Helping a woman handle hair loss

Nursing, Nov 1997 by Brand, Karen Paulsen

WHEN YOUR PATIENTS SELF-IMAGE IS THREATENED BY ALOPECIA. OFFER HER THESE TIPS ON WEARING A WIG.

Alopecia is an adverse effect of chemotherapy that can devastate your patient. Loss of scalp and body hair threatens her body image and self-esteem. A man with alopecia may choose to wear a cap, but many women prefer to buy a wig. If your patient makes this choice, discuss with her these practical points about choosing and caring for a wig.

Find out whether her insurance plan will cover the cost. Some carriers balk, regarding a wig as cosmetic. From your patient's perspective, however, wearing a wig may be crucial to her self-esteem and ability to function. If reimbursement is questionable, the physician may need to write an order before the insurance carrier will pay.

Advise your patient to select a wig before she loses her hair, if possible. She'll probably feel best if the wig resembles her natural hairstyle and color. An experienced stylist can offer advice and let her try on samples. If your patient must purchase a wig without consulting a stylist, remind her that after her hair falls out, the wig will fit differently.

A wig needn't be made of human hair-in fact, most are synthetic. Natural-looking and inexpensive, synthetic wigs are either hand- or machine-tied. More-expensive, hand-tied wigs more closely resemble natural hair because the hairs are arranged uniformly, allowing them to fall into place as natural hair would. In a machine-stitched wig, the hairs are arranged in layers that may settle into unnatural-looking flaps over the course of a day.

Most wigs have to be adjusted to the wearer-rarely is a new one ready to wear. Untouched, a wig may be bushier than natural hair, so to achieve a natural look, a stylist may need to style it on the patient. Although the wig may be synthetic, the stylist can straighten, curl, and reset the fibers.

Caution your patient not to expose a synthetic wig to heat from any source-a curling iron or hair dryer will make it frizzy. After a week or two of wearing the wi, she should return to the stylist for advice on fit, appearance, shampooing, and drying it. Once she's accustomed to the wig, she may find maintaining it even easier than caring for her natural hair.

Recognizing that hair loss can threaten your patient's self-esteem, you're in a pivotal position to help her in her decision to wear a wig. By becoming involved in this aspect of her care, you're providing holistic care when your patient is confronted with alopecia.

From "When You Lose Your Hair," Encore Echoes, Minnepolis YWCA Encoreplus Progrom Newsletter 1995 Minneapolis Young Women's Christian Association. Adapted with permission of the publisher.

BY KAREN PAULSEN BRAND, RN, CS, MA, MS

Associate Education Specialist Clinical Specialist, Gerontologic Nursing University of Minnesota School of Nursing Minneapolis, Minn.