Here’s a topic that is a real concern for men (and women) who wear hair replacements that we haven’t found discussed anywhere. Acne can break out on the scalp underneath toupees and wigs that come in contact with the scalp. There is also a kind of acne that is caused by hair extensions. Dealing with this kind of acne requires a totally different approach from dealing with acne on the face.
The reason acne breaks out on the scalp underneath hairpieces is that a glue or tape used to secure the hairpiece in place irritates the skin and the skin attempts to repair itself by producing sebum. There is a kind of blue sticky tape that hair salon operators will apply to the lower edges of a toupee to give it a “grip” on the scalp so the hairpiece doesn’t fly away in the wind. Not having your hair blow down the street on a windy day is of course a major plus in any hair replacement system, but any time a glue gets extremely sticky and stays on the scalp for the week, two weeks, three weeks, or month between hair appointments the sebaceous glands of the scalp will be activated.
Sometimes the excess production of sebum just generates a flaky yellow film on the scalp. So much sebum can build up that, ironically, the toupee sheds flakes of dandruff as if it were hair. Acne bacteria can build up in the pores to form small red pimples. It’s unusual to have a large pimple underneath the tape used to bind the hair replacement to the scalp because there is so little circulation through the skin of the scalp that the immune system does not generate much inflammation to fight the acne. On the other hand, acne-like infections such as impetigo can and do spread underneath toupees and can cause so much damage to the skin that the hairpiece cannot be reapplied.
What can people who wear hair replacement systems do to prevent acne and other skin infections?
First of all, if the salon provides you with a disinfectant to squirt on or (if your hairpiece has a lace front) under your hairpiece every day, use it. Don’t worry about all the things we tell you about the irritant effects of antiseptics on your face. Hairpieces can be great breeding grounds for bacteria and you need a way to keep those bacteria in check.
Secondly, shampoo every day. If you are only going to shampoo once a day, it’s best to shampoo after you work out or get sweaty. The accumulation of sweat underneath your hairpiece can cause a form of acne known as acne mechanica, especially if your hairpiece wasn’t not custom made and there are gaps in coverage against your scalp.
Many people who wear hair replacements have a problem with forehead acne, especially if they wear hair replacements with lace fronts. Sewing the hair into a piece of lace used at the front of the hairpiece makes the hairline invisible if you want to comb your hair back. However, the glue used to keep the lace front glued to your scalp clogs pores on your scalp and, if you don’t rinse backwards when you wash your hair. The skin on your forehead is more acne-prone than the skin on your scalp, and the glue used on the lace can clog more pores on your forehead than on your scalp.
It also helps to make sure you wash your bed linens, especially your pillow cases, at least once and preferably twice a week, and if you don’t sleep on a mattress that is more than 8 years old. Mattresses and bed linens can accumulate a skin mite known as Demodex folliculorum. It burrows into your skin and causes itching. If you have a hair replacement, you know that scratching around on your scalp is not exactly the best way to extend its life. One good scratch can cost you a few hundreds to a few thousand dollars, depending on the model. The mite triggers asthma attacks. And if also activates the immune system to fight acne bacteria.
The damage acne does to the skin isn’t accomplished by acne bacteria themselves. It’s mostly a result of leukotrienes and histamine released by the skin itself. The immune system attempts to kill bacteria with inflammation, but the bacteria release chemotactins, chemical decoys that redirect the immune attack to the skin itself.
People who have problems with sebum buildup can also benefit from “hair vitamins.” If the idea of spraying a hairpiece with a vitamin solution sounds more than a little odd, well, it is. You don’t need to provide nutritional supplements to artificial hair. But the B vitamins—especially biotin (vitamin B9)–help the scalp fight the mites that irritate the skin and trigger the production of excess sebum.
Other things you can do to prevent under-the-hairpiece acne include:
- Get a patch test for dyes before you get a new hairpiece. Most hairpieces are made with black hair, whether it is donated human hair or synthetic. Dyes are applied to the hair to make the hairpiece match any hair remaining on the scalp and to make sure the hairpiece does not clash with natural skin tones. If this is done at your local salon (sometimes it’s not), make sure the dyes your stylist uses are non-allergenic by doing a patch test before the hairpiece is cut in for its first use.
- Try tape before it is put on your scalp. Poorly fitted hairpieces require lots and lots of tape. Before you get tape applied to your scalp, make sure that you aren’t allergic to it. Take a snip (just 1/4″ x 1/4″ or 5 mm x 5 mm or so) of the tape and put it on the inside of your forearm overnight. It there is not redness or irritation on your arm, then it is probably safe on your scalp.
- When you get your shampoo at the hair salon, ask your stylist to use a product with jojoba or polyethylene plastic beads. These beads will break up sebum that has accumulated on the pores of your scalp since your last visit. Typically your stylist will have a variety of appropriate scalp care products and know to rinse thoroughly from front to back.
- Spend more to get a good fit. Bad toupees are the toupees that cause scalp problems. Spending more not only helps you look better, it can prevent a plethora of acne-related problems underneath your hair.