Hair pieces and wigs

Introduction

Hair loss may be permanent, such as in androgenetic alopecia (male pattern hair loss), female pattern hair loss, some cases of alopecia areata, and cicatricial or scarring causes of alopecia such as discoid lupus erythematosus or lichen planopilaris. It may also be temporary, due to medications (eg, hair loss due to cancer treatments), severe telogen effluvium or most cases of alopecia areata. Whether it is permanent or temporary, patients with hair loss can experience low self-esteem and depression.

There are several options for the treatment of hair loss. These include pharmaceutical hair restoration treatments such as minoxidil or finasteride, hair replacement surgery, micropigmentation (tattoo mimicking shaven scalp), and the use of hairpieces and wigs.

Hairpieces and wigs are often used to disguise hair loss and have the following benefits:

• Can be used in patients with any hair loss condition
• Provide an instantaneous result whereas other treatments may take months or years for visible improvements
• Safe to use

Uses of hairpieces and wigs

The use of wigs dates back to the 4th century BC where the wearing of wigs was used to show the ranking of office or status of the wearer or to disguise head lice. Nowadays, both males and females wear wigs or hairpieces for cosmetic, cultural, religious and medical reasons.

They are also used temporarily in patients undergoing lengthy hair transplant sessions. Results from hair transplantation may take a year or more to appreciate. Also, hairpieces may be used where hair replacement surgery has not been successful.

Types of hairpieces and wigs

Hairpieces and wigs come in many different forms and can be added to existing hair or directly to the scalp to give the appearance of a fuller head of hair. Other names for hairpieces and wigs are hair weaves, hair extensions, toupees, non-surgical hair replacements and partial hair additions. These external hair devices are made from human hair, synthetic fibres such as acrylic, or a combination of both.

The advantages and disadvantages of acrylic and human hair wigs are shown in the following table:

Partial hair additions are becoming more popular than wigs and can be attached to existing hair or the skin by several different techniques. Weaving, fusion, bonding and cabling are techniques used to attach new strands to the existing hair. Methods that use the skin surface as the anchor site include adhesives such as double-sided tapes and waterproof liquids. Hair pieces should not be sutured to the scalp because of the risk of scars and infection.

Access to hairpieces and wigs

In some countries, hospitals, charities or societies hold workshops where professional demonstrations of hairpieces and wigs are given. For example, in New Zealand, Look Good Feel Good, a charitable programme of the Auckland Cancer Society run cosmetic workshops throughout the country to improve the self- esteem of women dealing with the side effects of cancer and its treatment.

Hairpieces and wigs are available through hair replacement centres and many small salons. Although insurance generally does not cover male or female pattern hair loss, it may cover the cost of hair replacement when disease or other abnormalities cause hair loss. In New Zealand, the Ministry of Health's Disability Services will provide funding for people who suffer from severe hair loss as a result of a medical condition (not including that of a hereditary nature) such as alopecia areata and specific cancer therapies (chemotherapy or radiotherapy).