SMT/ SMT - Frequently Asked Questions



for a BOLD new look

New Hair Institute Medical Group


Is it permanent? – Yes, this is a permanent procedure like a tattoo.

Is it a tattoo? – Yes and no.  While Scalp Micro Tattoo (SMT) is permanent and similar to a tattoo, it is a different technique that utilizes different needles and a specialized ink.   The result mimics a closely shaved head of hair.

Are you guys tattooists? – No, we are physicians who specialize in medical and surgical hair restoration. We are experts with a combined experience of over 25 years. Our experience from treating thousands of patients over the years allows us to pull from a wide variety of hairline designs, suitable for either SMT or hair transplants,  that match the person’s ethnic background, his balding pattern today and his age.

Can my tattooist do what you do? – No.  SMT is unique in its application as we use specialized instruments, needles, and inks.  A tattooist may be expert at what they do, creating wearable art, and their clients are proud to show off their tattoo, but a successful SMT application should be virtually undetectable.  You also have the option to have the SMT performed under a local anesthesia – a tattooist cannot deliver anesthesia to ensure a painless procedure.

Is this a medical procedure? -- No. But SMT is performed by hair restoration surgeons and staff who are specially trained.

Is it safe? – Yes. We use sterile one-time-use only pre-packaged needles.  Local anesthesia is administered only by licensed personnel, and our medical facilities are AAAHC accredited.

Does it hurt? - It feels like tiny needles poking constantly on your scalp for 3 to 4 hours. Without anesthesia it can be very painful, especially over the ears and forehead. But because we are physicians, you have the option to have local anesthesia administered, making the procedure pain free.

What if I want to grow out my hair? – Depending on your balding pattern this may be possible.  Consultation between a prospective patient and an experienced hair restoration doctor before undergoing SMT is invaluable.

What if I am not bald but I want to make my hair look fuller using a concealer (Toppik and Dermmatch)? – SMT is  used to decrease the contrast between your scalp color and hair color, giving an illusion of fullness. You can think of SMT as a “permanent” cosmetic concealer such as Toppik or DermMatch. Unlike some concealers, with SMT you will not have to worry if your scalp is showing from the uneven application of concealers. Unlike some cosmetic concealers, SMT does not put a stain on your clothing, pillow, or on your significant other’s finger tips.

What if my hair turns gray or white? – Believe it or not, the stubble from white hair (and most colors of hair) is GRAY when you shave close to the skin.   Just look at blond men with a close shave and you will see the gray shade where the hair exits the scalp.  We try to match the shade of pigment based on your skin and hair color.  If you have dark hair now and it turns gray later on in life, the underlying shade will blend despite the hair color change because SMT covers the entire scalp (not just the bald areas).

What if I continue to bald after doing the procedure, will it look natural? – As we are physicians specializing in hair loss and its treatment, we can plan for a worst case balding situation to develop. Whatever is done, it must be designed to plan for the worst case balding scenario or the possibility that some day, you may decide to have a hair transplant or a stem cell transplant when that becomes available.

What if it fades? -- The SMT process requires two to three treatments at least 3 to 4 days apart, to get the color shade just right. Each individual absorbs some pigment at different rates. For the first year we offer free touch ups if there is any fading. Your finished SMT process should last years before needing a touch up, but everyone is different.

What if I want a hair transplant later on? -- You can always have a hair transplant on top of the SMT process. We have performed FUE (Follicular Unit Extraction) in combination with SMT giving the patient the look of a shaven scalp and with actual hair stubbles.  See patient AAB.

Can I ease into the decision to have this done? – Yes.  we have done test areas (about 1cm square area) in scars so that the person gets comfortable with the way it looks and we have done test areas where the balding scalp meets the side hair. This approach has been very helpful to the person who is ‘on the fence’ in deciding whether to do SMT or not.  Remember, we are doctors first and we want anybody considering this decision to be comfortable with the decision.

Does it look real? – Yes.  Although, there is nothing in this world that is “perfect”, with the artistry and technique we use at NHI,  you cannot tell that that someone has had SMT even up close.  SMT gives you the look of a permanent 5 o’clock shadow.  SMT blends in with the genetically resistant to balding hair around the sides of your head.  While photos on our site are great examples, you really need to see SMT in real life to be convinced. It is truly amazing and most of our clients do not mind sharing their experience or letting you examine their results in person.  We usually have a client who has had SMT done at our scheduled monthly Open House events.

Don’t tattoos turn green or blue and just look like a big blob over time? -- Traditional tattoos may discolor but this is highly dependent on the type of ink used, the depth the pigment was placed into the scalp and the amount of sun exposure you get. The key to minimize this effect is to use a specialty ink like we do and either wear a hat when in the sun or use a good sun blocker (with a high SPF factor). Regular tattoos, which are placed at a deeper skin level than SMT,  may spread out over time, losing definition and creating that ‘blob’ look.

Can you make a soft natural hair line? -- NHI physicians are experts at creating natural looking hair lines.  Most clients want a soft and natural fading front hair line, while others prefer a more distinct and linear look.  We advise and work with our clients individually to obtain the look they want.

I saw this on other websites called something else, what makes you different? -- The difference between NHI and other businesses offering similar services is that we are a team of ABMS Board Certified physicians with over 25 years combined experience in the hair restoration business. We are a medical group offering SMT in a AAAHC accredited facility. We offer anesthesia to ensure a pain free procedure. We are experts in the creation of natural looking hairlines and can combine SMT with Follicular Unit Transplant surgery for a comprehensive hair restoration solution.

What will I look like immediately after SMT is done? -- Immediately after the procedure, your scalp will look slightly pink, somewhat similar to a sunburn.  This pink color will fade out over the course of 24 to 48 hours. This is more pronounced in patients with light skin color. You will appear to have a full head of hair that has a closely shaved look. The pigment may also appear more pronounced until you wash your scalp and remove the excess pigment three days later. Depending on each patient and the type of skin, the pigment may fade as it settles in.  This is the reason why you may need more touch ups so that the shade and color is just right. Although we recommend at least 3 to 4 days between SMT applications, you can wait weeks or months depending on your schedule and geographic location.

I am a woman with thinning hair, can SMT help me appear to have thicker hair? – Yes, we have performed SMT on women, but we are cautious when it comes to women because we want to know the cause of the hair loss or hair thinning. With men, 99% have hair loss or hair thinning from genetic causes in a typical balding pattern (MPB), but women may have balding due to many medical conditions and we would want to diagnose them prior to offering SMT. As ethical physicians,  we want to be sure that we do not perform this process on women who have potentially reversible baldness from hormonal causes or thyroid or autoimmune diseases.

Can I get in contact with some of your clients? – Yes, you can use our to post a message for one of our clients.  You can also email us at or call us at (800) NEW-HAIR, and we can put you in touch with one of our clients.  We have monthly OPEN HOUSE events at our office where you can see SMT client results first hand.  These OPEN HOUSE events  also give you the chance to see results of hair transplant surgery patients, and you can observe an actual surgery and occasionally an SMT procedure as it is being performed. You can find our OPEN HOUSE schedule  here.