Pain Management

SMP® Knowledgebase

Many clients come to HIS unaware of what to expect during a treatment and unsure of how painful the treatment sessions will be. Below is some information that honestly answers these questions.

Please note that HIS Hair Clinic are not authorised to prescribe or recommend any particular drug for the management of any discomfort. We do recommend that you consult a suitably qualified medical professional prior to using any pain relief products

Realistically, what is the pain level?

On a pain scale from 1 to 10, with a one representing a minor scratch to ten representing something like a kidney stone or a major burn, most clients rate a SMP treatment overall as a three to five. Some clients have actually fallen asleep on us, but in most cases, the treatments are fairly mild. The most painful areas in general to treat are the areas right above the ears and skin over the temple nerves. The least painful areas to treat are the apex of the scalp and the back crown.

If I am sensitive to pain, what I can do before a treatment?

You have two basic options; you can try an over the counter medication such as Tylenol or you ask your family or general physician for something stronger. Many of our clients will be happy with the efficacy provided by over the counter brands. If a client feels a prescription pain reliever is called for, two common options would be a synthetic opioid or EMLA cream. Both of these options in many countries require a doctor’s prescription. Do not undertake either of these options without consulting a licensed physician in your home country. HIS will not be held liable for failure to obtain licensed medical advice or illegally purchased medication.

Can you give details on a synthetic opioid that I might ask my family doctor for?

A very popular choice if a client feels a prescription pain reliever is warranted is Percocet. (this medication may have other names depending upon country or region) Usually given in most countries by visiting your family physician and telling them what you plan to have done. This is a mixture of oxycodone and paracetamol. Oxycodone is semi-synthetic opioid and is highly restricted, so do no go thru airport security without a valid prescription. The method of pain relief is by K (kappa) or U (Mu) based opioid receptor channels in various parts of the brain (which are G protein coupled receptors). The actual pain relief mechanism to the mind (as distinct from the brain) is a bio-psychological modulation of large scale neural networks that is not well understood currently. The use of Percocet does not cause vasodilation or vasoconstriction, and should be fine in most clients for pain relief with SMP. It also does not thin the blood and the acts far from the dermal layer of the scalp, meaning chance for binding or affinity to SMP is likely zero. If you choose this route, a recommendation might be to ask the physician for the 10 mg Oxycodone with 325 mg of acetaminophen white oblong tablets. You will need to take one tablet (and only one tablet) about 45 minutes before the actual needle reaches your skin.

Another recommendation if you feel you are very sensitive to pain is Vicodin. This medication is a combination of hydrocodone and paracetamol. It is marketed under different names in different countries and is also called Zydone, Bancap HC, Loraet, Lortab, Dolacet, and Norco. Vicodin is generally considered to be slightly stronger than Percocet in terms of pain relief. And Vicodin must always be obtained from a licensed physician.
If you decide to choose Percocet or Vicodin, make sure to take a second driver for your car, so that you have someone to drive you home or to the hotel after a treatment. It is not legal in most countries to drive while under the effects of semi-synthetic opioid.

Can you detail analgesic creams and EMLA cream?

These are ointments or creams that usually have a local anesthetic such as lidocaine, prilocaine, benzocaine or tetracaine as the acting agent. The most widely recommended of these is EMLA cream , which is 2.5% each of lidocaine and prilocaine. In some countries you can buy EMLA without a doctor’s prescription and in other countries, you must visit your local doctor (such as in the UK and the USA). The lidocaine and prilocaine in EMLA work by blocking voltage gated sodium (ion) channels in nerves that register pain in the skin. There is not enough solid evidence to suggest that there would be any binding affinity for SMP type compounds, or that lidocaine would hurt an SMP treatment. Epinephrine modulation in reaction to lidocaine results in vasoconstriction and less blood flow to the affected skin area, which actually has the small benefit of helping the skin to retain more pigment. The downside is that EMLA (and most other ‘caine medications) needs to be applied with a wrap over the ointment so that oxygen cannot reach the medication or the scalp. If you simply apply EMLA to the skin, without a wrap over it, you will receive little to no pain relief. In order for EMLA to work, you need to apply it for one to two hours before the needle touches your scalp, and it can dull pain for about 50 minutes in most patients. After 50 minutes to two hours, your skin will return to its normal pain sensitivity. EMLA cream should only be used with HIS’ permission and with the express permission of your practitioner.

Are there any other special drugs, creams or foods which are recommended to reduce pain?

No. There are several old wives’ tails about a specific food or drug working to reduce pain, but they usually do not pan out and can actually be harmful.

Does the pain subside once the treatment is finished?

Yes. During the treatment, the client will feel like a number of tiny pin pricks are taking place on the scalp. As soon as a treatment section of the scalp is finished and the needle is pulled back, the pain abates. Once an entire treatment session is finished, the client will usually feel no pain whatsoever. A few clients report that when a session is finished, they feel very slightly tender as if they received a minor sunburn for the first 12 to 24 hours.

If I have major pain problems or sensitivities, what can I do?

You can try the Patch Test first. This is a quick trial treatment where a very few dots are laid down in the back scalp to test for both pain and allergic reactions. You can read about this here in the FAQ section, under Patch Test.

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