For many cancer patients, hair loss is the most distressing and feared side effect of chemotherapy and radiation treatment. If you don’t want anybody to know you’re losing your hair, a wig may be the answer.

Before You Buy

Ask your doctor

Not all treatments cause hair loss, so discuss with your doctor what the likelihood is that you’ll lose yours. If there is a high probability you’ll lose some of your hair, get a prescription for a “hair prosthesis” (most insurance plans cover wigs that are needed for medical reasons). Also, ask about steps you can take to help retain your hair.

Call your hairstylist

When you book your appointment, let the receptionist know you’ll need some extra time, and consider asking whether there is someplace where you can talk privately with the stylist. If not, you might want to schedule an appointment for when the salon is likely to be less crowded. As the person who knows you, your hair and, most likely, other clients with cancer, a hairdresser can be a great resource. He or she may be able to suggest a local wig shop or even order a wig for you. Once you’ve purchased the wig, your stylist can trim and style it to suit your face.

Take a short cut

Even if you have always worn your hair long, getting a short haircut is one of the biggest breaks you can give yourself during treatment. Long hair, pulled down by gravity, is more likely to fall out sooner. Short hair is better at masking initial hair loss and makes less of a mess when it does fall out. Just remember to keep a good-sized lock of hair to use as a guide for wig shopping.

Give yourself options

Since wigs can be uncomfortable and troublesome, you probably won’t want to wear one every day, all day. A hairpiece peeking out from under a hat or scarf can give the illusion of hair, without the annoyance and bulk of a wig. Most wig stores and specialty retailers for cancer patients stock a wide variety of bangs, side pieces, ponytails, curls and falls. Many of these are designed to be attached to a hat (e.g., using Velcro).

Where to Buy a Wig

In addition to asking your stylist, ask your oncologist for recommendations for wig retailers and wig salons.

Wherever you go, it should be a place where you feel comfortable and like the staff. Call beforehand to make sure the retailer or wig salon specializes in helping cancer patients, offers refitting, can provide a private area for try-ons and has a variety of choices, including hairpieces. Also, find out whether you can try on the wigs and return them (many states’ health regulations prohibit this).

You can purchase a wig online, but there is no way to tell what you are actually buying until it arrives at your door. If you do buy a wig via a website, be sure you can return it for any reason.

If you can’t afford a wig, you can try calling the American Cancer Society (800-227-2345; some local offices are able to offer wigs that have been donated) or CancerCare (800-813-HOPE; some branches have free wig clinics).

Choosing a Wig

There are a number of factors to consider when selecting a wig — e.g., human hair or synthetic; short or long; custom- or machine-made; and price.

Synthetic hair vs. human hair

Most people prefer synthetic hair; it’s less expensive and easier to maintain. Most synthetic wigs have their style molded into them, but some can be reset. The advantage to style-able wigs is that you can change their look, just as you can with real hair. The disadvantage is that they have to be reset every time they’re washed. Synthetic hair also dries faster than real hair. While synthetic wigs that are well made may look real, they never feel the same as real hair or move the way real hair does. Nor can you treat them like you would your own hair — they can fry when exposed to heat. So no curling irons or blow-dryers (unless they are specifically designed for use on wigs). Hot rollers can be used, but only at low settings. And avoid exposing the wig to any intense heat sources, such as an oven. The blast of heat will cause frizzing.

Wigs made of human hair will obviously look and feel more like your natural hair, but they are expensive and are far more time-consuming. You can use heated appliances on them for touch-ups, but you’ll probably want to take them to a professional to be washed and styled.

Wig construction

The way a wig is made affects how it looks just as much as, if not more than, the type of hair that’s used. A quality synthetic wig is preferable to a poorly made wig of human hair. 

There are three different types of wig construction: custom, handmade and machine-made.

• Machine-made wigs tend to be the least expensive and the most widely available. If you’ve ever worn a wig, this is probably the type you are familiar with. Wefts of hair are sewn together in a straight line, cut and assembled into a wig. (When you look inside a machine-made wig you can see the lines.) Many look extremely realistic as long as they are not parted, pulled back or otherwise altered. Some people find these wigs more comfortable because the construction creates vents that allow air to circulate to the scalp.
• Handmade wigs look the most natural of the prefabricated choices, because individual strands are knotted onto a skullcap rather than wefts of hair being sewn together. These wigs can be parted and styled with accessories, since there is no chance the vents will be exposed. The hair also falls and moves more naturally.
• Custom-made wigs are almost indistinguishable from natural hair; however, they are extremely expensive and generally take a couple of months to complete. If you opt for a custom wig, be sure that you have final approval on the choice of both the hair and the style. And unless you have prior knowledge of the shop, you might want to call your local chapter of the American Cancer Society to double-check that you are working with a reputable establishment.

Style

Some patients use this experience as an opportunity to experiment with a number of different looks, while others want a wig that looks just like their own hair. Either way, a few adjustments can help make your wig look as natural as possible.

• Keep in mind that a wig cannot replicate the way your hair blends into your skin. Sure, it does in the movies, but that requires a great deal of time and makeup — not to mention a team of trained professionals. For your purposes, bangs, or at least a few wisps of hair covering the hairline, will help your wig look more natural.
• Even if you opt for the same cut you currently have, you might want to try a slightly shorter wig. During treatment, many people lose weight and become slightly drawn. A shorter style can add fullness. Plus, short wigs have less hair to brush out at night and don’t tangle as easily as longer wigs.
• Wigs that utilize wide headbands along the hairline are easy to wear, but that means you’re locked into wearing a headband. Such models are better for occasional use or as a backup.
• Buying two wigs in different styles can make life easier than purchasing one very expensive wig. For example, you won’t have to restyle your wig every time you want to put your hair up.

Color

Whether you’re matching your own hair color or thinking about trying something different, consider going a shade lighter. It will help offset changes in skin tone that may occur during treatment.

Make sure you get the color you want. Examine the wig outside, in natural light. Look at the quality of the color as much as the depth of the color. There is more to selecting a brown wig than choosing light, medium or dark; be sure to check out the highlights, lowlights and underlying tones as well.

Shopping List

In addition to the wig, you’ll need some supplies: a head form on which to store the wig, a wire wig brush, T-pins (to hold the wig in place while brushing), hairnets, wig hair spray (or low-alcohol hair spray), wig shampoo (or baby shampoo), conditioner and, depending on the length, hairpins and rollers. All should be available at the wig shop, a beauty-supply retailer, through your hairdresser or online.

Wear and Care

Wear

The wig shop or your hairdresser can demonstrate how to put your wig on properly, by grasping it in the front and rolling it back over your head. It should fit securely but not be uncomfortably tight. Line up the points on the side of the wig in front of your ears, where a man’s sideburns typically start. Your ears should be pulled out over the wig, not tucked under.

As hair loss progresses, it may become difficult to tell where your natural hairline is, in which case you might end up wearing the wig too low or too high on your forehead. Keep a photo that shows your natural hairline to use as a guide.

Under any type of wig, you’ll need to wear a cap. These are soft, snug nylon or cotton coverings that protect your scalp, control your hair and keep the wig from slipping. Buy more caps than you think you’ll need; it’s good to have extras and rotate them regularly.

Your wig may need to be refitted after you lose your hair, particularly if you had long or thick hair when you purchased it. Most wigs have adjustable straps at the back to change the size; if the wig still feels loose, take it back to the store for adjustment.

Care

All wigs require a certain amount of daily care, but probably less than the time you’d spend on your own hair. For more information, Look Good Feel Better offers virtual workshops on wearing and maintaining wigs.

Daily care

• When you take off your wig, store it on a Styrofoam, wood or cloth-covered head form.
• Smooth out the hair with a comb.
• To set curls on short styles, simply pin curls in place; on longer styles, roll or twist the hair and secure with pins.
• If desired, lightly spray with wig hair spray (or low-alcohol hair spray) and let dry.
• Cover with a hairnet.
• Store away from heat, dust and humidity.

Washing and setting

If worn regularly, you’ll want to wash and set your wig every week or two. Synthetic wigs can be washed and styled at home or taken to your hairstylist or wig shop. Wigs made from human hair are more difficult to handle, so it’s best left to professionals.

Washing

• Brush wig with a wire wig brush, starting at the ends and working up to the scalp.
• Submerge wig in a bowl or sink of cool water and wig shampoo (or baby shampoo). Gently swish.
• Soak for five minutes.
• Rinse in cool water.
• If desired, condition hair with a product for wigs or a conditioner with lanolin.
• Rinse again in cool water.
• Gently squeeze out water; do not twist.
• Blot dry with a towel.
• Place wig on a tall, slender object, such as a can of hair spray, so air can circulate through the wig.
• Allow to air-dry completely. Never brush a wet wig. (Blow-dry only if the manufacturer recommends it.)
• Gently brush with wig brush, from ends to scalp.

Setting

As mentioned above, most synthetic wigs have the style molded into the hair, in which case you simply need to control and emphasize the style with hot rollers set on medium or low heat. And again, never use a curling iron or hair dryer on a synthetic wig.