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Prostheses & Cosmetics

WIGS: Questions & Answers

We don’t know yet why alopecia areata causes hair loss. We do know that hair loss often results in loss of self-esteem and self-confidence, and the media can magnify the resulting stress and frustration. Advertisements for various hair products often imply that the use of those products will restore the quantity of hair as modeled in the ad. Wigs and hairpieces are available to those who are seeking a natural looking hair replacement, but advertisements for these products do not always fully disclose the details. Over the last several years, many wigs and hairpieces have been sold as new hair systems, hair units, or hair replacements—misleading names that falsely imply that consumers are getting something “more” and so they pay a much higher price.

For someone experiencing alopecia totalis or alopecia universalis, a wig or a full hairpiece is the only answer to regaining a natural head of hair. But for those experiencing alopecia areata, more often than not, the solution could very well be in a 3/4 wig or 3/4 hairpiece, where the remaining hair on the lower nape of the neck and sides is blended into the smaller wig or hairpiece.

We hope the following questions and answers will help you determine what you really need before you purchase a wig or a hairpiece.

Is what you are wearing or planning to purchase a wig and/or hairpiece?
No matter how the product is attached to your head (with double-sided adhesive tape, clips, combs, glue or bonding, suction cups, or weaved onto your own remaining hair) the item is a wig or a hairpiece.

Should I expect to see sample wigs and hairpieces rather than just photographs or videos?
Absolutely. You should be shown a variety of wigs and hairpieces, with different types of foundations and different hair color, length, and texture. If you are solely shown photographs and/or videos, I urge you not to place an order since you will have no point of comparison when your item is completed.

Wigs and hairpieces are secured to the head by using bonding glue or by using weaving or biolock techniques to attach the outer perimeter of the hairpiece to remaining hair. Should I be concerned with the type of attachment?
Definitely. Bonding glue often causes irritation, itching, and discomfort to your scalp. And any form of attachment to your existing hair, be it weave or biolock, will cause further damage to whatever remaining hair you may have.

Is the item or will the item be handmade?
For the best results, the wig or hairpiece should definitely be handmade.

Will a custom and handmade wig or hairpiece accomplish a more natural look?
Yes. In addition, a custom and handmade wig or hairpiece should fit your head perfectly. The hair color and texture should be exactly the same as your natural hair color, or the hair color that you chose for the wig. Also, the volume of hair (light, medium, heavy) should be the same as your natural hair, and the base of the wig should fit well.

I have been told that the hair used in my wig or hairpiece will be human hair. What does that mean?
Human hair means hair taken from an individual and hand tied into a foundation. There are only a handful of companies that use 100 percent European human hair, which is considered the best.

Is the wig or hairpiece made at the establishment where I am placing my order, or is the order being sent to Asia to be made?
Ninety-five percent of all wigs and hairpieces are made in Asia. Although the price may be more expensive, the final result will be much more effective if the wig and/or hairpiece is made at the establishment where you have purchased it, using European human hair.

Am I better off to have a wig or hairpiece made of synthetic rather than human hair?
Although synthetic hair will not oxidize (fade in color), there are several problems pertaining to it: (1) it has an artificial feel when you touch it, (2) it has a high shine beyond the normal look of quality human hair, (3) when worn near heat, synthetic hair will frizz, and (4) synthetic hair often is used in inexpensive premade one-sizefits-all stretch wigs. I suggest avoiding any synthetic hairpiece which must blend into your remaining hair.

How long should I expect to wait for delivery of a custom, handmade wig or hairpiece, especially if it is to be made at the establishment where I’ve purchased it?
Delivery time should be no more than two to three weeks. Should this time frame go beyond five to six weeks, be aware that the item may be coming from abroad, with final adjustments only being done at the local establishment.

Will I be unrealistic in expecting the wig and/or hairpiece to last more than just a few months and to be comfortable wearing it after two or three years?
Provided it is a quality wig or hairpiece made of quality material and provided that you periodically have it professionally serviced and/or repaired, a quality wig or hairpiece certainly should last more than just a few months.

If the hair color is not what I ordered, or the hair length is not correct (it is too short), or the hair texture is not what I expected, should I allow the firm to dye or perm the hair in order to correct the error?
Absolutely not. If this is a custom made wig or hairpiece, color, texture, length, and fit should be exactly what you ordered.

If I am not satisfied upon pickup of my order, should I accept it and pay my balance?
Absolutely not. The establishment must either adjust what is wrong at no further expense to you, or remake the wig or hairpiece as per the original order.  If for what-ever reason the establishment refuses to do so, do not pay the balance and demand a refund of the original deposit.

How to Care for Synthetic Hair

Washing

  • Gently remove tangles using a wide tooth comb and turn inside out.
  • Use a mild shampoo (or a shampoo formulated to clean synthetic hair).
  • In a sink or basin, mix a capful of shampoo in cool water and immerse your hairpiece.
  • Let soak for five minutes. Gently swish and rinse the hairpiece in cool water until shampoo is removed.
  • Do not rub/scrub the wig; just swish from side to side and dunk up and down.
  • Rinse thoroughly

Conditioning

  • Using conditioner is highly recommended to reduce tangling.
  • Refill the sink or basin with clean cool water and add a capful or conditioner.
  • Immerse hairpiece and agitate gently. DO NOT RINSE OUT CONDITIONER.
  • Blot dry in a towel and then gently shake.
  • You can also use a “spray-in” conditioner. Simply spray your wig thoroughly after washing and blot dry with a towel to remove excess water.

Drying

  • To avoid damage, be sure not to rub, wring or twist, brush or comb wig when wet.
  • Allow your hairpiece to air dry on a wig stand or on top of a hair spray canister. Avoid using a styrofoam head form. It may damage your wig when drying.
  • DO NOT BRUSH OR COMB THE HAIRPIECE UNTIL IT IS COMPLETELY DRY.
  • Once dry, spray sheen or detangling spray onto the wig and comb or brush depending on the type of wig you have.

Don’t Use Heat
Never expose your synthetic wig to excessive heat as it will damage the hair fibers. Do not use hot blow dryers, curling irons, flat irons or similar tools to style it. Also avoid heat sources such as oven or open flames. They will melt the synthetic hair stands and ruin the wig.

Setting & Styling

Synthetic hair wigs can be set quite easily by following these instructions:

  • After washing, comb the hair (as instructed below) then set in rollers with rolling papers and setting lotion.
  • Put the wig under a sitting hair drier on low heat for 40 to 50 minutes. If you do not have access to a sitting drier, the wig may be left on a wig stand overnight until completely dried.
  • Once dry, take out the rollers and style the wig as desired.
  • A clothing steamer can be used to straighten synthetic hair. Place the wig on a wig stand, steaming the hair with a clothing steamer while combing the hair down.
  • If wig hair get frizzy, try any sheen spray or wig spray to calm the frizziness and then comb. If not, wash then set with a setting lotion to get the frizziness out. When wigs are tangled, use any detangling or sheen spray then comb the hair.

Combing and Brushing

Length

Style

Style With

Short

Straight /Wavy

Any combs or brushes

Short

Curly

Wide-toothed comb or brush out with fingers

Chin Length

Straight

Any combs or brushes

Chin Length

Curly/Wavy

Wide-toothed comb or brush out with fingers

Shoulder Length

Straight

Any combs or brushes

Shoulder Length

Curly / Wavy

Wide-toothed comb

Long / Very Long

Straight / Wavy

Wide-toothed comb

Long / Very Long

Curly

Brush out with fingers

Eyebrows  – Making Fake Look Fabulous

Tools for Designing Eyebrows

  • Foundation
  • Loose powder and sponge or powder puff
  • Eyebrow pencils (two colors: one close
  • to your hair color, another lighter)
  • Eyebrow shadow
  • Eyebrow brush
  • Pencil sharpener - Keep pencil sharp!
  • Q-tips
  • Hair spray

Application Steps

  1. Apply make-up foundation to face, including brow bone and eyelid.
  2. Use a sponge or powder puff to apply loose powder over make-up foundation on brow bone and eyelid. (This helps to set the eyebrow make-up.)
  3. Study your brow bone - your goal is to outline the brow bone. (This adds depth, definition, harmony and balance to your face.)
  4. Refer to the illustration above as a guide for drawing eyebrows.
  5. Use eyebrow pencil to make dots (points) to outline the shape of an eyebrow.
  6. The outline of the eyebrow should begin at Point 1, directly over the corner of the eye. Take a long pencil and align it with the edge of your nose and the inside corner of the eye. Use an eyebrow pencil to make the first dot at Point 1.
  7. The highest point of the eyebrow (or arch) is at Point 2, directly over the outer edge of the iris. Align a long pencil with the outer edge of the iris. Use an eyebrow pencil to make the 2nd dot at Point 2. The dot made at Point 2 should be higher than Point 1.
  8. The eyebrow ends at Point 3. Align a long pencil again with the outer edge of your nose and the outside of the eye. Use an eyebrow pencil to make a third dot at Point 3. The third dot should be parallel to the first dot.
  9. Use eyebrow powder to connect Points 1, 2, & 3 to form the shape of an eyebrow.
  10. Make outward strokes. Pick up a very sharp eyebrow pencil. Anchor your fist to your cheek bone with the eyebrow pencil in hand. (This helps to give you more control.)
  11. Starting at Point 1, use the very sharp eyebrow pencil to make short upward strokes at and slightly above the eyebrow line drawn with eyebrow powder. (This helps to create the illusion of eyebrow hair.) Make strokes from Point 1 to Point 2 straight up. Angle the strokes from Point 2 to Point 3. Add a few wild strokes to make the eyebrow look real.
  12. Spray a small amount of hair spray into the palm of your hand. Use your finger to dab a touch of the hair spray onto the eyebrow. (This helps to keep the make-up in place.)

Application Tips – Eyebrows

  • You can purchase eyebrow pencils and eyebrow powder at most make-up counters in department stores, beauty supply stores and drug stores.
  • If you have trouble keeping make-up on because of the climate in which you live, and/or perspiration, you may want to consider eyebrow tattooing. Costs can range from $300-$1,000; tattooing is supposed to last 5-10 years. Get references first!
  • Try the removable eyebrow tattoos.
  • Remember to sharpen your eyebrow pencils often - with every use, at the very least. The color of your eyebrows should be close to your hair color. Here is a guide for you:

Hair Color             

Eyebrow Color

Ashy, cool tones, brown or blonde

Ashy, cool tones, light to medium

Red or with reddish highlights

Auburn or brownish red

Platinum Blonde Taupe

light brown, medium brown

Golden, dark blonde

Medium brown or golden brown

Brunettes

Dark brown

Black

Dark brown or charcoal black

Grey or white

Medium brown or slate grey

Practice Makes Permanence!

At first, you will be frustrated when trying to apply eyelashes and drawing on eyebrows. Expect it. If it’s important to you, don’t give up. It takes us about 30 days to make a new behavior our own.

EYELASHES

Tools for Applying Eyelashes

  • Tweezers
  • Glue
  • Eyelashes - Upper
  • and Lower
  • Small scissors
  • Eye lining pencil
  • Mascara
  • Watch or clock
  • Toothpicks
  • Eyelash comb

Application Steps

Top Lashes

  1. Pull the eyelashes off of the package.
  2. Hold the eyelash up to your eye to see if you need to trim it. You may need to trim the end of the eye lash to fit the width of your eyelid, or you may need to trim the overall length of the lashes is they are too long. Make short jagged cuts to help create the illusion of real.  
  3. New eyelashes have a bit of glue on them from the package. Be sure to pull this glue off before you start to apply the lashes.
  4. Line the edges of your eyelids with eyeliner. Start with the upper lid, and get as close as you can to the bottom edge of your upper eyelid. Then line your lower lid.
  5. Squeeze a thin line of eyelash glue onto your finger. Then, with a pair of tweezers, pick up the eyelashes in the center and drag the edge of the eyelashes through the glue on your finger. Put a thin coat of glue on the edge of the eyelash.
  6. Let the glue sit on the eyelash for one minute before trying to apply it to your eyelid - until it gets tacky. If you apply the eyelashes before the glue is tacky, it will slide all around. If you wait too long, if will be too dry to stick.
  7. Lift the eyelash to your eyelid. Place it as close as possible to the bottom edge of your upper eyelid. Press the eyelash to the middle of your eyelid to get it to stick. Then, use the tweezers to place each end of the eyelash on the ends of your upper eyelid. You may need to adjust the entire lash a bit.
  8. Reline eyelid, if necessary. Use mascara, if desired.

Lower Lashes

  1. Cut each lash into two or three pieces.
  2. Clip edges so that they are shorter at the edges of the inside and outside of your eye.
  3. Drag edge of lash in glue. You won’t have to wait if using glue from applying upper lashes.
  4. Apply first piece to corner of eyelid, then apply 2nd and 3rd pieces.

Additional Tips for Eyelashes

  • Clean glue off daily - just pull it off with your fingers.
  • Clean mascara (or glue) off lashes with a lash comb.
  • Lashes last about a month.
  • Bring a tune-up kit with you - glue, tweezers and toothpicks - in case you become “unglued”.
  • Duo glue is highly recommended and can be found at Walgreens or Sally’s Beauty Supply.
  • You can find eyelashes in many drug stores, beauty supply stores and some make-up studios.

How to File for Insurance Reimbursement

Many people with Alopecia Areata are trying to convince insurance carriers to cover the cost of a prosthesis even when the law does not require it.  Information from people who have succeed in obtaining insurance payments for hair prostheses or medical treatments has been compiled in NAAF’s Insurance Packet. NAAF will provide this packet upon request.

Here, in brief, are the steps we suggest you follow to convince an insurance carrier to cover the cost of hair prostheses or medical treatment:

  • Check your benefits and covered expenses. Copy any page that specifically states that prosthetic devices (or treatments) are covered for alopecia areata or other types of hair loss.
  • Complete the claim form.
  • Obtain a doctor’s letter or prescription stating the need for a hair prosthesis or treatment.
  • Obtain the “Quality of Life Investigation of Patients with Alopecia Areata” from NAAF, and include it with your claim. This report by NAAF grant recipients Drs. Wilma Bergland and Berna Remzi contains an outline that indicates the negative impact of hair loss from alopecia areata.
  • Obtain receipt that says ‘hair prosthesis” and have the person who provides you with the prosthesis sign your insurance form.
  • Take pictures of yourself without a wig or corrective eye makeup (pictures can also be used to emphasize why treatment is needed).
  • Enclose a NAAF brochure describing alopecia areata.
  • Provide a detailed personal account of the emotional effects of your alopecia areata (and discuss the costs of frequent hair prosthesis purchases).
  • Ask your employer for a letter stating the importance of your general appearance, including your hair.

Prepare for Denial of Your Claim

  • Speak with your plan administrator.
  • Obtain a list of your rights as the Insured.
  • Obtain a copy of your full contract.
  • Know your contract.  Pay particular attention to exclusions for prosthetics (wigs may be excluded as cosmetic).  If your policy does not spell out exclusions under prosthetics, this may help you win your claim. If your claim is denied as ‘not a covered benefit,’ write an appeal.
  • Ask for a review by a medical review board
  • Attach a copy of your original claim and all supporting materials.  Explain the difference between a wig and a prosthesis.  Explain the functions of body hair: it protects the scalp from the sun; protects eyes from dust particles; regulates body temperature; filters particles from the nose and protects the skin.
  • If you are undergoing treatment, explain again how this is NOT cosmetic treatment.
  • Ask for a written reply (insurance companies resist writing anything that may be considered ‘bad faith’ in future court cases).
  • Send your appeal to a claims supervisor or manager. If you don’t, the person who initially reviewed your claim may reject it again.

Consider Small Claims Court

  • Keep all correspondence in preparation for this possibility.
  • Do not reply on your memory.
  • Insist on written confirmation from your carrier for all conversations.  Make sure this includes date, time and full name and title of the person with whom you spoke.
  • You should follow up all conversations with your own confirmation letter, which you should supply to the insurance carrier. Make sure to document the date, time, and full name and title of the person with whom you spoke.

Contact Your State Insurance Commissioner

  • You may file a claim against your insurance company through your state Insurance Commissioner’s office.

Work with your State Legislature to Secure Mandated Coverage


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