Overview of physical appearance and alopecia
Many people spoke about changes in their physical appearance when they had alopecia. Most people talked about the impact of alopecia on the scalp, but...
Wearing wigs, scarves and hats with alopecia
Some of the people we talked to had tried to cover up or limit the visibility of their alopecia, such as by styling their hair over bald patches, wearing wigs, hair pieces, scarves, bandanas or hats.
Others opted to having nothing on their heads. None of the young men we talked to opted to wear a wig. Ben and Michael felt it wouldn’t look natural and might draw more attention to them.
Young people’s decision about whether or not to wear something on their heads could depend on where they were going e.g. social occasion, gym, friend’s house, work, if they wanted a particular look (professional, ‘rock chick’) and what felt comfortable at the time. Annie X chose to wear a bandana instead of a wig at school because the wig felt “fake”. Danny doesn’t like to wear hats or scarves as he finds them a “bit irritating”.
Many people mentioned backcombing their hair and using hairspray to keep it in place to cover up any areas of baldness, especially when they had quite small patches of hair loss. Michael also wore beanies (hats) at sixth form and liked this because he had a fringe which showed through at the front.
Styling hair to cover patches could become more difficult if the hair loss became more extensive. Kayla and Imogen both had a hairdresser in the family who put extensions in their hair when it began to fall out more. Kayla’s aunt stuck extensions directly onto the scalp, while Imogen’s mum sewed human hair onto a bandana so it looked like her real hair. A few people wore partial wigs. Rochelle wore a front fringe wig when she first started losing her hair and when her hair started to grow back she wore a U-part wig with some of her natural hair showing. Arti wore a partial wig at first so that she could mix it with her own hair which she felt more comfortable with.
Most people didn’t wear a full wig until they had lost all or most of their hair. Although a few people lost all of their hair very quickly, for many it was a slow process and so they had already been living with alopecia for some time before trying out wigs.
Getting a wig for the first time could be daunting or feel strange. As Arti explained, it can feel “a bit odd wearing hair that’s not yours on your head”. Meghan doesn’t wear a wig currently and finds the thought of it in the future scary. This wasn’t always the case though and some people were less concerned about having or wearing wigs. Rochelle felt there was less stigma surrounding hair extensions and wigs amongst people of Afro-Caribbean descent and she found wearing a wig quite “natural really”.
Comfort and wearing wigs, scarves or hats
Wearing a wig, scarf or hat could mean not having to worry about other people noticing patches or baldness as much, which some found “liberating”. Emily says wigs let people with alopecia “just carry on with their lives”. For some who had become very self-conscious about their alopecia, it could help get their confidence back. Kayla thinks wigs have helped her “come out of my shell a bit more and I can pretty much do anything”. She says “when I have a good wig, I feel on top of the world”.
A few people experienced others touching their wigs, scarves and hats or asking questions about them, but Annie Y said people don’t seem to notice her wig. Some people with alopecia on their scalps said they were often cold or could feel wind and rain on their heads when they went outside. When it was sunny, their head could become sunburnt. Wigs, hats and scarves helped people to be more physically comfortable.
Many people owned several wigs, scarves and hats which they changed between. Some said it could be “fun” changing how they looked quite quickly and easily. Emilie enjoyed meeting a woman once who told her about different ways to style head scarves. Some people only wore their wig when going out to public places and would wear a hat or scarf when seeing friends. Grace wears a cotton head scarf at the gym, which is more breathable.
While wigs could be comfortable to wear, most people did not keep them on for long periods and people often removed their wigs when they got home. Some found wigs were itchy, tight or too warm on their heads. A few people said their wigs were comfortable enough to sleep in. Annie Y lives in a shared house with friends and sleeps in her wig most of the time as her friends don’t realise she has alopecia. She prefers this as it means she doesn’t have to talk about it. Kayla said she only discovered at an alopecia meeting that most people take off their wigs to sleep. The wig adhesive she uses now irritates her scalp so she has to let the skin breathe for a while and sometimes applies a lotion to help the skin heal if it’s become weepy.
Types of wigs and hair-pieces
As well as being different colours and cuts, people spoke about various types of wigs available. Wigs could be made from different materials, have a different top/cap onto which the hair is attached and cover all or part of the head. Different types have benefits and disadvantages. Some of the types of wigs people spoke about were:
- Real/human hair – these were seen as being more flexible and could be styled using heat, like curling tongs, straighteners or hairdryers. Many people felt these wigs looked more natural but they tended to be more expensive.
- Synthetic hair – these are usually cheaper but often become dry, are not heat-resistant and can wear out quite quickly.
- Monofilament and lace front/top – these types of wigs have a cap that allows the parting to be changed, making them easier to style than basic wig caps.
- Vacuum or suction cap – these tend to stay on the head better.
- Partial wigs and hair extensions – these cover just one part of the scalp such as the fringe, for example, and can be clipped in and blended with existing hair.
Wigs usually only last for a limited time, sometimes only a few months, depending on the quality, length of the hair, material, how often it is worn and how it is maintained. It could take time to get comfortable with a new wig.
Choosing the ‘right’ wig
With so many different types of wigs available, buying a wig for the first time could be overwhelming. Arti says it’s “a very confusing new world”. People talked about finding a wig that was the right colour and shape for them as well as quality and cost. Some people preferred natural colour wigs but liked that they had different styles and lengths. The variety of wigs meant people could chose wigs to make them look more ‘professional’, ‘fun’ or even ‘comical’ for special events like fancy dress parties or plays. Most people enjoyed trying out different types of wig and had a few that they could choose from at any one time.
There are a variety of places to get wigs from: online, shops, charities, specialist salons and NHS prosthetics departments. Some people were provided with wigs free on the NHS with a prescription from their dermatologist, although a few were not aware of this being an option. The prices and types of service varied a lot.
Professor Moss explains the NHS allowance for wigs.
Hannah hadn’t known that she was eligible for free NHS wigs and had been buying her own wigs for a few years.
Getting a good shop or online supplier could take time, which Kayla described as a “rocky road”. A few people described having a consultation where a specialist found a wig to suit them or let them choose a colour and texture which they then styled, as a hairdresser would, according to their preferences. Some preferred to shop online so they could try wigs on at home without anyone seeing and avoid having to go into a wig shop. Many said though that visiting a wig shop, at least initially, could be helpful.
Maintaining wigs
Wigs need to be maintained, such as washing and drying them. This depended on personal preference as well as how often they wore the wig. Some people washed their wigs quite frequently (once or twice a week) but others did it less (once every month or so). Special conditioners and shampoos were needed for synthetic wigs. Kayla also tried using argan oil to stop the hair from drying out and Krista found using fabric conditioner kept it “shiny and nice”. Laurel uses a special wire brush for her synthetic wigs and finds after a while the ends begin to split. Some people bought or made their own wig stands to dry theirs overnight after washing.
Avoiding getting wigs dirty, for example by getting sand it in at the beach or wearing it to the gym where you sweat a lot, was important. Some people avoided wearing their wigs while swimming, on holidays or to festivals, where they would not be able to look after it properly. As well as looking after the hair on the wig, the foundation or base of the wig can get easily damaged and become uncomfortable. Some found over time the wig base became looser and could poke out at the back of their neck. People mentioned taking care while brushing the hair on the wig not to rip or damage the base of the wig.
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