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8 Biggest Scalp Micropigmentation Regrets

Knox Beasley, MD

Reviewed by Knox Beasley, MD

Written by Steph Coelho

Published 05/03/2023

Updated 05/14/2024

If you’re looking to achieve the look of a full head of hair, you may be willing to consider any treatment to achieve results — including hair tattoos, a process more formally known as scalp micropigmentation (SMP).

If you’re considering getting this special cosmetic tattoo to hide a receding hairline, you might be wondering whether other folks have had regrets about scalp micropigmentation. 

SMP is a cosmetic procedure that mimics the appearance of natural hair follicles and creates the look of fuller hair. A skilled SMP cosmetician can help address concerns such as thinning hair and male or female pattern baldness (also known as androgenetic alopecia).

SMP is not a medical procedure, but like with every type of treatment or procedure — or tattoo, for that matter — it’s important to do your due diligence before making an appointment.

Below, we dig into common scalp micropigmentation regrets and offer tips on ensuring you end up with realistic-looking results. 

1. Going With An Inexperienced 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.

Scalps have a surprisingly intricate anatomy, so finding an experienced SMP technician and a reputable clinic is crucial.

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)

  • A clean and sterile environment with a sink

2. Bad Scalp Micropigmentation Technique

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

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

That said, some techniques that will 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

  • Performing a patch test to check for skin reactions

You can also ask for photos of your technician’s previous results and information on how they prepare and perform SMP on each client. 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. Natural-looking hairlines are important in SMP, so watch out for an uneven hairline outline.

Looking at photos of your SMP technician’s previous clients can 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.

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4. Using Incorrect Equipment

While scalp micropigmentation is similar in some ways to tattooing, the SMP procedure requires different equipment, like extremely fine needles that create pigment dots less than 1 mm (millimeter) in diameter.

While a single-pronged needle is good for finer areas on the scalp, such as the hairline, technicians may use needles with up to six prongs across the rest of the scalp. Make sure that your chosen clinic has these different types of needles.

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 into the right pigment shade for you based on your natural hair color and skin tone. 

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.

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. 

6. Not Following Aftercare Instructions

Like with a tattoo, scalp micropigmentation aftercare is crucial 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

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Before/after images shared by customers who have purchased varying products, including prescription based products. Prescription products require an online consultation with a healthcare provider who will determine if a prescription is appropriate. These customers’ results have not been independently verified. Individual results will vary. Customers were given free product.

7. Having 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. 

8. Waiting Too Long to Get SMP

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

However, before spending money on any cosmetic procedure, it’s important to research and vet different technicians by booking free consultation visits. 

Don’t be afraid to ask questions about a technician’s previous client results, techniques, certifications, and clinic safety and sanitary standards.

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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.

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

Here are the basics of what to look for:

  • 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 get a sense of their performance and skill level.

  • Consult with 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, W. R., Pak, J. P., Kim, J., & Estrin, N. F. (2015). Scalp Micropigmentation: A Concealer for Hair and Scalp Deformities. The Journal of Clinical and Aesthetic Dermatology, 8(3), 35-42. Retrieved from
  2. Dhurat, R. S., Shanshanwal, J. S., & Dandale, A. L. (2017). Standardization of SMP Procedure and Its Impact On Outcome. Journal of Cutaneous and Aesthetic Surgery, 10(3), 145-149. Retrieved from
  3. Scalp Micropigmentation (SMP): Semantics, Terminology, and Standards - ISHRS. (2019, July 31). International Society of Hair Restoration Surgery. Retrieved from
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

Dr. Knox Beasley is a board certified dermatologist specializing in hair loss. He completed his undergraduate studies at the United States Military Academy at West Point, NY, and subsequently attended medical school at Tulane University School of Medicine in New Orleans, LA. 

Dr. Beasley first began doing telemedicine during his dermatology residency in 2013 with the military, helping to diagnose dermatologic conditions in soldiers all over the world. 

Dr. Beasley is board certified by the American Board of Dermatology, and is a Fellow of the American Academy of Dermatology.

Originally from Nashville, TN, Dr. Beasley currently lives in North Carolina and enjoys spending time outdoors (with sunscreen of course) with his wife and two children in his spare time. 





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