Wigs and hairpieces

One practical way of coping with hair loss is to wear a wig or hairpiece. Nowadays there are many different styles and colours to choose from and they are very natural looking and comfortable to wear. Wigs can be made of human or synthetic hair (monofibre), or a mixture of both.

Types of wigs

There is a more limited choice of styles for men, and it can be very difficult to find suitable wigs or hairpieces.

Real hair wigs can cost between a few hundred and a few thousand pounds, and are not normally available on the NHS. They often look more natural and last longer than synthetic wigs. However, a natural hair wig will need regular dry cleaning, setting and blow-drying by a professional, which can be expensive. It can help to have two wigs so that you can wear one while the other is being cleaned.

Synthetic (acrylic) wigs are cheaper than real hair wigs, and are lighter and easier to look after. They can cost anything from fifty to several hundred pounds, but may be free on the NHS. The style is heat-sealed into the hair so that they can be hand-washed with shampoo, left to drip-dry overnight and are then ready to wear. They can be combed or brushed through gently. They usually last for around 6–9 months. Hair spray can be used if necessary, but avoid using too much as this can make the hair look dull and less natural.

All wigs come with instructions on how to look after them and you should follow these carefully. A free literature pack showing wigs and accessories for people with hair loss from chemotherapy, is available from Trendco| .

Fitting your wig

The nurses on the ward can arrange for a wig-fitter to visit you and help you choose a style and colour that suits you. Most hospitals will supply wigs to people having treatment as outpatients, but this does not happen in all hospitals.

This can be an emotional time as you are forced to face up to the reality of losing your hair. The wig specialists will understand your feelings and will do all they can to make you feel comfortable and at ease during your fitting. You may want to have a relative or friend with you to help you make the decision. There is no pressure on you to choose a wig immediately and you can always leave the decision until you feel ready. If you have a hairdresser you trust you may find it useful to speak to them first.

Some people like to choose their wig before their hair falls out so that they can match the style and colour. The advantage of this is that if you lose your hair more quickly than expected you will already be prepared. It also gives you a chance to get used to the wig before you really need it. If your hair has not yet fallen out, the wig should be quite tight so that it gives a good fit later on. Some wigs adjust to any head size.

If all your hair has fallen out and the wig is slipping, you can get sticky pads to hold it in place. Some pads are hypoallergenic, which can be helpful if your skin is sensitive due to chemotherapy or radiotherapy.

Choosing a wig

If you don’t want the wig to change the way you look:

• Choose the same volume of hair as you had before. Too much hair can make it look obvious that you are wearing a wig. If in doubt, choose a wig with very slightly less hair than you had before. Remember that the wig can be cut and styled to suit your needs by your hairdresser or the wig consultant.
• Choose your own colour or one shade lighter. If the hair is darker than your natural colour, it can look strange to your friends and draws attention to the change. Generally a change to a lighter colour will be less noticeable.
• Remember when choosing a wig or hairpiece that as your hair falls out you will need a smaller size. Try to get a wig which adjusts to any head size.
• If you have a good hairdresser, they could help you choose your wig and, if necessary, cut and restyle it for you.
• Wig manufacturers include the cost of styling the wig in their prices and will give instructions on how to look after your wig. If you have any questions, check with the manufacturer or your hairdresser.

Another approach is to treat this as a chance to try a completely different style or colour, to have a little fun and to surprise your family, friends and colleagues. Wigs are available in various colours if you fancy being outrageous.

Paying for your wig

In the NHS

Currently you are entitled to a free acrylic wig on the NHS if you are having, or have had, cancer treatment and:

• you are a patient in hospital when the wig is supplied
• you or your partner are claiming Income Support, Family Credit, Income-based Jobseeker’s Allowance or Disability Working Allowance
• you have an NHS tax credit exemption certificate
• are named on an HC2 certificate
• you are under 16 years old or between 16 and 19 years old and in full-time education.

The Department of Health leaflet HC11 Are you Entitled to Help With Health Costs? can tell you whether you can get a free wig from the NHS. You can get a copy of the leaflet from your post office or the staff at the hospital. You can also read the information on the Department for Work and Pensions website. The Department of Health leaflet Charges and Optical Voucher Values (HC12) gives information about how much wigs cost. You can get a copy of this from your post office or JobCentre Plus office.

If you are not entitled to a free wig you can still get one from the hospital at a subsidised price. You will need to apply for help with the costs on an HC1 form, which you can get from a JobCentrePlus office or staff at the hospital. You can also request a form by telephoning 0845 850 1166. After that the full cost or part of the cost may be covered by the NHS. You can ask your social worker or specialist nurse to make sure that you are getting all the help that you are entitled to.

You are entitled to a new wig (paid for by the NHS) every six months if necessary. Human hair wigs cannot be prescribed on the NHS unless you are allergic to acrylic wigs or have a skin condition that may be made worse by an acrylic wig.

Buying a wig privately

If you want to buy a wig privately, you can get them from:

• wig departments in department stores
• directly from a wig manufacturer
• from a specialist wig shop.

VAT (Value Added Tax) does not have to be paid on wigs when hair loss is caused by cancer treatment. You will need to fill in a VAT form, which most shops will give to you at the time you buy the wig. The tax cannot be claimed back at a later date.

If you are not entitled to a free wig, other financial help may be available. Macmillan Cancer Support often gives money towards the cost of a wig, but the application must be made through a health professional or social worker.