Hair Prosthetic Injuries Disproportionately Affect Women in US Emergency Departments
Key Takeaways
A new study shows hair prosthetic–related injuries presenting to US emergency departments increased by 56.3% from 2013 to 2022.
Women accounted for 94.1% of cases, with Black women comprising 53.4% of injured patients.
Dermatitis, lacerations, and contusions were the most common diagnoses, most frequently involving the head, eyes, and ears.
A recent analysis of the National Electronic Injury Surveillance System (NEISS) looking at hair prosthetic–related injuries presenting to US emergency departments (EDs) between 2013 and 2022 suggested these injuries disproportionately affect women.
Hair prosthetics, including wigs and hairpieces, are widely used to address alopecia and other hair disorders and may improve quality of life and self-esteem, according to the authors. Adhesives, fixatives, and device components can contribute to scalp and periauricular injury. Using keyword queries for “wig,” “hairpiece,” and “toupee,” investigators identified 88 cases to evaluate. Mean patient age was 34 years (range, 2 to 84), and 94.1% were female. Race was documented in a subset of cases; 53.4% of injured patients were Black and 10.2% were White. Overall injuries increased by 56.3% during the study period. White women presented more frequently than White men (10.8% vs. 0.0%, P = 0.002). Race documentation was less frequent among patients aged 35 years or older compared with younger individuals (46.3% vs. 25.5%, P = 0.04).
Dermatitis, lacerations, and contusions were the most common diagnoses. Lacerations were more frequently reported in women than men (16.9% vs. 0.0%, P < 0.001). Women also more often reported wig-related pain (6.0% vs. 0.0%, P = 0.02) and sustained more ear injuries (7.2% vs. 0.0%, P = 0.01). The head, eyes, and ears were the most commonly affected anatomic sites.
"Hair prosthetics are an avenue for patients to address hair changes, improve their self-esteem, and feel empowered over their scalp and hair concerns," the authors concluded. "However, sub-groups, such as Black women, appear to be disproportionately affected by scalp reactions and prosthetic-related trauma in the ED. Dermatologists are encouraged to increase patient education and preventative measures to minimize prosthetic injury."
Source: Khatri S, et al. Journal of Drugs in Dermatology. 2026;25(3):9186