Hair Treatment



While doctors have focused on the most up-to-date and effective medical and surgical treatments for hair loss in patients, most patients feel that non-medical camouflage agents can provide an immediate and relatively inexpensive and easy cosmetic solution for hair loss. These agents are particularly useful for patients who may not yet be candidates for surgery or who have started drug therapy but want more immediate cosmetic improvement while waiting to evaluate their response, especially for patients who have just undergone early thinning.

Camouflage agents work by eliminating the color contrast that occurs when light passes through the hair and is reflected off a lighter scalp. Although camouflage agents try to improve the cosmetic appearance of existing hair, when hair is absent or areas of hair loss, especially large hair prostheses such as wigs or hairpieces can offer a much better cosmetic alternative.

As mentioned, hair prostheses can provide hair to small or large areas of hair loss, including eyebrows and eyelashes. The following information contains descriptions of the camouflage agents followed by a list of commercial products available. After that, a brief introduction to scalp prostheses is made. An increasingly popular non-medical and non-surgical alternative is the Scalp Micropigmentation (SMP), a very specific tattoo procedure.

Topically Applied Pigmented Agents

Topical camouflage agents are products that are applied to the hair and/or scalp, giving the natural hair a fuller appearance without actually adding hair. These are mainly for treating thinning areas in patterned baldness. However, in some patients, it can be used for scarring or traumatic injuries. Even though the hair follicles are quite miniature, they work best with some existing hair in the treated area. It can help to camouflage a completely bald or injured area as long as the area is small (less than 3 cm) and covered with normal density hair surrounding it.


There are various fibers made with wool or brass keratin, rayon or human hair that are used to mask alopecia or thinning areas and to coat the hair and scalp. Most fibers come in multiple colors to match the patient’s hair color and blend into the scalp. Both hair and fibers have natural static charges that help the fibers retain their adhesion.

Spreading or dusting the fibers with diffuse distribution over the thinning zone in skillful application is critical for an effective natural result. Over application can create “clumping” in the scalp, which can be a cosmetic problem. The fibers should be applied near the hairline, but never over it.

The advantage of the fibers is that they can be quickly and easily removed by shampooing. Unlike spraying and powdering they hold the shine of the hair pretty well. The new products claim to be resistant to rain, wind and perspiration.

To apply, the fibers can be easily shaken into the affected areas of the scalp.

However, the most effective results come from using a spray pump attachment. With this technique, you gather the hair groups and blow them into the hair that has been removed, allowing the fibers to coat the hair and then float over the scalp.


These are a colorant obtained from a dry paste to be applied with either a dry or wet sponge. When applied wet, it becomes one of the most resistant application to water and sweat. It is slightly slower to apply than fiber but has become very popular in these days.


When they are applied with a dry or slightly moisturized sponge, this product is a bit slow to apply, but has been on the market for over 20 years. The products come in a tube. After the application, let the product dry and then scrub. Some people add fiber after hair is brushed.


Generally gas based sprays are quick and easy to use, relatively water resistant. There have been a few complaints that they come and get dirty on furniture and pillows, but with use the patient can usually control this problem. It may give you a little less shine. These can dry quickly (less than a minute).


This set of non-medical camouflage for hair loss and thinning includes wigs, hairpieces and hair extensions.

Wig hair fibers can be synthetic or made from human hair. The latter is more expensive depending on the origin of the hair. Wig bases can range from a synthetic base to mesh dome basics and both can be attached to a lace cap. The hair strands can be attached to the machine or individually manually for more natural hair movement and styling. Human hair and handmade wigs are generally more expensive. Custom-made wigs are the most expensive, to create a silicon or polyurethane vacuum base which allows the wearer to securely adhere to the scalp, allowing the user to swim and engage in other physical activities without worrying about falling off.

In which situations is scalp micropigmentation recommended?

1- Androgenetic Alopecia Cases

Scalp Micropigmentation is recommended in cases where the Norwood scale is low or when the thinness of the follicles is observed to achieve the effect of density around the pain areas.

In addition, it is also recommended at high Norwood values in cases where there are very weak or insufficient donor areas, usually together with hair transplantation.

2- Unresectable Alopecia Cases

Scalp Micropigmentation is recommended in cases where the patient suffers from systemic microangiopathy or has been exposed to cytotoxic drugs and does not recommend hair transplantation (i.e. diabetes type 1, scar tissue, atherosclerosis, heavy smokers, etc.).

Also, in cases where the patient suffers from vitiligo, alopecia areata or other connective tissue diseases (lupus erythematosus, rheumatoid arthritis, scleroderma, etc.), sarcoidosis, or skin diseases such as alopecia universalis (alopecyto totallis).

Finally, it is recommended in cases where the patient is suffering from serious adrenal problems such as liver or kidney dysfunction or other serious immune problems.

3- DHI Scalp Micropigmentation for Aesthetic Transplantation

Scalp Micropigmentation is recommended in cases of scarring alopecia such as traumatic scars (wounds or burns), postoperative scars (FUT or other surgeries) as well as genetic problems in hair growth.

Scalp Micropigmentation is also recommended in cases where the patient wants to instantly increase the effect of density in areas suffering from hair loss, without using temporary products such as dust or microfiber without being exposed to hair transplantation.

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