pairing SMP with proven hair loss treatments like finasteride and minoxidil that can promote a healthy hair growth cycle.

3 Sources

  1. Rassman WR, et al. (2015). Scalp micropigmentation: a concealer for hair and scalp deformities. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4382144/
  2. Dhurat RS, et al. (2017). Standardization of SMP procedure and its impact on outcome. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5782438/
  3. International Society of Hair Restoration Surgery. (2019). Scalp micropigmentation (SMP): semantics, terminology, and standards. https://ishrs.org/2019/07/31/scalp-micropigmentation/
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Knox Beasley, MD

Education

Training

Certifications

Medical Licenses

  • Dr. Beasley is licensed in all 50 states

Affiliations & Memberships

Specialties & Areas of Focus

  • Hair Loss, Dermatology

Years of Experience

  • 10 years of clinical practice as a Dermatologist

Previous Work Experience

  • Medical Director - YouHealth Medical Groups, 2025–

  • Private practice, 2024–

  • Chief of Dermatology - , 2023–2024

  • Chief of Dermatology - , 2019–2023

Chief of Dermatology - , 2015–2019

Publications

  • Wilson, L. M., Beasley, K. J., Sorrells, T. C., & Johnson, V. V. (2017). Congenital neurocristic cutaneous hamartoma with poliosis: A case report. Journal of cutaneous pathology, 44(11), 974–977.  

  • Banta, J., Beasley, K., Kobayashi, T., & Rohena, L. (2016). Encephalocraniocutaneous lipomatosis (Haberland syndrome): A mild case with bilateral cutaneous and ocular involvement. JAAD case reports, 2(2), 150–152.  

  • Patterson, A. T., Beasley, K. J., & Kobayashi, T. T. (2016). Fibroelastolytic papulosis: histopathologic confirmation of disease spectrum variants in a single case. Journal of cutaneous pathology, 43(2), 142–147.  

  • Beasley, K., Panach, K., & Dominguez, A. R. (2016). Disseminated Candida tropicalis presenting with Ecthyma-Gangrenosum-like Lesions. Dermatology online journal, 22(1), 13030/qt7vg4n68j.

  • Kimes, K., Beasley, K., & Dalton, S. R. (2015). Eruptive milia and comedones during treatment with dovitinib. Dermatology online journal, 21(9), 13030/qt8kw141mb.

  • Miladi, A., Thomas, B. C., Beasley, K., & Meyerle, J. (2015). Angioimmunoblastic t-cell lymphoma presenting as purpura fulminans. Cutis, 95(2), 113–115.

  • Beasley K, Dai JM, Brown P, Lenz B, Hivnor CM. (2013). Ablative Fractional Versus Nonablative Fractional Lasers – Where Are We and How Do We Compare Differing Products?. Curr Dermatol Rep, 2, 135–143.

  • Siami P, Beasley K, Woolen S, Zahn J. (2012). A retrospective study evaluating the efficacy and tolerability of intra-abdominal once-yearly histrelin acetate subcutaneous implant in patients with advanced prostate cancer. UroToday Int J, June 5(3), art 26.

  • Siami P, Beasley K. (2012). Dutasteride with As-Needed Tamsulosin in Men at Risk of Benign Prostate Hypertrophy Progression. UroToday Int J, Feb 5(1), art 93. ​​https://www.urotoday.com/volume-5-2012/vol-5-issue-1/48691-dutasteride-with-as-needed-tamsulosin-in-men-at-risk-of-benign-prostatic-hypertrophy-progression.html

Why I Practice Medicine

  • Dr. Beasley began doing telemedicine while serving in the U.S. Army, providing dermatologic care for soldiers stationed around the world. This experience sparked his passion for telemedicine and inspired his commitment to expanding access to healthcare for patients across the United States. 

Hobbies & Interests

  • In his free time, Dr. Beasley enjoys cooking, reading, and trips to the beach with his wife and two kids (with sunscreen of course).

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