Waxing/epilating operates under the same idea of pulling the hair out at the root but that doesn't cause permanent damage. I dont see why it would on the scalp
If it's hair from a balding scalp that's ripped out, then the hair that will grow back in its place will be much shorter and thinner. It may even come back as mere vellus hair. That's permanent damage imo, especially if you're not on meds.