Abstract
BACKGROUND: Scalp micropigmentation (SMP) is a non-surgical procedure used to camouflage hair loss or scalp scars. Although SMP is legally permitted only when performed by licensed medical professionals in South Korea, it is frequently administered in non-medical settings, raising safety and regulatory concerns. OBJECTIVE: This study aimed to evaluate the awareness, perceptions, legal knowledge, treatment experiences, and provider preferences related to SMP among dermatology outpatients with alopecia in South Korea. METHODS: A structured 13-item questionnaire was administered to 131 adult dermatology outpatients with hair loss at Incheon St. Mary's Hospital. The survey assessed participants' awareness of SMP, sources of information, willingness to undergo the procedure, legal knowledge, and previous experiences. RESULTS: Among the respondents, 90.8% had heard of SMP, most commonly through the Internet or family and friends. A majority (65.6%) were aware that SMP is legally restricted to licensed medical professionals. However, all five participants (3.8%) who had undergone SMP received the procedure in non-medical settings. Notably, 82.5% of participants without prior SMP experience preferred medically supervised settings, and all individuals with prior SMP experience indicated they would choose a hospital for future procedures. CONCLUSION: This study reveals a disconnect between legal awareness and actual treatment behavior regarding SMP. While most patients understand that SMP is a medical procedure requiring physician oversight, many still receive treatment in non-medical environments. The findings highlight the need to expand access to physician-led SMP services, enhance public education, and reinforce regulatory enforcement to ensure patient safety and align practices with clinical standards.