ABCs of Wig Selection and Care

Many chemotherapy agents can cause your hair to fall out or thin. Exactly when this happens can vary depending on your treatment, but is generally around 2 weeks after the first chemotherapy treatment. Will it fall out overnight? Sometimes, but every person's experience is different given the different medications that can cause hair loss. While no one should tell you it will be easy to lose your hair, there are some steps you can take to make it easier.

• Decide if you want a wig – there are no rules and you should do what is comfortable for you.
• Consider cost – the various types of wigs can range from a few hundred to a few thousand dollars (more on the types below). Some insurance companies will cover the cost with a prescription from your healthcare provider - call them to investigate.
• Have fun selecting a wig! Take a friend or 2 to help you choose a great style and color for you.
• If the hair falls out naturally, it can be several days of waking up to a pillow full of hair and handfuls in the shower. Some people choose to shave their hair off or cut it short before it falls out to avoid the drawn out experience. It can give you some control over the experience of losing your hair.

Types of Wigs

There are a few types of wigs available and visiting a wig shop that works with people with cancer can be a great education on the topic. (The ACS can help you find a local wig boutique – 800-ACS-2345).

Wigs can be made of human hair or synthetic hair. A human hair wig tends to be heavier and can be quite costly, ranging from 1500-5000 dollars. A synthetic hair wig can range from 300-700 dollars.

The base of the wig is like a cap that is adjustable to conform to your head. The "wefts" of hair are tied to this cap and how it is tied affects the look and feel of the wig. Some methods of tying can result in a wig that irritates your scalp, others allow the hair to fall more naturally, or better hide the scalp. This is why it is so helpful to go to a boutique where someone can help find the best option for you.

Caring for Your Synthetic Wig

Washing

It is recommended that you wash your wig every 21 days of wear. Use a special shampoo made especially for wigs or Woolite. To wash your wig:

• Fill your tub or sink with enough warm water to submerge your wig.
• Add your shampoo and gently swish the wig around, then leave it to soak for 5 minutes.
• Rinse thoroughly until no suds remain. Run the water from the scalp to the ends to reduce the tangling or matting that can occur when washing.
• Gently slide your hands down the wig to remove excess water or blot with a towel.
• Give the wig a shake to remove excess water - NEVER comb or brush a wet wig.
• Put your wig on a stand to dry.

Use a wig stand to dry and not a Styrofoam head. These have a tendency to lead to poor evaporation and cause stretching of the wig cap. If you do not have a stand, a tall can of hairspray can substitute.

• A note on human hair wig care: it is recommended that these wigs are professional cleaned, often where it was purchased. This should be done once a month and can add to the cost of these wigs.

Conditioning

Spray conditioner and detangling sprays are made to restore luster and shine to your synthetic wig. It is recommended to use products made especially for wig care, which contain ingredients friendlier to your wig. They help reduce normal wear and tear as the synthetic fibers break down over the normal life of a wig. To condition your wig:

• Spray evenly and lightly throughout the wig. Pay close attention to the inside hairline.
• Do not rinse.
• Comb through to distribute throughout the wig with a wide tooth comb.
• Put wig on your wig stand and allow to air dry before wearing.

Holding Sprays

Holding spray or curling glazes are specially formulated for wigs. They do not contain glue, which is found in regular hair products, so they will not leave a sticky residue on your wig. If you are going to use hair spray as a styling aid for your wig, it is recommended that you use one of these products.

Styling

Today's wigs have come a long way. We used to tell people to never use a curling iron, hair dryer or straightened on a wig, but things are not so straightforward anymore. When you purchase your wig, be sure to ask how these rules apply to your wig. You can style a human hair wig and some synthetic wigs are made of heat resistant materials able to tolerate styling tools.

"Cutting In" a New Wig

It is a good idea to have a trusted hair stylist trim your wig to fit your face. A wig is "off-the-rack"; think of buying a nice dress or suit off the rack. Having a tailor take it in to fit you specifically makes it fit just right. A wig is no different; just a little trimming can make a big difference.

Thinning Hair

If you have not lost your hair completely, you may want to try adding hairpieces or "wiglets" to cover bald spots, be a fringe peeking out from under a scarf or bangs under a cap. A partial wig can be weaved into your remaining hair to add fullness.

Insurance Coverage for Wigs

Every insurance carrier is different, so you will want to check with your carrier to see if they pay for a wig. They may pay up front or require you to pay and be reimbursed. To pay, carriers require a prescription from your healthcare provider for a "cranial prosthesis", your diagnosis code and a sales receipt to be submitted. Some cancer boutiques offer reduced rates on wigs and, in some areas, the ACS has wig banks for those who cannot afford to buy a wig (call 800-ACS-2345 to find out more).

Caring for Your Scalp

Losing your hair isn't all cosmetic. Your scalp may become sore or itchy. Your scalp needs protection from the sun and cold weather. Some tips for dealing with these concerns include:

• Keep your scalp moisturized! Use a hydrating body wash instead of shampoo or soap. Apply moisturizing lotions or balms, which can be specially formulated to treat and prevent itching and irritation.
• A wig cap or liner can prevent the wig wefting from irritating your scalp.
• A slumber cap can keep your head warm at night.
• Don't go out in the sun without some head covering; a hat, wig or scarf to protect your scalp from sunburn.

Want to learn more about hair, skin and nail care during cancer treatment? Watch this panel discussion about this important topic!

Other Wig Resources

Cancer Care Wig Clinic (services NY/NJ/CT) 800.813.HOPE (4673)

TLC (Tender Loving Care)-American Cancer Society

Many cancer centers have partnerships with local boutiques that offer wigs, turbans, scarves and other products for cancer patients. Ask your healthcare team for referrals to local resources.