BH18 Wig education: are healthcare professionals wig-wise?

Abstract

Wigs offer a nonpharmacological intervention within NHS dermatology hair clinics, supporting patient wellbeing and holistic care. Despite this, wig provision and prescribing pathways vary across services, with clinicians’ understanding of wig services and prescribing processes poorly characterized. This study aims to assess clinicians’ knowledge and confidence of wigs and prescribing using a questionnaire-based approach, to identify educational needs and inform service improvement. A cross-sectional survey of clinicians within a teaching hospital dermatology department assessed self-reported understanding of wigs using a five-point scale (1 = poor, 5 = excellent). Knowledge of wig provision and care was evaluated through true/false questions covering cost, indications, safety and practical issues, including prescription pathways and the trust’s contracted supplier. Seventeen clinicians responded (85% response rate), including consultant dermatologists (n = 12), registrars (n = 1), clinical fellows (n = 3) and an advanced nurse practitioner (n = 1). Six of the 17 (35%) reported no previous experience prescribing wigs and rated their understanding below average. Knowledge varied across domains: most were aware of cost differences and provided accurate advice on wig use during sleep (15 of 17, 88%) and in relation to disease activity (13 of 17, 76%). However, 7 of 17 (41%) were unaware of the need for ongoing follow-up, and safety knowledge regarding synthetic wigs while cooking. Five of 17 (29%) believed NHS wigs were only indicated for scarring alopecia, 6 of 17 (35%) were unaware of differences in heat tolerance and replacement frequency between wig types, and only 3 of 17 (18%) correctly identified the trust’s contracted supplier. In summary, wig prescribing is not routine among dermatology clinicians, and many lack confidence and understanding of wigs and local pathways. Gaps in eligibility criteria, safety advice and follow-up may directly affect patient counselling, highlighting the need for targeted education. A recently introduced multidisciplinary model integrating clinicians, an on-site wig provider and a clinical psychologist aims to address these gaps, improve confidence and promote equitable access.