This section presents the results from the desktop research, manufacturer and user surveys, NHS study and wig bank interviews that were conducted in this research. The section is structured according to the four high level stages of the FHP life cycle: global sourcing and manufacture of FHPs, UK imports and exports of related products (including manufacturers and suppliers in the UK), product use and disposal.
Global sourcing and manufacture
As identified in the literature, the majority of human hair is sourced from India, through the religious process of tonsuring , although China, Brazil, Peru and Eastern Europe are major sources of human hair. In countries such as the UK, human is donated to charities to be made into wigs for those that have lost hair for medical reasons. Hair that has been sourced from Europe is much more expensive  due to its colouring and lack of availability. Synthetic materials for FHPs are typically manufactured in countries including China, Japan and Korea.
The raw materials (both human hair and synthetic fibres) are sent to countries including China, Myanmar and Bangladesh for manufacturing – China is the biggest importer of human hair according to data from the Observatory of Economic Complexity . With limited peer reviewed data available, market reports estimate that China increased its imports of human hair to 1.1 million kg in 2015. It is during the manufacturing process that human hair is chemically treated. This process involves untangling the hair by hand, bleaching and chemically treating the hair to remove the cuticles. The exact chemicals used in this process remain unknown. The finished products (both human hair and synthetic FHPs) are then exported, with countries including the United States, United Kingdom and other parts of Western Europe as major importers of FHPs. Figure 4 summarises the global trade in both human hair and synthetic FHPs.
International standards (ISO9001:2000 and ISO4001:2015) are met by some major suppliers of synthetic materials used in FHPs and relate to requirements for a quality management system in the organisation and requirements for an environmental management system for the organisation to enhance environmental performance. However, it is not apparent whether these standards are met by all major suppliers and there was no evidence found of standards in place to regulate the quality of the product or safety of the user or of any quality control relating to the sourcing or processing of human hair.
UK import/export of FHPs and related materials
On a global scale, a review of internet findings indicates that China, Indonesia and Hong Kong are the main exporters of human hair wigs, with the total export value around $1.2 billion in 2015 . Top importers of human hair wigs were the USA, Japan, UK, France and Republic of Korea, with a global import value of $98 million .
Analysis of UK imports and exports through the Observatory of Economic Complexity (OEC)  database identified a lack of standardisation regarding the categorisation of false hair products. The following classifications were identified as relevant to the FHP industry:
Hair, human unworked, waste human hair
Wigs, false beards, eyebrows, etc. of human hair
Wigs, false beards, eyebrows, etc. of other materials
Complete wigs of synthetic textile materials
UK imports and exports of these products are summarised in this section. There has been a rise in the amount of FHPs and related material exported from the UK since 2010, reaching a peak in 2014 as shown in Fig. 5. It is unclear why this then dropped in 2015 – potentially due to changes in legislation or categorisation of such products. However, there has been a general rise in the value of exports over this five year period. What remains unknown from the data is the quantity of individual units – this raises uncertainty over whether more products are being exported or if it is simply the value of those products that has increased. Fake hair was the highest value export over this time frame, although it is unclear exactly what products fall under this category.
UK imports also show a general increasing trend since 2010, with a significant increase in the import of fake hair and human hair products in 2012, as shown in Fig. 6. Again the case for this rise is unknown. Fake hair is again the highest value import, with fake hair, wigs made from synthetic materials and wigs made from human hair showing an increase over the time frame.
It is noted that the above data has shortcomings, regarding the definition of the categories provided by the OEC. No definitions are provided within the data source, leading to difficulties in identifying the types of materials and products included in each import and export category. For example: not all human hair waste may be utilised in the false hair industry, fake hair does not necessarily imply it replicates human hair nor that it is used for the purpose of FHPs, while processed hair may not necessarily be human. However, by examining all categories an overview of the import and export of the materials used in the false hair market in the UK is provided.
Additional information relating to the UK’s import and export of FHPs came from charities in the UK, which provides wigs to cancer patients who have lost hair due to treatment. Informal discussions with the charity identified, since its creation in 2006, the charity has given out 5000 wigs, typically at a rate of 100 per month. The charity reported that donated hair was received in ponytails and plaits, which was sorted in terms of colour and length and air freighted to the manufacturer, categorised for export as “human hair”. The finished product is returned to the UK as “hair pieces”. Based on the data gathered from the OEC, it is unclear what category “hair pieces” would fall under.
Based on the import/export data for the UK, an assessment of the environmental impact of the global supply chain of FHP materials and production estimated the carbon emissions to transport manufactured FHPs from China to the UK was calculated. Using figures provided by the World Shipping Council , a 10,000 container capacity cargo ship emits 10 g CO2 to carry one tonne of cargo 1 km, it was estimated that the transport of one tonne of FHPs from Qingdao Port to Felixstowe would produce 227,040 g CO2. Market reports estimate the UK imports around 1000 t of FHP products and materials a year, resulting in 2,270,400 kg CO2 annually – equivalent to the annual CO2 emissions from 400 homes in the UK .
In a survey to wig suppliers and manufacturers in the UK, it was found that only 17% solely sourced products from within the UK, indicating that this is very much an international industry. Companies that responded manufactured and sold a range of FHPs, with full and partial wigs, toupees and wefts the most popular. Other products included weaves, extensions, toppers and eyelashes. Full wigs were reported as the bestselling product due to high demand – however, it is noted that this may be due to many respondents indicating that they were a supplier of wigs to the NHS.
Use of false hair products
This section presents the results gained from the NHS in relation to the number of patients registered with hair loss and the number of wigs provided by the NHS. Results from the user surveys are presented in relation to those using FHPs due to medical hair loss and those using FHPs with no hair loss.
NHS provision of FHPs
Results from Freedom of Information requests to the NHS were analysed to assess the medical demand for FHPs and the product type supplied by the NHS. The provision of wigs on the NHS varies within the UK. In Scotland, alopecia patents can receive up to four synthetic wigs or one human hair wig per year from the NHS. Cancer patients who have lost their hair can receive up to two synthetic wigs per year, but cannot receive a human hair wig from the NHS . In other parts of the UK, there are no nationally set limits on the number of wigs a patient can receive from the NHS, although there is nothing in place to prevent local NHS organisations from setting their own limit . Unlike in Scotland, users receiving wigs provided in other parts of the UK are subject to prescription charges. Human hair wigs are not provided by the NHS in England unless the patient is allergic to the synthetic alternative.
Table 1 summarises the responses gained from the Freedom of Information request to each NHS region. Only eight regions provided data on the number of people registered with hair loss, with two providing data on wig suppliers and number of wigs provided. It was found that hair loss is often either not recorded or is contained within individual patient case files and therefore not accessible with a Freedom of Information request. As hair loss is often experienced as a result of another medical condition (i.e. cancer treatment) it is not the primary cause for the patient to be admitted. However, this does not address why there is no record of those with long term hair loss available from the NHS.
The lack of data regarding the number of patients with medical hair loss is surprising, but further highlights the lack of data available in this field. NHS Scotland reported providing 13,328 wigs in 2016, while Northern Ireland reported 2991 wigs fitted for the year 2013. The NHS in England and Wales were unable to provide the total number of wigs provided by the NHS. The lack of data relating to those with long term hair loss and those with hair loss as a result of chemotherapy is concerning and makes it difficult to estimate the size of this market.
User survey – Long and short term hair loss
To gain a more detailed understanding of the types of FHPs used by those with hair loss, a user survey was conducted with two user groups with hair loss: those with long term hair loss and those with short term hair loss. 231 people with long term hair loss and 40 with short term hair loss responded.
Full wigs were the most popular FHP, used by 90% of those with long term hair loss and 75% of those with short term hair loss. Synthetic fibres were the most common material, used by 64% with long term hair loss and 59% of those with short term hair loss. The findings of product type and material are summarised in Fig. 7. Users reported that maintaining a natural look, avoiding attention and increasing confidence were key factors they associated with their FHP. However, many users reported issues with FHP quality and cost, noting that wigs were expensive to buy and replace, and when worn every day the quality of the wig did not last.
Users replaced their FHP on average 11.2 months for long term hair loss and 12.2 months for short term hair loss. Those with long term hair loss paid between £100–£200 for their FHP, while those with short term hair loss paid £200–£300. Only 5% of users with long term hair loss received their FHP from the NHS, in contrast to 62% of those with short term hair loss who had their FHP paid for by the NHS. Users were asked the condition of their FHP at the time of disposal – breakage and thinning of hair was the most common response and included frizzing of the hair ends (particularly for synthetic materials) and poor overall condition of the hair. Breakage, tearing and stretching of the cap were also widely reported.
User survey – No hair loss
It was impossible to source exact figures of the FHP market itself in the UK. However, figures from the hairdressing and beauty industry suggest the industry as a whole is growing. The National Hairdressers’ Federation reported over 40,000 hairdressing, barbers and beauty salons in the UK for 2016, up 5000 from 2011 to 12 figures reported by HABIA . The industry employs up to 270,000 people in the UK, making it the 5th most popular independent start-up business. Online reports estimate the UK hair extension industry to be worth between £45–£60 million, with some companies reporting a 70% growth over the last five years.
The user survey conducted as part of this study included those with no hair loss, with 67 respondents. Within this group, the type of FHPs used varied and included extensions, weaves and full wigs as the most popular products of choice as shown in Fig. 8. Motivations for wearing a FHP included dislike of own natural hair, a change in style and ease of maintenance. 56% reported their FHP to be made from human hair, while the remaining 44% currently used products made from synthetic fibres.
Users replaced their FHP on average every 3.2 months with the majority paying under £100 for their product. In many cases, users commented that this was due to a desire to change the style of their hair. Condition of the FHP at the time of disposal varied between those who updated due to the condition of the FHP (with the hair fibres becoming frizzy and adopting a tired appearance) and those who updated their FHP for a change of style (in which case the FHP was generally in good condition when disposed of).
User response to sourcing and manufacture of FHPs
Table 2 summaries user responses to whether they would want to know whether materials used in their FHPs have been ethically sourced and the product sustainable manufactured. On average 70% of users across the three surveys wanted to know the materials had been ethically sourced, while 73% wanted to know the FHP had been sustainably manufactured. Figure 9 illustrates user importance placed on ethical sourcing, sustainable manufacture, both or neither – results were mixed between the three user groups, showing those with long term hair loss were more concerned with the sustainable manufacture of their FHP, while 59% of those with no hair loss felt both ethical sourcing and sustainable manufacture were equally important. When asked to expand on their responses, users reported: “I wish the donators to do so of their own free will and be compensated fairly” and “it is important no one is being unfairly treated or areas being misused”. Those that did not want to know the sourcing and manufacturing origins of their FHP responded: “there are such limited options available, the look and feel of the wig has to be the top priority” and “all that matters is that I look normal and comfortable – where it comes from is quite irrelevant”.
Disposal of FHPs
Informal interviews were set up with six wig banks in the UK to identify donations of used FHPs, restoration/reuse of these products and their disposal. Only wigs were donated – no other types of FHPs were reported. General findings indicated that wigs are often donated directly to the wig bank (either posted or delivered). The number of wigs donated varied between wig banks – from an average of 10 per month to 5–10 per year. One wig salon had announced a second hand wig event less than a month before the time of interview and had received 40+ wigs from their customers over that timeframe, indicating that people were more likely to donate their FHP if they were aware of accessible facilities to do so.
With respect to the re-use of false hair products, only one example was identified in the UK where materials from used FHPs were reused in another, new product. In this case, those who wore quality human hair extensions are given the opportunity to donate their used extensions to charity, where they are made into wigs for those who had lost their hair through cancer treatment. The extensions used are made from human hair and are extremely high quality, which if maintained correctly, will remain for many months. Although only one example of this kind of material reuse was reported, it provides an example of the potential for the reuse of human hair, resulting in a quality product.
Most wigs donated to the wig banks were synthetic – wig banks that received human hair wigs tended to come from users who had received them themselves from charity, indicating that these higher quality human hair wigs were rarely bought by the users and had typically been used by those undergoing cancer treatment. Issues with the reuse of wigs included hygiene concerns and wigs often being personalised in terms of colour and style for the original recipient. The condition of the wigs received by the wig banks varied, with synthetic wigs typically reported as “frizzing” where the fibres had rubbed on the shoulders – in this case, the frizzed ends were cut before reuse. The reuse of wigs also varied between wig banks – some reused all donated wigs, not disposing of any as all donated wigs were in good condition. Others only reused wigs that were considered to be in good condition, while donating those of poorer quality to hairdressers for training purposes or to theatre groups. Where wigs could not be reused in anyway, they were disposed of as landfill waste. Wigs that were reused were typically cleaned (sterilised, washed, dried and treated) and restyled (cut to remove frayed ends).
Within the user survey, users were questioned on the condition of their FHP when it was disposed of. Responses from those with long and short term hair loss indicated that FHPs were in poor condition at the time of disposal with breakages in the hair most common, in addition to wear and tear of the cap. In contrast, responses from the user group with no hair loss reported that many FHPs were often in good condition and were replaced due to the user preferring a change in style. This agrees with finding where those with no hair loss reported their FHP lasting an average of 3.2 months, whereas FHPs used by those with long and short term hair loss lasted closer to a year on average. This indicates differing uses between user groups, where many users with long and short term hair loss use their product until it becomes worn out, while those with no hair loss update their FHP more frequently due to style changes.
The user survey asked each of the user groups how they currently disposed of their FHP, as shown in Fig. 10. It is clear the majority (72% long term hair loss, 58% short term hair loss, 96% no hair loss) currently dispose of their FHP by throwing it in the bin. However, when users were asked whether they would recycle their FHP if the facilities were available to do so, the majority (86% long term hair loss, 89% short term hair loss, 67% no hair loss) responded that they would. The user surveys also asked FHP wearers whether they would wear a recycled, remanufactured or reconditioned FHP worn by either themselves or someone else, the results of which are summarised in Table 3. While the response to wearing someone else’s recycled/reconditioned/remanufactured FHP was close to an even split for users with long term hair loss, a significant majority of those with short term hair loss and no hair loss would not wear a product previously worn by someone else. Quantitative responses from users indicated that hygiene issues associated with such a personal item were the main reason for user reluctance to buying a recycled/reconditioned/remanufactured product – “I don’t know if another person would keep their wigs as clean” and “a wig is a personal thing so I wouldn’t be comfortable wearing one that someone else had previously worn”. Other responses simply indicated that users were not prepared to buy second hand goods – “I think it’s related to social stigma around second hand personal items, and also knowledge of its previous use”. The majority of respondents from all user groups indicated that they would wear a recycled/reconditioned/remanufactured FHP that had previously been worn by themselves.
Manufacturers and suppliers were also questioned on how they disposed of waste materials. Human hair was identified as the most common waste material, with all respondents reporting they disposed of waste materials in landfill.
Current FHP life cycle
In response to the first research question – what is the current life cycle of FHPs – the first complete life cycle analysis of FHPs is illustrated in Fig. 11, based on results detailed in this section. The life cycle is predominantly linear – little evidence was found of current recycling and reuse of materials. The life cycle illustrates the global supply chain of materials and manufacture of FHPs, before the products are sold, used and disposed of within the UK market. Although not significant within the size of the false hair market, instances of product reuse are noted where users donate used FHPs to wig banks. These FHPs are either reused by the user, theatre groups or hairdresser training. Products that are not suitable for reuse are disposed of.