Among us are some respected members who believe that Trichology is a subfield of Dermatology and hence there can be no other kind of professional figure who can work in this field other than a Medical Doctor of Dermatology. However a respectable opinion this may be, it seems to us that this idea has been superseded by the reality of modern times and that most of us today believe there are professionals with specific skills who can contribute to the field of Trichology, such as:
Trichology Technicians (Hairdressers and Barbers) are professionals who deal with the “aesthetic care” of hair but who, strictly speaking, could not and should not recommend a topical treatment for excessive hair loss. Just as a doctor cannot pretend to be a hairdresser, a hairdresser should not pretend to be a doctor and should never advise any sort of therapy. It should be well understood, however, that the work of a Hairdresser or Barber is a delicate job that is often underestimated. It involves taking into consideration the client’s mood and psychological state of being and then knowing how to interpret the client’s wishes in the best way possible. We also believe that a Technician who has successfully attended courses of a specific curriculum can perform simple tests and microscopic examinations which, without ever making a medical diagnosis, can help in providing a service that often proves difficult.
Non-Medical Trichologists (Pharmacists, Biologists, Chemists, Nurses, Psychologists, etc.) are professionals who have completed an accredited academic course of study and who know Trichology from a perspective of anatomy, physiology and associated problems. They can address hair and scalp issues from the point of view of their respective field but are not permitted to make diagnoses, prescribe any medical treatment nor work as a Surgeon of Trichology in the absence of a Medical Surgeon. These professionals, in our opinion, are certainly qualified to do research, exams and tests, as long as they do not cross the line in diagnosing or prescribing therapy. They are also qualified, when able, to teach Trichology to other professionals.
Graduates in Medicine and Surgery who work in Trichology are the only professionals authorized to diagnose and to medically “treat” (also with pharmaceutical drugs) those who have hair and scalp problems.
Trichology Doctors (Trichologists) are those who have graduated in Medicine and Surgery with a specialization in Dermatology, or (for surgeons) in Plastic and Reconstructive Surgery and/or have trained in the field through publication or academic studies (such as a University Master’s Degree in Trichology Science) in addition to a Bachelor’s degree and/or a specialized degree. These Trichologists are authorized to propose trichological therapy protocols, make diagnoses and to medically “treat” those who have hair and scalp issues. They are the natural point of reference of all who work in the field of Trichology. It is in this regard that the Italian Society for Hair Science and Restoration feels it is necessary to institute a Public Registry (without legal status but with great moral status) listing the doctors known to the Registry who can be considered Trichologists in all the effects and who meet the requirements to care for patients with pathological or aesthetic conditions due to hair or scalp issues. (https://www.sitri.it/pubblico-registro-dei-medici-tricologi/).
We believe that those who offer services to treat hair and scalp problems without possessing the appropriate academic and legal qualifications should be prevented from practicing in that it constitutes a violation of practicing a profession without a license.
Amongst Trichologists are also Trichological Surgeons. Here we pose the issue of who can “operate or work” in the Operating Room during the Trichological operations.
We believe that only a Surgeon who has graduated, trained and been admitted to the country’s professional guild where he or she intends to practice should be authorized to perform hair transplants. Furthermore, it should not be possible to even consider a transplant without the physical presence of the Surgeon. Only the Surgeon, respecting the country’s laws where he or she works, is qualified and authorized to cut, make incisions, or use needles or other instruments for piercing the skin. The Surgeon is solely responsible for the correct execution of the surgical procedure and for the entire operation. A Surgeon who finds himself in a country different from his own must obtain authorization from the host country in order to operate or even to diagnose, otherwise he is practicing a profession without a license.
In the operating room, during Trichology operations, Registered Nurses and Technicians are often present. Only Registered Nurses (or professionals with a bachelor’s degree of first or second level in a medical biology subject matter) – who will also have to assume their part of responsibility for the work provided – can assist the Surgeon in extracting or implanting the hair follicles for a transplant and are not authorized to make incisions or prepare the reception area for the implants.
A Technician without a Bachelor’s degree and who by law (of his/her own country or of the country where he/she works) is therefore not qualified, can only make the preparations for the transplant, sectioning and selecting the hair follicles and tending them before handing them to the Registered Nurse and/or the Surgeon who then does the implant.
It will be necessary to carefully further evaluate the position of those who have already worked for many years in Trichology without the necessary professional qualifications and who, in the absence of definite guidelines, have been providing services for which they are not clearly authorized.