Hair Restoration

A hair restoration surgeon is a physician who specializes in diagnosing and treating hair loss, medically and surgically. At Well by Messer, our hair restoration surgeons evaluate hair loss of the scalp, eyebrows, and eyelashes, identify its cause, and treat it with the full range of options, from prescription medical therapy and regenerative treatments to advanced transplantation and reconstructive surgery of the scalp.

Hair loss, known medically as alopecia, is a disruption of the normal hair growth cycle that leads to thinning, shedding, or permanent loss of hair. It affects the majority of men and a substantial proportion of women over a lifetime, and it is rarely only cosmetic: hair loss is often the visible signal of an underlying hormonal, nutritional, autoimmune, or inflammatory process. Because dozens of distinct conditions can produce what looks like the same thinning in the mirror, accurate diagnosis is the essential first step, and it determines which treatments can actually work.

The most important distinction in diagnosing hair loss is between nonscarring and scarring alopecia. In nonscarring alopecia, the hair follicle remains alive, and hair can often be regrown with treatment. In scarring (cicatricial) alopecia, inflammation permanently destroys the follicle and replaces it with scar tissue, so hair that has been lost cannot regrow, and the goal of treatment is to halt the disease before more follicles are destroyed. Because that window is limited, early evaluation matters enormously.

These are some of the nonscarring forms of hair loss:

• Androgenetic alopecia (male and female pattern hair loss) — by far the most common cause of hair loss, driven by genetics and androgen hormones, and highly treatable when addressed early

• Telogen effluvium — diffuse shedding triggered by illness, surgery, childbirth, emotional stress, rapid weight loss, and medications

• Alopecia areata — an autoimmune condition causing patchy or widespread hair loss

• Traction alopecia (early stage) — thinning from persistently tight styling, including braids and extensions, and reversible when caught before scarring develops

• Trichotillomania — hair loss from compulsive pulling

• Hair loss from thyroid disease, iron deficiency, and other nutritional or hormonal causes

These are some of the scarring (cicatricial) forms of hair loss:

• Central centrifugal cicatricial alopecia (CCCA) — a scarring alopecia beginning at the crown that disproportionately affects Black women

• Frontal fibrosing alopecia (FFA) — progressive recession of the frontal hairline and loss of eyebrows, more common in women

• Lichen planopilaris (LPP) — an inflammatory condition that destroys follicles across the scalp

• Traction alopecia (late stage) — permanent follicle loss after years of tension

• Scarring from trauma, burns, radiation, or previous surgery

Many patients have more than one process at the same time, and treating one while missing the other is a common reason hair loss care fails.

Treatment plans commonly combine medical therapy, regenerative treatment, and surgery.