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SMP Scalp Micropigmentation for Women

Shanan Zickefoose, BSN, RN, CMM, CPCP 

Published Author, Principles of Infection Control for the Tattoo Industry

(918) 724-5614
4870 South Lewis Ave, Ste. 130
Tulsa, OK 74105                                                                                                                                  

Registered Nurse

Member of Society of Permanent Cosmetic Professionals (SPCP)

2011-2013 Board of Directors of SPCP

Certified Permanent Cosmetic Professional (CPCP)

Oklahoma State approved Instructor for Cosmetic Tattooing 

2017-Present: SPCP Train the Trainer Education 




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What happens to the pigment when it is implanted in the skin? 

When researching for an article I was writing for the the permanent cosmetic industry, I found an article that was quite interesting. It is written for the medical community related to a specific area of cosmetic tattooing, but the basis of what happens to the pigment after it is implanted in the skin.

Unlike many works of art, I work on a living canvas. It changes constantly. Your body is constantly working with the pigment I implant. Please read this very interesting description.  All photos have been removed from the content. 

Excerpt from: 

Scalp Micropigmentation A Concealer for Hair and Scalp Deformities



"Once the pigment is placed into the scalp, the amount of pigment that remains over the first few days reflects the quantity and depth of placement. The epidermis ranges in thickness between 0.5 to 1.5mm. Both the stratum corneum and stratum granulosum, constitute the primary barriers for the protection of the skin. The largest layer in the epidermis is the stratum spinosum, and this area fills with pigment in the track created by the needle(s). The deepest layer of the epidermis is the stratum basale, a row of columnar cells resting on the basal lamina that separates the epidermis. Redness which appears on day of procedure and disappears in 1 to 2 days. These cells are mitotically active and they migrate upward toward the surface. The authors try to limit the depth of the needle(s) to the upper dermis. Significant amounts of pigment may be found in the basal cell layer immediately after the process is done. Pigment particles are found within the cytoplasm of both keratinocytes and phagocytic cells, including fibroblasts, macrophages, and mast cells. At one month, the basement membrane is reforming, and aggregates of pigment particles that are present within the stratum basale are starting to disappear, as these cells migrate upward toward the surface. In the dermis, phagocytic cells that contain pigment may concentrate along the epidermal-dermal border below a layer of granulation tissue that is closely surrounded by collagen. The cells of the stratum granulosum and the stratum spinosum contain particles of pigment, as they migrate upward. eventually, all of the pigments found in the epidermis will be pushed upward with the exfoliation of the stratum corneum. The only pigment that will remain will be the pigment originally placed in the dermis. This represents a satisfactory outcome. The portion of ink that washes away on the patient’s first hair wash (2–3 days) reflects the pigment on the surface of the scalp or from the needle track within the stratum corneum and stratum granulosum. With the normal stratum corneum turnover of ~27 days, it is likely that the pigment remains below the stratum corneum in the lower layers of the epidermis for a few months. How much of the pigment remains in the stratum basale and how long it stays there probably varies in different people, especially those with skin diseases that impact skin cycling. eventually, all of the epidermis becomes free of pigments. The depth of the stratum basale from the surface of the skin varies significantly along the skin, millimeter by millimeter, reflecting an undulating depth of the epidermis at the dermal border. This makes the depth control by an operator who manually controls the needle by the feel of the resistance a very difficult skill that takes considerable experience. The needles are worked into the superficial dermis and this is the portion of the pigment that remains long term. Black pigment granules vary in diameter from 0.5 to 4.0μm. At one month, transepidermal elimination of ink particles through the upward movement of cells in the stratum spinosum is still in process with ink particles present in keratinocytes, macrophages, and fibroblasts. This is what causes changes in the appearance the patient sees in the first few weeks/months. Touch-ups are an important part of the service in follow-up for these patients, as the initial uniformity in appearance, after the first procedure, changes. An active foreign body reaction is induced by the pigment and the speed of the reaction varies with individuals; the quality and quantity of pigments used; and the local anatomy, physiology, and pathology of the scalp. In biopsy specimens reported at two to three months and at 40 years after tattooing, ink particles are no longer found in the epidermis, but they are found in dermal fibroblasts, predominantly in a perivascular location beneath a layer of fibrosis that replaced the granulation tissue. Tattoo pigments are found both intracellularly and extracellularly, with mild fibrosis and occasional foreign-body giant cell reactions. Pigment particles are initially dispersed diffusely as fine granules in the upper dermis, as well as in the epidermis in the tract at the point of the injection. The ink particles normally aggregate to a more focal location in the upper dermis from Days 7 to 13.10,11 Some of the soluble components of the pigment may be absorbed initially and taken away by the lymphatic system, while the insoluble components are incorporated with the connective tissue that surrounds each of the fibroblasts containing ink particles. The changes that can often be seen in these early days after the process has taken place include washing out of the surface epidermal pigments and extravasation (bleeding) of the dermal pigment beyond the area it was placed. The experienced operator has to balance what is seen at the surface at the time the first procedure is performed with an anticipated loss of some of the more superficial epidermal pigments after a number of days pass. With the stratum corneum penetrated, some leakage of pigments can be seen in the first couple of days after the procedure is performed. Since the pigment in the dermis is not initially stable under the body’s foreign body reaction, some pigments may be absorbed or change color over time.12 exposure to ultraviolet light can accelerate changes in color. The authors have seen an almost complete loss of pigment within a few weeks of the initial treatment at one extreme, which might reflect a needle insertion that was too superficial. Considerable extravasation (a bleeding amalgam) of the pigment outside the areas where it was placed in the dermis could also negatively impact the visual aesthetic process as early as in the first week.'


RASSMAN, W. R., PAK, J. P., KIM, J., & ESTRIN, N. F. (2015). Scalp Micropigmentation. Journal Of Clinical & Aesthetic Dermatology8(3), 35-42.


A new normal

As many of my clients are aware, I returned to college a few years ago to acquire my bachelors in nursing.  I have found myself in many forms of continuing education my entire adult life and I was eventually lead to nursing school to better understand the medical side of skin care and permanent cosmetics.  Little did I know how important the knowledge of nursing school would help navigate my family’s needs.

When my 15-year-old daughter was diagnosed with acute myeloid leukemia (AML) and a major infection (flesh-eating bacteria) after her first round of chemotherapy, I knew why I was in nursing school. I was there to better understand everything about the human body. It sure helped me navigate the world of childhood cancer, bone marrow transplants, and wound care due to necrotizing fasciitis (flesh eating bacteria).

When youngest daughter was diagnosed with cancer, I took a year off nursing school so I could care for her.  We finally began to find a new normal after her skin graft in May 2014. I re-enrolled in The University of Tulsa’s nursing school program to finish my final year of my degree.

I am happy to report, I will be finishing my bachelor’s in nursing in May 2015.  Most importantly, my youngest daughter is in remission and doing phenomenal in her junior year of high school.

My oldest daughter, my youngest daughter, and I missed Thanksgiving holiday 2013, while we were cooped up in a bone marrow transplant unit in Texas, so we have big plans to celebrate this year.   We have a new normal. We have so much to be thankful for! 

As far as this business, it has grown exponentially over the last 9 years and I am so thankful for each and every one of you. I know each of my clients recognize and appreciate the value of quality work. They each know I will never reduce my services to the quickest online coupon service or daily deal.  Permanent makeup is better than your highest quality handbag and quality work is worth every penny.   Why would you shop for discounts for permanent face alterations? My work is important to me and I will always honor my brand! 

As a client of Permanent Makeup by Shanan, you will always be proud of your permanent cosmetics and you will never require corrective procedures. xoxo


From September 2013

My 15 year old daughter got an infection in the hospital in July 2013. She got necrotizing fasciitis, aka, "Flesh Eating Bacteria", while in the hospital. It changed the course of her treatment plan. We are rapidly proceeding to a bone marrow transplant due to her massive wound in her right thigh. 

We will be in Ft. Worth for a few months for a bone marrow transplant and skin grafting reconstruction. After she is healed, I will be back to work ASAP. Thank you for your patience during this time. You can follow my daughter's journey here:


From June, 2013

 To all of my clients, I want to share with you the journey we are on. My daughter recently fell ill and was diagnosed with acute leukemia this week.

Friends, I wanted to provide an update for my youngest daughter. She was diagnosed with acute leukemia today. We have a really difficult battle ahead of us. AML is a curable form of leukemia but is treated very aggressively from the beginning. I understand we are in for a difficult and bumpy ride. We are overwhelmed with all of the kind texts and private messages.




Importance of Professional Affiliations

Please take a few minutes to watch my colleague talk about being a member of the Society of Permanent Cosmetic Professionals. I am very proud to tell you I earn all of my continuing education hours from the SPCP. There is NO other affiliation that offers such high standards of training. 

I am proud to say that I received my Certified Permanent Cosmetic Professional credentials in 2010. I won the award for the highest score for 2010.

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