ABSTRACT
Wigs and hairpieces have been worn for centuries, and have evolved with prevailing social mores and fashion trends. Ancient Egyptians wore wigs to protect their shaved heads from the sun, while seventeenth-century British aristocrats wore them to define social rank. In modern times, wigs, hairpieces, extensions, and scalp-covering cosmetics are used to either change the appearance of a hairstyle or to camouflage hair loss. In the setting of hair loss due to a medical condition, custom-made wigs are also known as hair prostheses. These devices enable patients to maintain the normal appearance of hair while undergoing treatment for an underlying condition. Alternatively, many patients choose to wear a wig or hairpiece in lieu of medical or surgical treatment. The choice depends on factors including the type, duration, and extent of hair loss and individual economic and lifestyle factors. Health professionals play an important role in introducing hair
prostheses to patients. A discussion of wigs and hairpieces at the appropriate time can be very useful in helping patients cope with various forms of alopecia. The tone and timing of this discussion must be considered carefully. Ideally, the option of a hair prosthesis should be presented in the course of an in-depth patient interview. After a thorough history and physical examination, the diagnosis should be discussed in detail. Patients will have questions about the extent, potential chronicity, and possibility of remission of their condition, so the professional should be prepared to answer these questions with as much evidence-based information as possible. When discussing treatment, hair prostheses can be introduced while outlining the medical and surgical options for therapy. The option of a hair prosthesis should not be
presented as a last resort. It should be considered a reasonable, practical, and effective means of coping with hair loss. The goal of this chapter is to acquaint medical professionals
with the most common devices used for hair replacement and supplementation. The practitioner will be able to identify the types of wigs, hairpieces, and extensions that are worn by patients and recognize the potential benefits and problems associated their use. Although a detailed study of specific hair styles is beyond the scope of the chapter, basic wig and hairpiece construction are discussed. Equipped with this information, the medical practitioner will be able to partner with the patient to make an informed choice about hair replacement.
