Wig Out: What to Know When Choosing a Hairpiece

Most women who are told they’re going to need chemo wonder: Am I going to lose my hair? If I do, what will I do about it?

The good news is, not every woman undergoing chemo will lose her hair—and if you do, your hair will grow back when treatment ends. In the meantime, there are many options to help you look and feel your best—from head scarves to hats and of course…to wigs. But choosing a wig requires some thought.

“Buying a wig can be overwhelming at a time when emotions are often already at an all-time high,” says Sherry Brooks, a wig fitter and licensed cosmetologist at MCGHealth Cancer Center, part of Georgia Health Sciences University, in Augusta, Ga. “The important thing is to make sure your wig is comfortable and fits properly.” Brooks also recommends following these other steps when making your wig choice:

  1. Go for a wig-fitting before your hair falls out. When Brooks sees a woman’s natural color, length and style, it helps her style the wig as closely as possible to her everyday hairstyle. “Wigs are meant to be cut and styled to fit your face shape,” she says, adding that even if you buy an inexpensive wig, it’s better to take it to a wig fitter for styling, rather than to your regular hair stylist.
  2. Don’t assume that real hair is better than synthetic. Brooks notes that these days, some synthetics are so lifelike that they’re easily mistaken for natural hair. Besides, she adds, real hair is heavier—and hotter—than synthetic hair, and requires more upkeep. “Curly synthetic hair stays curly,” she says. “Some synthetics are so realistic that the roots are actually darker."
  3. You get what you pay for. The cost differential in synthetic wigs is mainly due to how the hair is stitched into the surface of the wig, says Brooks. Less expensive wigs have larger strips of hair machine-sewn into the fabric. Higher quality ones are “hand-tied,” where each strand is hand-sewn one at a time, which makes for a more natural look. A “monofilament” wig has hand-tied hair at the crown only.
  4. Consider a wig with a liner. Some women have naturally sensitive scalps that are prone to itchiness. If you’re among them, one possible solution is buying a wig that contains a wig cap. The wig cap, also known as a wig liner, is a softer fabric that covers where the wig is in contact with your scalp. You see it only when the wig is inside out. Not every style of wig comes with a cap—if yours doesn’t, you can buy one separately.
  5. Check out medical insurance benefits. Some healthcare plans provide for “cranial prostheses”—otherwise known as wigs—with a medical doctor’s prescription. If this benefit is part of your coverage, take advantage of it.
  6. Take charge of your hair loss.  It is not unusual today for women with hair medium to long in length to cut their hair short in advance of it falling out. Some have even done a buzz cut, to truly empower themselves for when their hair will be gone (vs. waiting for the chemotherapy drugs to cause the hair to fall out).  If considering either, ask your medical oncologist or a nurse when to anticipate hair loss happening. Some drugs cause hair loss just a few days after the first dose; others may take several doses before it happens.
  7. Opt for a totally new look. Despite the comfort of the familiar, some women decide to buy a wig whose color and style are totally different from their pre-cancer look. “Chemo brings a lot of changes in a woman’s life, so it’s natural that some women might also want to change their hairstyle.”

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