Hair Wigs and How They Lead To Hair Loss?

The hair has had a lot of cultural and historical value over time. An example of this is the Egyptians, who are reported to be the first ones to wear wigs as early as 2700 BCE. They were initially used as a way to protect an individual bare scalp from the heat of the sun. They did not necessarily were made from hair-like material; instead, Egyptians used materials like a palm leaf, wool, and fibers. Experts believe that wigs had a more important role than just protecting the head from heat; they were used as a status symbol. The type of wigs worn by the men and women dictated their rank, religion, and social status. The Egyptians then brought wigs to Europe in the 1770s and 1790s. (1)

Meet the expert

Dr. Reena Jogi is a dermatologist who specializes in PRP Hair Restoration in Houston, Texas.


What are the Types of Wigs?

There are many types of wigs currently available in the market to be worn either on top of hair or on the skin of the scalp. Based on how they are made, wigs can be classified as custom-made or ready to wear. In contrast, the ready-to-wear wigs are produced in large quantities and are usually considered one fit for all. On the other hand, custom-made wigs are considered more valuable as they are made according to the individual’s needs and preferences. However, a disadvantage of the custom-made wigs is that they are much more expensive, making them inaccessible to a large population ratio.

How Wearing a Wig Can Lead to Hair Loss

Even though a large number of population with hair loss benefit tremendously from wearing wigs as it helps hide the bald spots or hair thinning on their head. On the other hand, wearing wigs regularly may also lead to hair loss. Experts believe that individuals who wear super tight wigs or wigs that require gluing or binding to the hair follicle underneath are generally not healthy for the hair health and can lead to hair loss. Another factor associated with wigs which are often associated with hair loss promotion is the synthetic bands, which can cause problems for individuals with sensitive skin. They can lead to skin rashes and promote hair loss.

In order to understand how wigs can lead to hair loss, it is important first to understand the Koebner phenomenon. Koebner phenomenon is also known as Isomorphic reaction, and it is associated with the lesion development after a site undergoes physical trauma. (2) This was initially recognized by the German expert known as Heinrich Koebner in 1876. This phenomenon is associated with several dermatological conditions. (3) Amongst these dermatological conditions, Vitiligo, Psoriases, and Liches Planus are a part of the true Koebnerization phenomenon. (4) This may be triggered by specific factors like cytokines, stress proteins, and adhesion molecules which are produced in larger amounts and cause a non-specific inflammatory response.

Another condition that is common in wig wearers is the Frontal Fibrosing Alopecia, which is characterized by hair loss with a quasi symmetrical pattern.

The alopecia caused by this condition is usually along the margins of the head and be seen in the frontal and temporal aspects. It may also present with scarring in some females. This condition was initially recognized by experts known as Steven Kossard in 1994. (5) Women who get diagnosed with this condition complain of a progressive hair recession, which starts from their frontal hairline. They also report this to be asymptomatic in nature; hence they do not usually experience any pain or irritation on the site of hair loss. They may also report loss of eyebrow hair in association with loss of hair on the frontal hairline. (6

The association of this condition with wearing wigs was further investigated in a study. The study showed that women who are found to be affected with Frontal Fibrosing Alopecia who wear wigs occasionally experience lichen planus at the site of attachment of the wigs. This lichen planus eventually leads to hair loss, according to the Koebner Phenomenon.

How To Manage Hair Loss From Wigs?

Hair loss caused by wigs has been a topic of interest amongst experts all over the world, particularly due to the increasing trend of wearing wigs for purposes of fashion. The management methods which may be opted by females who have experienced hair loss caused by wigs include:

  • Stop Wearing Wigs with Tight Attachment Option: The attachment points of the wigs commonly cause excessive pulling of hair and local irritation, which can lead to promoting dermatological conditions like lichen planus or even hair loss at the site of the attachment points. This is why after consulting specialists, the individual should first try to shift to a different wig type, which is more hair and scalp friendly.
  • Anti Inflammatory Injections: Since the site of attachment of the wigs can lead to irritation and inflammation of the scalp, anti-inflammatory injections may be effective. Eliminating the local inflammation can help improve the healing process.
  • Hair Transplant: Individuals who have tried more conservative methods like injections and ointment and have experienced no success may be recommended for hair transplants. However, these are usually very expensive and may not be affordable for everyone.


Wigs are considered ahead accessories that may be made up of different materials like human hair, animal hair, or synthetic materials. These have been used for thousands of years for various reasons; however, the recent trend is mainly bolstered by fashion and style. However, an increasing number of studies are linking wearing wigs to hair loss. This is why it is recommended to consult a hair restoration exerts if an individual experiences hair loss, rather than simply covering it up with a wig. Furthermore, it is also recommended to wear wigs that are not too damaging to the hair underneath, as this damage and irritation over time can lead to bald patches and hair loss. Hence, whenever an individual decides to start wearing a wig, whether it is for any reason, they should always weigh the positives and negatives of doing so.

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