For Hair, Thin Isn’t In



TO DEAL WITH THINNING HAIR, the latest buzz touts hair tattoos – which are not really tattoos but ink marks inserted under the scalp skin that mimic the look of tiny hairs. These go by many names: “cosmetic transdermal hair replication,” “cosmetic hair follicle replication,” “micro hair technique,” and “scalp pigmentation.” Bryce Cleveland, founder of Scalp Aesthetics in Bethesda, calls it “scalp micropigmentation” (SMP) and insists on its difference from tattoos: “getting tattooed hair to serve the same purpose is another story altogether.”

The hair thinning that occurs with every decade of life after the 20s is usually in fact the diminishing diameter of the hair shaft, called” involutional alopecia” — so the number of hairs doesn’t diminish but each strand is thinner. Thinner strands can break more easily, and, because hair grows more slowly with age, the overall effect is less hair.

Every day, everybody loses some hairs – which are actually a string of dead keratin cells, pushed through the surface of the skin as follicles produce new hair cells – around 100 hairs a day. For some women in their 40s and older, a genetic condition called female pattern baldness or “androgenic alopecia” causes thinning all over the scalp, especially at the crown.

Causes of temporary hair loss include stress and illness, very low-protein or calorie-restricted diets, and cosmetic procedures such as shampooing too often, dyeing hair, using rollers and heated curlers, and combing, especially through tight curls.
“The development of new treatments, including drugs and cell-based approaches, for hair loss is at an all–time high,” NYU Clinical Assistant Professor Kenneth Washenik told WebMD. Hair tattoos or any of the alternate epithets, however, were not on his list.

Cell-based hair follicle regeneration, also called “fully functional hair organ regeneration,” involves taking cells and stem cells from around hair follicles, manipulating them in the lab and then re-injecting them into the scalp. While Washenik calls this method “promising,” its actual use appears to be a long way off.

Then there are drugs. Because thinning hair can be due, in both sexes, to higher levels of male hormones, drugs that block their production can help: besides the prescription drug Propecia (finasteride), there are over-the-counter (OTC) preparations such as Hairomega – for which at least one LittleBird colleague has high hopes.

Latisse, an FDA-approved, a prescription liquid for eyelash growth, may help regrow scalp hair, but it seems to work best in combination with medication used to treat allergies, and can cause redness and itching. Rogaine (minoxidil) is an OTC lotion applied to the scalp, but has a long list of side effects. Because minoxidil was designed to treat high blood pressure, it can cause lightheadedness; because lotion can spread, especially when you sweat, it can drip on the ears and nose, and other places where you don’t want hair; and oddly, it can even cause hair loss.

Low-level light combs and helmets may help, and laser combs seem most effective in combination with other methods such as Rogaine. Various hair products, including “volumizing” shampoos, “flexible” hair sprays and mousse can also fake fuller hair.

Finally there are hair tattoos. Compared to normal tattooing, the SMP needle is thinner and doesn’t go as deeply into the skin, and the ink is different. “The success of this procedure is dictated by the color, shape, density and placement of the pigments,” writes Cleveland. Scalp Aesthetics Treatment (which Cleveland calls “the SAT”) should last four to six years, but if the “vibrancy” of the pigments fade, they can be touched up. Cleveland says the SAT can sometimes stimulate new hair growth.

Treatment at Scalp Aesthetics can run $3,000 to $4,000, with more precise quotes available by uploading your photo to the website. The time involved: 3 to 5 hours for the first session, and 2 to 3 for the second. There’s a one-year guarantee for touch-ups.

For any hair tattoo, the general advice is to do a small patch test first, and then to proceed carefully. Start with a conservative hairline, especially because natural hairlines recede with age, and because removing mistakes can be difficult and very painful, advises Elizabeth Leamy of ABC news. “You can always add more.”

Because the SMT procedure is relatively new, long-term effects are not entirely predictable. Fading can be a problem, especially if the pigment fades unevenly. And although some clinics can add or change the dye to match changes in your hair color as it grays or when you decide to dye it, long stretches of fading color or even the weeks between dye jobs as the hair grows out can be especially challenging.

— Mary Carpenter

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