This is one of the most commonly asked questions I get. I should say upfront that I sell hats and headscarves and I don't sell wigs. So take my view for what it's worth. What I can do is tell you honestly what I hear from customers, including the ones who chose a wig and were glad they did.
The real answer is that the decision is unique to you. Some people only wear a wig, some only wear a hat or headscarf, some go for both.
Why wear a wig during chemo treatment
The main reason most people opt for a wig, is that nobody knows you are undergoing treatment. You can walk into the school playground, a meeting or the supermarket and have a normal conversation without feeling self conscious.
That matters enormously to some people and barely at all to others. If you work in a public-facing job, if you're not ready to tell people, or if you simply want the option of an ordinary day, a wig does something no scarf can.
Modern synthetic wigs are far better than their reputation. The style is heat-sealed in, so you wash it gently, arrange and leave it overnight and it's back to its shape by morning, but you can also get real-hair wigs too.
How much does a wig cost?
In England, an NHS synthetic wig carries a charge of £80.15. One important catch: the free prescriptions exemption for cancer patients does not always cover wigs.
You'll get one free if you're an inpatient when it's supplied, under 16, aged 16 to 18 in full-time education, hold an HC2 certificate, or receive certain income-related benefits. Non-means-tested benefits like PIP don't count. If money's tight but you're not on benefits, apply to the NHS Low Income Scheme with form HC1, because a lot of people qualify who assume they won't.
In Scotland, Wales and Northern Ireland, NHS wigs tend to be free.
The NHS covers synthetic wigs only. Real hair wigs run from a few hundred pounds into the thousands, take weeks to make and need styling like real hair. You may also be entitled to a replacement NHS wig every six months, though some areas set their own limits.
There's more on all of this in our guide to what cancer patients can claim on the NHS.
The honest downsides of a wig
Nobody tells you these until you're wearing one.
- They're hot. This is the complaint we hear most, and it's worse if you're getting hot flushes, which many people are.
- They can itch, particularly on a scalp that's already tender.
- You take it off at home. Almost nobody wears a wig around the house, so you'll want something else for evenings and weekends.
- You can't sleep in one.
- There's a self-consciousness period, where you're convinced everyone can tell. They usually can't.
- Fit changes. As your hair falls out you'll need a smaller size, which is worth knowing before your fitting.
Why wear a chemo hat or headscarf during treatment?
Comfort, mostly. They're light, breathable and cool, which matters more than you'd expect during treatment.
They're quick. A pre-tied head scarf or a soft chemo hat pulls straight on with no mirror and no styling, which is exactly what you want on a day you can barely get dressed.
They're gentle on sensitive skin and some come fully lined, seam-free so nothing rubs against a scalp that's become irritated.
They're cheap enough to own several, so you're not washing one item every night and you can mix and match them to suit your outfits.
And they suit the whole day. You can wear one to sleep in, round the house, in the garden and out to the shops.
The honest downsides of chemo headwear
- People know. A scarf reads as illness to most people, and some days you won't want that conversation.
- You may feel more exposed, particularly early on before you've got used to your own face.
- Square scarves take practice, though pre-tied designs get round that entirely.
Making your decision
Rather than choosing one for good, think about where you'll be.
A wig tends to suit work, weddings, big family occasions, the school run, and any day you'd rather not explain yourself.
A hat or scarf tends to suit treatment days, home, sleeping, hot weather, hot flushes, exercise, and days when comfort beats everything.
This is why most people end up with both, and why we'd never tell you to skip the wig fitting. Take the appointment, you can always decide afterwards.
If you're leaning towards a wig
Go to the appointment before your hair falls out. It's far easier to match colour and style to your own hair while it's still there, and you get used to wearing it before you need it.
Take someone with you who'll be honest. Ask about care, and ask whether you're entitled to a replacement.
If you're leaning towards chemo headwear
Buy more than one, because whatever you're wearing sits against your scalp all day and needs washing. Having said that, there is no need to buy the shop all at once - get a couple to get you started, then see how you feel and go from there.
Get the fit right - too loose and you'll be tugging at it all day. Our guide to measuring your head takes two minutes.
Square scarves are lovely once you've got the knack, and the knack is the last thing you need in week one, so I always advise to get a hat, but if you like the look of a scarf, go for one that is an easy-tie version where some of the shaping has already been done for you. If you want to learn how to tie a square scarf from scratch, HeadWrappers run free online scarf-tying sessions.
Get something for the night. Heat loss through a bare head surprises everyone, and something soft to sleep in makes a real difference.
And if you want neither
That's a perfectly good answer, and more people choose it than you'd think.
Some go bare-headed from the start. Others try a wig, hate it, and never go back. Some cover up for three months and then stop caring. We've heard it all.
There's no version of this that's braver than another. Covering up is not hiding, and going without is not showing off. It's your head and don't decide once and think you're stuck with it. What you want in week two is rarely what you want in month four.
Frequently asked questions
Is a wig or a headscarf better for chemotherapy hair loss? Neither is better. Wigs give you privacy in public, headwear gives you comfort at home and on treatment days. Most people use both depending on where they're going.
How much does an NHS wig cost? In England the charge is £80.15 for a synthetic wig. In Scotland, Wales and Northern Ireland NHS wigs are free. The cancer prescription exemption does not cover wigs.
Can I get a free wig on the NHS? In England, yes if you're an inpatient when supplied, under 16, 16 to 18 in full-time education, hold an HC2 certificate or receive certain income-related benefits. PIP and DLA don't qualify.
Are wigs hot to wear? Most people find them warmer than headwear, and it's the most common complaint. If you're having hot flushes, you'll probably want a breathable hat or scarf as well.
Should I get a wig before my hair falls out? It helps. Matching colour and style is easier while you still have your hair, and you get used to wearing it before you need to.
We sell hats and headscarves and don't sell wigs, so do weigh our view accordingly. Your treatment team can advise on NHS wig entitlement in your area.
