Hair Pieces

Hair loss from alopecia areata can be frustrating and challenging—in many ways. But finding a wig (or hair piece) that reflects you — your identity, confidence, and sense of normalcy — shouldn’t be another hurdle. This guide equips you with essential knowledge to help you make informed, empowered decisions about hair loss solutions that support your journey.  

Toppers vs. Full Wigs

Toppers or partial hairpieces (sometimes called “crowns”) are ideal for individuals with partial hair loss, especially at the crown. They blend with your existing hair to add volume and coverage and are available in synthetic or human hair options. They usually clip onto existing hair using combs that are attached to the topper base.  

Full Wigs (also called cranial prostheses) offer total scalp coverage for those with severe or complete hair loss. Wigs come in a variety of fiber types (human hair, synthetic, synthetic blend) and a wide range of styles, colors, and prices. Your choice will depend on your level of hair loss, lifestyle, and styling preferences. 

Fiber Type: Human Hair vs. Synthetic Fibers 

Wig fibers refer to the material used to create the hair, and they play a major role in how a wig looks, feels, and fits into daily life. The three most common fiber categories are synthetic, heat-friendly synthetic, and human hair, each with distinct advantages and trade-offs. 

Traditional synthetic fibers are made from specially engineered materials designed to hold their style. These wigs arrive pre-styled and retain their shape even after washing, which makes them a popular choice for beginners or anyone who wants low maintenance. Synthetic wigs tend to be lighter in weight and more affordable than human hair wigs, and they perform well in humid conditions. However, they cannot usually be heat styled and may have a shorter lifespan (4 – 6 months) with daily wear. Some people find the fibers “shiny” (especially blonde colors) and lack natural movement. 

Heat-friendly synthetic fibers offer a middle ground between traditional synthetic and human hair. They look very natural and allow limited heat styling (blow dryer, curling iron, straightener, etc.), giving wearers more flexibility to change the look. Some makers also offer a hybrid of heat friendly synthetic fibers blended with human hair. Heat-friendly fibers require more care than traditional synthetic wigs and are more sensitive to friction from clothing, scarves, or car/plane seat headrests. For people who wear wigs daily, this type of fiber can be appealing but may need more frequent replacement. 

Human hair fibers are made from real human hair and provide the most natural movement, texture, and styling versatility. These wigs can be cut, colored, and styled much like biological hair, which many people find empowering. However, human hair wigs are the most expensive option (hundreds to thousands of dollars). They do require the highest level of maintenance, including regular washing, conditioning, and styling, but if cared for properly, can last for years. They are also more affected by weather and humidity. For some, the realism and flexibility are worth the added effort; for others, the upkeep can feel burdensome. 

Ultimately, the “best” fiber is the one that fits your lifestyle, comfort level, and budget. 

Cap Construction 

Wig cap construction refers to how a wig is built on the inside—the materials used, how the hair is attached, and how the cap sits against the scalp. For people with alopecia areata, cap construction can be just as important as the hair itself, since it directly affects comfort, breathability, security, and how natural the wig looks, especially when there is little or no biological hair to cushion the scalp. 

Wefted caps (also called “basic” caps) are the most common and typically the most affordable construction. Hair is sewn into rows (called wefts) that are attached to a stretchy base. These caps are lightweight and allow for good airflow, but they usually have a less realistic appearance at the part and hairline. Wefted caps work well for occasional wear or for people who prioritize breathability and cost over realism. 

Monofilament caps feature a fine, transparent mesh at the crown or the part of the wig where individual hairs are tied to mimic the look of natural hair growth. This construction allows the hair to be parted in different directions and creates a more realistic scalp appearance. Monofilament caps are often more comfortable than basic caps for sensitive scalps. 

Lace front caps are designed with a sheer lace panel along the front hairline, allowing the wig to blend more seamlessly into the forehead/natural hairline. This creates the appearance of hair growing directly from the scalp and makes it possible to wear the hair pulled back or off the face. The quality of lace can vary—less expensive lace fronts may be tied in with larger knots, looking a bit less realistic. However, a high-quality lace front will be nearly undetectable and should “melt” into the hairline. Lace fronts can be combined with other constructions, such as wefted, monofilament caps or hand-tied caps. 

Hand-tied caps are considered the highest level of quality of cap construction. Each hair is individually tied throughout the entire cap, resulting in exceptional movement, softness, and comfort. Because there are no wefts or seams, hand-tied wigs are ideal for people with total hair loss or scalp sensitivity. They are also the most expensive option, but many wearers find the natural look and feel worth the investment. 

Medical wig caps usually refer to features included in cap construction to make the wig secure and comfortable for those with total hair loss. These might include soft bamboo, silk or cotton lining, and/or silicone gripping to enhance security for those with no scalp hair. Medical cap features are then added to monofilament, lace front and /or hand-tied cap construction. 

In practice, many wigs combine multiple construction features—such as a lace front with a monofilament top and wefted back—to balance realism, comfort, and affordability. Understanding these differences can help you choose a wig cap that works best for your comfort needs, how often you’ll wear it, and your personal style. 

Measuring for a Wig 

If you visit a wig boutique, the wig professional will measure your head to ensure a proper fit. However, if you are purchasing from an online retailer, you should know your head’s measurements so you can select the correct size. 

You’ll need a fabric measuring tape, mirror, and something to record your measurements. If you have a trusted friend or partner, ask if they can help. 

Step-by-step: 4 key wig measurements 

1) Circumference (most important and typically the number used to determine basic wig sizes, e.g., small/petite, average, large) 

• Place the tape at your front hairline (or where you want the wig hairline to sit), usually about 4 fingers above the eyebrows. 
• Run the tape above the ears, around the back of your head to the nape, and back to the starting point. 
• Keep it snug but not tight (you should be able to slide 1 finger under the tape). 

2) Front to nape 

• Put the tape at the center of your front hairline (or desired hairline position). 
• Run it straight over the top of your head to the center of the nape (where your head meets your neck). 

3) Ear to ear (over the top) 

• Place the tape at the point just above one ear where the wig’s ear tab would sit. 
• Run it over the top of your head to the same point above the other ear. 

4) Temple to temple (around the back) 

• Place the tape at one temple (about where eyeglass arms sit). 
• Run it around the back of your head (not over the top) to the other temple. 

If you’re between sizes, it’s usually better to go slightly larger (a wig can be adjusted smaller more easily than stretched bigger). 

Webinars

WEBINAR

The Good, the Bad, and the Itchy: Managing the Wigs Process and Cosmetic Challenges in Alopecia Areata

WEBINAR

Your Questions Answered! More on Managing the Wig Process and Cosmetic Challenges

Resources

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