Most people with extensive hair loss usually caused by alopecia totalis or cancer chemotherapy prefer to wear a wig. In recent years, wigs have improved greatly, and it is no longer painfully obvious that someone is wearing one. The Alopecia UK website has an excellent section on wigs.


In the UK, the National Health Service (NHS) will supply a wig if a consultant (for example, your dermatologist) considers it necessary. These are free of charge for hospital inpatients, for under 16s, for 16- to 18-year-olds in full-time education and for those receiving income support or family credit. People on low incomes may get some help towards the prescription cost. Some trusts only have access to subsidised wigs, or wigs are only available for chemotherapy patients.

Acrylic wigs are lightweight and look extremely natural, although they may feel hot to wear. They can be washed (but do not use a hairdryer the heat can make them frizzle or melt). They are pre-styled, so their hairstyle stays in shape after washing. It does not matter if an acrylic wig is worn in the rain.

Because they are in stock sizes, acrylic wigs can be obtained quickly. They need to be replaced every 6–9 months. Most people have two: one to wear and one to wash. For totally bald heads, special adhesive pads are available to stop the wig slipping, and some women also use them for extra security.

Real-hair wigs. Some people still prefer a real-hair wig, but these are more expensive than an acrylic wig. However, they last for 3–4 years. They are made to measure, and this takes a few weeks. They cannot be washed and must be protected from rain. They are also more trouble than an acrylic wig because they have to be styled and set like real hair, and you will have to buy a wig block for styling it.

Hair Systems

For male pattern baldness, some men like to wear a hairpiece. Like wigs, these have improved in recent years and some now look very natural if carefully matched to the existing hair. Some systems can even be slept in and kept on during showers. Some clinics suggest implanting clips into the scalp to hold the hairpiece more firmly in place, but this is not to be recommended because it can result in inflammation and infection of the scalp. Modern hairpieces are glued to the scalp and remaining hair, so there is no danger of them coming off. However, they usually need to be adjusted every 6–8 weeks as your own hair grows.


First published on:
Reviewed and edited by: Dr Ahmed Kazmi
Last updated: October 2020

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