There is far more involved with SMP treatment than the average layman will know. Here is an article dealing with scalp conditions and their implications for successful SMP treatment.
SMP is the art of placing specific pigment into the upper levels of the dermis. The body has many ways of responding to this process and there are many factors that will have an effect on the result of a SMP treatment. It is recommended that you seek a medical diagnosis from your GP, Trichologist or Dermatologist, of your hair loss or any scalp conditions prior to undertaking SMP.
It is helpful to be aware of the process of SMP, in order to understand the treatment.
The scalp consists of 5 layers:
S – Skin
C – Connective tissue (dense)
A –Aponeurosis (epicranial)
L- Loose Areloar Connective tissue
For the purpose of SMP, we are only concerned with the 1st layer, that being the skin.
The skin is comprised of the epidermis, dermis and subcutaneous layer. The SMP technician will implant the pigment into the upper layers of the dermis, just under the basement membrane also known as the Dermal-epidermal junction.
The epidermis is the most superficial layer of skin that sheds dead cells. It is composed of keratinised stratified squamous epithelium. The keratinocyte cells migrate through the 4 layers of the epidermis and become flat, losing their nucleus and organelles. As there is no blood supply in the epidermis, these cells are considered dead and once they reach the stratum corneum they shed off. It takes approximately 3-4 weeks for this process to occur. As pigment is implanted into the dermis, some will remain in the layers of the epidermis. As these cells shed, the pigment will slightly fade off, this is normal and considered by the practitioner when choosing a pigment shade.
Your immune system can also create fading of your SMP. As the pigment is injected into the upper levels of the dermis, the immune response begins. The pigment is considered a foreign body within the dermis triggering the response of the immune system. A combination of immune cells collects tiny particles of pigment and takes them away through the lymphatic system, sometimes collecting in localised lymph nodes. If you experience swollen lymph nodes in your throat/neck after SMP, this is the particles of pigment being dispensed with and is not a cause for concern. The lymph nodes will shrink back to normal over the coming days as the immune cells remove the pigment molecules.
Your SMP will heal into the skin over the coming days, with the redness dissipating and should be fully healed 1 month after treatment.
For the best results, always follow the recommended aftercare from your SMP artist.
The condition of the scalp will affect your results from SMP. Scalp conditions such as eczema, psoriasis and dandruff will cause failure of pigment deposit, excessive fading and possible migration of the pigment under the basement membrane due to the inflammation of the area and the fast rate of shedding of the keratinised epidermal cells.
The most common scalp condition is dandruff (pityriasis capitis) and in extreme cases, seborrheic dermatitis. Dandruff is an excess of skin shedding and is easily treated with zinc supplements and shampoos. Seborrheic dermatitis is a more severe form of dandruff which produces large red, itchy and flaky patches on the scalp. There is a lot more inflammation and quite often involves the sebaceous glands producing more oil which in turn activates the yeast on the scalp, creating the itch.
Psoriasis and eczema (atopic dermatitis) are considered auto immune conditions, though are induced from different immune responses. Psoriasis is caused when T Lymphocytes drive an alteration in healthy keratinocytes, accelerating the life cycle. This creates a build up of extra cells on the skins surface, forming inflamed patches of red, itchy skin covered with silvery scales.
Eczema is a response to an allergen in people with a genetic predisposition. The T Lymphocytes produce factors will change the keratinocytes and cells within the dermis.
All scalp conditions need to be diagnosed and successfully treated prior to any SMP treatment. Clients need to be aware that any flare ups of these conditions may cause fading and uneven results of their SMP.
SMP can be a solution for many types of hair loss. Always seek a medical diagnosis prior to starting any treatment for hair loss. Male Pattern Baldness and Female Pattern Baldness are the two main types of hair loss, however great results can be achieved for Alopecia Areata, Alopecia Universalis and Alopecia Totalis. Extra care needs to be taken with Alopecia Areata as this condition will continue to spread if still active. Also, as the hair grows back, the client may be left with darker areas where the SMP has been implanted.
Scarring alopecia’s such as Frontal Fibrosing and Lichen Planopilarius can also be treated with SMP however they need to have been treated and not be active. Other types of hair loss such as Telogen Effluvium are temporary and can be reversed with correct treatment, though SMP can add density while the hair is growing back.
If undertaken by a skilled, qualified technician, SMP is a safe and valuable contributor to the confidence and well being of many men and women. If you have concerns regarding anything you have read in this article, please contact Lew to discuss your queries.
Our thanks to Kate Dawes who is the senior trichologist, Director of Medical Hair Restoration Australia and Director and leading practioner at Folisim who have multiple SMP clinics across Australia for this expert and insightful article explaining scalp conditions and their implications for successful SMP treatment.