Tricopigmentation: Using tattoos to hide baldness and post-transplant scars.


Tricopigmentation is a little-known, but effective and convenient solution. Discredited by several unfounded rumours, used by just a few dermopigmentation specialists, it is, unfortunately, often represented by works that are poorly executed. We are talking about Scalp Micropigmentation, named by Ennio Orsini, Tricopigmentazione® (Hair Pigmentation).

Main application fields of Hair pigmentation®

The use of tattoos to hide baldness is extensive and sometimes providential.
Listed below are the main cases where Hair pigmentation can give significant aesthetic improvements:

One of the basic techniques of this discipline is called “Bounce ® ”, which is just an implementation of the old techniques already existing for this purpose. The same manual technique and working parameters were revised and improved to create a real operating procedure, which is called “Bounce ®”. This development has led to a working system capable of producing an shaved and realistic effects, with less chance of colour changes and colour migration. These problems, in fact, are quite common with old treatments which do not take into account some important factors that could affect the final result. Figures 7, 8 and 9 show some problems caused by scalp tattoos in the past years. These imperfections can now be avoided with Hair pigmentation.

A realistic and natural scalp micropigmentation, namely Hair pigmentation, should show some punctiform micro deposits of brown/greyish pigment, located in the superficial dermis at a suitable distance from each other. This will create a shaved or darkening effect of the areas affected by hair loss, depending on the techniques employed.

Duration of Hair pigmentation® treatments

First case: Hair pigmentation treatment performed with bioabsorbable pigments

When micropigmentation is performed with bioabsorbable pigments, (improperly called “semi-permanent”), it is called “Bioresorbable Hair pigmentation”, and in this case it may last from 4-6 months, up to 14/16 months. It could last even longer, and no one can say in advance when it will disappear completely. Even if usually a treatment performed with these pigments disappears completely over time, it is important to point out that sometimes, or if the treatment is not properly performed, the treated area may retain a mark. The factors that may accelerate the disappearance of the pigment in the dermis are many, but the most important are:

• The individual phagocytosis
• The age of the individual (closely related to the previous factor)
• The individual healing ability after the treatment
• The individual anatomy of the scalp
• The type of pigment pushed into the dermis
• The manual technique used to perform the treatment
• Prolonged sun exposure or use of tanning lamps
• The use of corticosteroids and anticoagulants

According to the above, therefore, we can say that the duration of a Hair pigmentation treatment is highly subjective. Usually, at least two sessions are needed to get good results, although in rare cases a single session may be enough. The duration of the first session can vary depending on the work to be done: on average, from 2 to 8 hours. Any second session, which is performed to stabilise the treatment, should be scheduled no sooner than 40/60 days after the first. Any other sessions should be scheduled approximately 50 days after the last treatment. Once the entire treated area is homogeneous, the treatment will last for about 8/10 months (statistical data).
Actually the Hair pigmentation treatment will take at least twice as long to disappear completely. Although the use of bioabsorbable pigments is not a permanent solution, and it’s quite hard to be preserved, this is definitely the most prudent and rational approach. The opportunity to re-evaluate your own choices each year makes bioabsorbable Hair pigmentation the ideal choice for all those who do not want to take irreversible decisions. Moreover, if there is a predisposition to grey hair, a temporary solution is certainly the best choice. The first approach to Hair pigmentation should always take account of this type of option, because it gives the opportunity to evaluate the actual aesthetic result and the visual impact offered by Hair pigmentation.

Second case: Hair pigmentation treatment performed with permanent pigments (very risky, to be performed only in rare cases)

In some special and very rare cases, Hair pigmentation can be performed with permanent pigments. This choice must be pondered very carefully together with a dermopigmentation specialist. Being a permanent treatment, it attracts many customers who think they can solve all their hair problems once and for all, but this is not true. Over time, nothing remains exactly the same, including iron oxides used to create pigments. In other words, there is no guarantee that a treatment performed with permanent pigments remains unchanged throughout life. It may happen that certain colours, such as brown, may turn into other colours. Although this problem can be relatively kept under control with an appropriate balance of the chromatic components of brown colours, it still remains a significant bottleneck for dermopigmentation in general, as well as a very risky choice. Among the factors that contribute to or, somehow, interfere with colour change of brown colours used in Hair pigmentation, we find:

• Excessive exposure to ultraviolet rays of the treated area: sun or tanning lamps
• Extreme temperature swings
• Alkalinity of extracellular fluids in the dermis
• Purity of raw materials used in the colouring preparation used for Hair pigmentation treatments (iron oxides)
• Autoimmune diseases of the individual undergoing the treatment
If the customer experiences colour changes over time, seriously impairing the naturalness and credibility of the treatment, it is possible to intervene in the following ways:
• Removing Hair pigmentation with laser therapy
• Performing a new treatment on the area previously treated with Hair pigmentation, with a new mixture of pigments. Indeed, by injecting some kind of “antidote”, it is possible to restore the original colour.
(This method is certainly the most difficult and complex, and there is no guarantee that the treatment will be successful)

Moreover, grey hair is still a problem to be taken into account, when making this choice, and that could be solved in the following ways:

1. Dyeing white hair on a regular basis
2. Shaving white hair and treat the area with Hair pigmentation, blending the surrounding areas or the entire area
3. Removing Hair pigmentation with laser therapy

As for treatment sessions, the procedure is the same: a first session of about 2-8 hours (depending on the type of treatment to be performed: covering a scar, alopecia areata or just an area affected by hair loss), and a second session, if necessary, to stabilise the treatment, after 40/60 days. Once the treated area is homogeneously covered, pigments will remain in the dermis forever, but today there is no guarantee that the treatment will remain unchanged over time.
Nevertheless, we should mention the fact that a good number of people have already been treated with permanent pigments without problems, but the absence of a real “follow-up”, does not make this treatment reliable enough.

Other possible sessions of Hair pigmentation to stabilise the treatment (valid in both cases)

A second session, performed about 2 months after the first session, sometimes is not enough to achieve the homogeneity of the treated area. The chances of success depend on many factors, not least the individual predisposition, for example, the different conformation of the dermis in a healthy and in a sclerotic tissue (like that of scars due to transplantation).
Of course, healthy skins will recover better, thus resulting in an increased likelihood of retention of the colour injected. Scar tissues, on the other hand, are more difficult to treat! In conclusion, some specific cases may require more than two sessions of treatments, to be performed at a distance of 45 days.

Possibility to perform an allergy test before the treatment

Although the quality of products used today for Hair pigmentation is very high, and despite the fact that today allergic reactions reported following Hair pigmentation treatments are rare, according to ministerial guidelines, the possibility of an allergic reaction must still be communicated to those undergoing this type of treatment.
While most professionals recommend to perform an allergy test before the treatment, we must remember that only allergists can say with certainty whether an individual is allergic to a particular product or not. Only after performing some specific tests at a specialised centre, it is possible to really minimize the risks, that are already infinitesimal. However, Hair pigmentation treatments must be performed by a qualified professional that will inform his customer of all the risks associated with the treatment.
In other words, being or becoming allergic to pigments is always possible but very unlikely. But this test should be run by the professional to assess possible colour changes. Specific allergy tests, on the other hand, should be run by a specialised centre. As for colour changes, experienced operators usually skip this procedure.
But customers who want to undergo this procedure should know that:

• This test must be run at least 40 days before the treatment session
• This test is not free
• This test must be booked in advance

Post-treatment situation

Frequently Asked Questions on post-treatment are always about recovery: “Can I go back to work the day after the treatment?” or “How long will the redness last?”, or “Can I drive after the treatment?”. In fact, this treatment is much less invasive and painful than you may think. 90% of Hair pigmentation treatments are performed in a single day, only cases of alopecia universalis need a two-day session. Immediately after treatment, the area shows a redness due to inflammation of the treated tissue. Such redness will take at most 48 hours to regress, but in most cases it disappears after 24 hours.

Obviously, in order to accelerate this healing process, customers are asked to apply specific soothing ointments, recommended by the operator. Once the redness is gone, the treated area will be more clear, less opaque than expected and each single “dot” will be slightly darker than it will be in the future, as well as with more defined edges. This first situation is temporary.
It corresponds to the first period of the healing of the skin after the treatment. Before the skin heals completely, it will become more clear at the beginning (sometimes very visible) and, finally, slightly darker. Once the healing is over and the tissue is repaired, the second period, with the adjustment of the pigment in the dermis, will begin.

Differences between the adjustment period and the healing period.

Although the treated area may seem completely healed after about a week, actually tissue repair is still ongoing. This process may last up to a month and will end with re-epithelialization and subsequent greying of the colour used.
Once this healing process is over, punctiform micro-pigment deposits will settle expanding their edges (each single bounce will fade, thus losing definition), and therefore their diameter, with a consequent increase in the total coverage of the treated area. This second phase, called adjustment, can last up to two months.
That is why a second session should be performed after about 40/60 days. If the second session is scheduled earlier, the risk is that we will darken an area that will probably darken anyway, creating an unnatural dark spot. Basically, the result of a Hair pigmentation treatment session, should be assessed only after about 2 months.

You should not consider the initial changes you could notice throughout the adjustment period. Do not be in a rush to see the final result, because this could be very dangerous!

Interactions with implants or cosmetic products

As for prosthesis wearers, my advice is to take at least two days off work. By doing so, you can evaluate the result of the treatment without the initial redness and decide to shave the rest of the hair (nape), or to do that later, after about 2 months. In this last case, it is recommended to use the prosthesis as little as possible during the period of adjustment, and to reduce the use of adhesives in the treated areas.
Tattoos need oxygen to heal properly. Also, you should thoroughly clean the prosthesis, especially in the first 7/10 days. However, you can reuse their prosthesis already after the third day, possibly avoiding to cover the skin for too long and removing the prosthesis whenever possible.
Anyway, shaving the nape after the second session is a good idea, when you have a greater chance of having achieved the best result. If you use cosmetic substances to colour the skin, you should wait 3-4 days, before using these products again. Reduce the use of these products in the first ten days.


In all cases:

Once the healing period is over, use colouring products (Toppik, Dermatch, etc..) only if the result of the first session of Hair pigmentation is not homogeneous. Obviously, these products should be used only until you reach the ideal result with the following sessions. When you reach the desired result, there will be no reason to use these products. To conclude this section, we should point out that:

• Performing this treatment on healthy skin and full of hair, has no negative effect on the normal growth of the hair itself; in other words, tattoos (if done correctly), do not damage the existing hair;
• Treating a bald area does not interfere in any way with and does not prejudice the possibility to perform hair auto-transplant
• The treatment does not interfere with local pharmacological treatments, such as MINOXIDIL.

Nevertheless, we recommend to suspend the topical applications in the days just after treatment.
Preparing the area to be treated
To cover small areas affected by hair loss, we recommend to buzz the entire area to be treated (razor), or leaving a maximum length of 2 mm (hair cutting electric machine). This will help the operator to perform the treatment and will make the end result much more realistic. Moreover. If you use cosmetics to cover the skin, you should wear your makeup, so that your specialist will have precise information on your hairline and the shade you are used to “wear”.
To cover scars, we recommend to undergo the treatment only after the scar has healed completely, but not after vascularisation. The scar must be relatively flat and must have reached a pearly colour. You should ask to your surgeon, to determine when is the best time to undergo the treatment. Also in this case, your hair should be shaved, even though after the first session, unfortunately, the scar will still be visible.
From the second treatment session, the scar should be much less visible. Sometimes, a third session may be required (the number of sessions, in this case, depends on the quality of the scar tissue). Only prosthesis wearers may avoid shaving the area to be treated. But even this choice is optional.
In all other cases, you should come with the hair length you intend to keep after the treatment, or your usual length.
We recommend wearing, after any type of treatment, a clean hat, like a cotton baseball cap or o a bandana. We recommend not to use, for at least one week prior to treatment, blood thinners or anticoagulants.
In this regard, ask to your doctor. Avoid sun exposure in the days prior to the treatment (at least one week), in order to avoid erythema which would make it impossible to perform the treatment, and prevent pigments from stabilising in the dermis.

For any other information, please visit our website

If you want to schedule an appointment but you do not know where to start, please read the FAQ page on our website:

If you want to learn more about the costs of our treatments, please visit this page:

Patent and trademarks by Orsini&Belfatto s.r.l. – The use of the information contained in this document are protected pursuant to Italian law and in particular by Law No. 633 of 22 April 1941, and subsequent amendments, on the protection of copyright and related rights and, unless otherwise specified, they belong exclusively to Orsini & Belfatto srl. Therefore, their reproduction, distribution and use in any manner, even partial, that have not been authorized by the entitled person shall be prosecuted under the above Act. All reproductions, even partial, of the pages and the contents of this site are strictly prohibited, without the prior written consent of Orsini&Belfatto s.r.l.. Requests for such consent may be sent to the following email address: