As Scalp Micro Pigmentation (SMP) is becoming more widely discussed, prospective clients increasingly ask about the level of pain or discomfort they are likely to experience. Basically, they want to know if their SMP treatment will hurt.

Although SMP is a very different process to a tattoo technique, many people align their expectations with what pain they experienced when they had a tattoo on their arm, torso and so on. The truth however is that although SMP also utilises a needle that pierces the skin and deposits a pigment, that is where the similarity ends, and the actual sensation is entirely different from a tattoo for most people. I have never had a tattoo so I put the question to Paul Clarke, a HIS practitioner based at our Birmingham clinic. Paul has many tattoos on his arms, neck and torso, and has a keen interest in tattooing in general. Paul has never had SMP as he has a full head of hair, however curious about the pain level, Paul had a mock patch test recently using water instead of pigment. He confirmed that the discomfort he experienced felt very different from when he had his tattoos, and was less intense.

So what factors influence the level of discomfort?

Everyone has a different pain threshold, and discomfort levels can vary. For this reason it is difficult to provide blanket answers, however there are certain variables that can make a Scalp Micropigmentation treatment more or less comfortable, as follows:

The required 'follicle' size

Fundamental to effective SMP techniques is the ability to seamlessly blend pigmented areas with real hair. In order to achieve this, the replicated follicle size needs to match the size of your real hair follicles as closely as possible. To do this, HIS practitioners vary the dot size by increasing or decreasing the hand pressure applied accordingly. Larger dots require slightly more pressure, and are therefore likely to be a little more uncomfortable to apply.

The area of the scalp being treated

Some parts of the scalp are more sensitive than others. Generally clients experience more discomfort around the frontal hairline, temples and the crown, and less discomfort in the middle and the back of the head.

The condition of the skin

If the skin on your scalp is suffering from some sort of skin complaint such as dermatitis, the pain level could increase as the needle is penetrating an already inflamed area. Clients with excessively dry skin can also experience more discomfort, as it is more difficult for the practitioner to position the pigment deposits as required. For this reason we always recommend that clients moisturise their scalp regularly in the days running up to each session. If you have scar tissue that requires treatment, perhaps as the result of a hair transplant procedure or an accident, the discomfort level is sometimes difficult to predict. Many clients report a complete lack of any discomfort, whereas others experience heightened discomfort. It depends on what nerve endings are present in the scar, and this varies enormously from person to person. As a general rule, indented scars usually hurt a little more during treatment than the surrounding skin, whilst raised scars usually hurt significantly less.

The thickness and tightness of your skin

The machines we use are specifically designed for SMP procedures, and are custom built for HIS Hair Clinic to our specification. Each machine includes a variable setting to change how aggressively the needle penetrates the skin. An average setting is suitable for almost all of our clients, however those with particularly thick skin may need a higher setting. This causes the needle to penetrate more forcefully, and could affect the level of discomfort you experience. It is difficult to predict because those with thicker skin are also less sensitive to the penetration of the needle, so in most cases these two factors effectively cancel each other out. Those with loose scalp skin (I have loose skin around the back of my head) may experience a little more discomfort, as the practitioner needs to pull your skin tighter during the procedure to prevent the needle from 'bouncing' off your skin surface.

The level of bleeding

Everyone experiences a small amount of bleeding during an SMP procedure. Generally you have no need to worry about this as your practitioner will wipe your head every few seconds, and we're talking very small amounts here. Some clients bleed more than others, which can cause the pigment deposits to be partially flushed out of the skin. In these cases, more dots and additional hand pressure may be necessary which can increase the discomfort level. The difference is small however, and cases like these are not common.

Which session you are undertaking

Most clients experience more discomfort during their first session, in comparison to subsequent sessions. This is usually due to nerves more than anything else, however it also follows that by the second session the client has had the opportunity to develop a heightened pain threshold. A small number of clients experience more discomfort during their second session rather than their first, however this is a less common occurrence.

Your state of mind

Believe it or not, how relaxed and comfortable you are on the day has a significant bearing on the discomfort you are likely to experience. Happy, laid back clients generally have an easier time during each session, whereas those who panic and experience a high level of stress are more likely to feel additional discomfort. The best advice we can offer is to take it easy. Remember that you are ultimately in control of your treatment sessions and the outcome, and with the worlds most experienced SMP practitioners, you're in safe hands.

How bad is it, really?

Honestly for the vast majority of clients, its a little uncomfortable, nothing more. Reports vary, but generally the feedback is the same. It hurts, but not all that much and besides, its worth it for the long term gain. As I write this post I'm in the middle of my treatment sessions (12th, 20th and 27th June 2013 - see diary thread). I have a decent pain threshold, but I have a real issue with needles. I can honestly say that my treatment has been uncomfortable, but really not that big a deal. On a scale of 1 to 10, my pain level was about a 5 during my first session, and a 4 during my second session. Finally I always remember Scott, the 15 year old boy who had SMP to camouflage his alopecia at our Manchester clinic. At just 15 years old, he breezed through a 6 hour session, double the duration of the average SMP session. With full head alopecia, ALL his sensitive scalp areas had to be treated including his sideburns, crown and the back of his neck. He described the pain level as "fine". You can see Scotts video here.

What can be done to reduce the pain level?

We are a Scalp MicroPigmentation business, not a pharmacy, so we are not able to provide advice regarding painkillers. That said, many clients have reported that taking generally available painkiller tablets shortly before a session can reduce the level of discomfort. Personally, I took two Co-Codamol tablets (500mg paracetamol and 8mg codeine per tablet) before my first two sessions, and another two tablets about midway through, and I think they helped although I can't say for sure. Before taking any sort of medication, always read the label and seek medical advice beforehand if appropriate. Please note that whilst you are welcome to provide your own anaesthetic cream, we would advise that under normal circumstances these creams are best avoided as they could interfere with the pigment deposits.

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By Damien

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