In the process of hair thinning, decreased volume of hair no longer provides sufficient canopy to camouflage the naked scalp. As the light passes through the hair and reflects upon the scalp, an individual experiences bothersome “see-through” effect. The bigger the color contrast between the scalp tone and hair color, the more exposed the scalp appears and the more obvious thinning becomes. Camouflaging agents are topical products applied to the hair or scalp to increase the visual density of the hair. When applied to the hair, these products are usually hair-building fibers (such as keratin protein or rayon fibers) that cling to the hair, creating a web-like coverage. Although these fibers can be affixed to the hair more tenaciously with additional hair sprays or specifically designed sealers, a disadvantage of fibers is that they can come off onto pillows or clothes or by running a hand through the hair, causing social embarrassment and loss of effect. As people who have dandruff avoid wearing dark clothes, people using hair-thickening fibers should avoid wearing light-colored clothing. In addition, these products can be slightly messy during application. Because camouflaging agents intertwine with an individual's own hair, these fibers should resist light rain but can be displaced with a heavy downpour or worse during swimming. Another category of camouflaging product is applied directly to the scalp as a cream or lotion with the benefit that they are more resistant to washing out. The downside to the use of this kind of product is that they are more difficult to apply in a long hairstyle and that they become too obvious if the hair is very sparse.

Camouflaging products are used principally for two reasons: independently to cover existing baldness and/or in combination with a hair transplant. The first reason is obvious: the individuals are bothered by hair loss but they are not interested in any surgical procedure. Alternatively, when combined with hair transplantation, camouflaging products can be offered as a temporary solution before or after surgery. If an individual has to wait to undergo hair-transplant surgery, these products can ease one's discomfort in dealing with his or her thin hair before surgery. In addition, they can be used in the postoperative setting when the patient experiences disturbing and unacceptable postoperative thinning (telogen effluvium) or during the transition period in anticipation for transplanted hair to grow.

It is important to mention that camouflaging products can accumulate and clog the scalp; hence, proper scalp hygiene should be addressed with every patient. For that reason, it is not recommended to use camouflaging products right after the surgery while scabs are still present. Furthermore, if a person is using minoxidil and camouflaging products simultaneously, it is important to stress the application of minoxidil on a clean scalp first. Therefore, the individual is instructed to apply minoxidil first and then the other products in the morning and for the evening application of minoxidil to wash or wipe off any residual camouflaging product before minoxidil application.

The above-noted products provide a temporary solution and are washed out with every hair wash. Scalp micropigmentation (SMP) is a semipermanent camouflaging treatment that consists of tattooing the scalp to decrease the hair-to-scalp contrast. Small round or oval dots are tattooed into the scalp to mimic shaved hair and to provide the illusion of hair density. Scalp micropigmentation can be used on a bald person to “create” a hairline or to cover the scalp and to make it look like closely shaven hair. Alternatively, it can be used between hairs to add visual hair density or to camouflage scars, specifically those donor scars that arise from prior hair transplant procedures. The biggest advantage of SMP is its immediate result but the following disadvantages may be observed: the pigment may change color and turn, e.g., from black to blue, spread under the skin, fade, or conversely maintain the original color to cause problems when the hair turns gray with aging. In addition, pigmented dots on a bald scalp are two- dimensional and do not look as natural and effective as when they are placed between hairs. However, when well done, SMP can be a valuable complementary treatment to hair transplantation.

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Kempton Park Johannesburg

3rd Floor, Medical Suite Building,
Arwyp Hospital, 22 Pine Avenue,
Kempton Park, Johannesburg.

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Room 1, 130 Woburn Avenue,
Fairhavens Sessional Rooms,
Glynwood Hospital, Benoni


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Benoni

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266 Polaris Ave,
Waterkloof Ridge Pretoria

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Ground Floor
Greenhill Complex,
Behind La Coline Commercial Centre,
Candos (close to hospital) Quatre Bornes

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