When TV celebrity Miki Yakata was told she would need chemotherapy after undergoing a mastectomy in April, she realized she would have to buy a wig.

“I found a relatively cheap one made from synthetic fiber on the internet,” said the 26-year-old, who was diagnosed with breast cancer at the start of this year. “But when I first started wearing it, my hair was falling out and my scalp was very damaged. On top of that, I was wearing the wig every day and it soon started to deteriorate. I didn’t know what to do.”

Yakata was a member of Nagoya-based pop group SKE48 for eight years until she left in February 2017, and she understood the importance society places on appearances. She looked at wigs made with real human hair but was disappointed to find that the prices, generally ranging from ¥200,000 to ¥300,000, were beyond her means.

Then she made a discovery.

“I found out that there was a nonprofit organization called Fukuribi that offers advice about wigs and also makes them,” she said. “I told them I was wearing a synthetic wig, and they told me wigs made from real hair were better. I got one from them. I thought wigs made from real hair would be too expensive for me. But this one was under ¥100,000 and it’s easy to wear. I’ve been wearing it since June.”

Aichi Prefecture-based NPO Fukuribi began life in 2007 as a visiting beauty service for the elderly, and expanded to open a salon providing specialist care for cancer patients in Nagoya in November 2015. Another branch opened in Tokyo in May this year.

Appearance Support Center Tokyo, located in the capital’s Bunkyo Ward, offers wigs, makeup advice and nail care for people undergoing chemotherapy. The side effects of the cancer treatment cause hair loss and harm the skin and nails, but Fukuribi General Manager Hitomi Iwaoka says the damage is more than just skin deep.

“Someone receiving treatment for breast cancer might lose a breast and their hair, and they feel they’ve lost their femininity,” said Iwaoka. “You can make a prosthetic breast, but you have to wait until after you’ve recovered from the operation. If you have a cute wig, you can transform yourself back to the way you used to look. A wig and makeup can give you a positive outlook.

“A lot of people don’t have enough confidence in their appearance to leave their houses. A lot of them fall into a state of depression. A lot of people will get a wig and they suddenly feel able to go out again.”

Fukuribi’s wigs can be made to order or bought off the shelf, and come in a variety of styles and lengths. The range of wigs made with real hair starts from ¥60,000, which Fukuribi director and wig designer Katsuyuki Akagi believes is a fair and symbolic price.

“Why is it ¥60,000? In one year, Japanese people usually spend about ¥60,000 to ¥80,000 at a beauty salon,” he said.

“This center started with our customers. One of our customers got cancer and ordered a wig from a big company. The wig arrived and they didn’t like it, so they tried another and didn’t like it. They were expensive. I was very dissatisfied with it all, so I really wanted to make a wig for that customer.”

The hair used to make Fukuribi’s wigs comes largely from China. Iwaoka explains that hair donated from Japan is often damaged from coloring and other treatment, and is generally not strong enough to use.

The wigs need to be washed about twice a week, and can last for 1½ to two years if properly taken care of. The hot summer months can make wearing them uncomfortable, but Iwaoka says Fukuribi is on hand to help patients deal with such problems.

“Patients can’t really ask doctors for advice on what they should do about their hair and nails,” she said. “Nurses are always busy and patients don’t feel they can ask them, so they carry that unease around with them.

“Being able to get advice here makes them more comfortable. They can get specific support here. For example, if the wig is too hot, you can put a small absorbent sheet inside to soak up the sweat. Sometimes hospitals will offer this kind of counseling, but not always.”

Yakata didn’t know where to turn when she was diagnosed with cancer earlier this year, after finding a lump on her breast and going to the hospital to get it checked out.

“First of all, I didn’t want to have chemotherapy,” she said. “I’m in the entertainment industry. I thought that if I lost my hair, even if I covered it, I would hesitate to appear in front of people.

“It was a horrible thought, but I knew I had to accept the fact that I was ill. A lot of people told me that chemotherapy patients’ hair starts to grow back a few years after they finish the treatment. I realized I wasn’t alone.

“I hated wearing a wig at first,” she continued. “If you have no hair, people who know the reason will understand, but people who don’t will be surprised by it. I would pick up on that and I hated it. I resented the fact that I had to wear a wig, but then I just tried to enjoy it. I used to have short hair, but now I can wear a long wig or one that’s a different color. I look on the bright side and enjoy it.”

Cancer has been the leading cause of death in Japan every year since 1981, according to the latest report from the Health, Labor and Welfare Ministry, which includes data up to 2017.

But Japan also had the highest five-year survival rate for lung cancer and esophagus cancer among 71 countries and regions in a survey conducted by an international research group and published earlier this year in the British medical journal The Lancet.

Japan’s five-year breast cancer survival rate of 89.4 percent in the same survey, however, was lower than the United States’ 90.2 percent and Australia’s 89.5 percent, but higher than France’s 86.7 percent and South Korea’s 86.6 percent.

Iwaoka believes attitudes toward cancer are changing in Japan.

“In the past, people thought that being diagnosed with cancer meant certain death,” she said. “These days, more and more people feel positive going into cancer treatment. But on the other hand, the realization that you might not die straight away means you need money, so you can’t quit your job. More young women are getting cancer, and some have young kids and they need to keep being a mother to them.

“A wig is a good weapon to use in all the battles you need to fight — you have to deal with cancer and you also have to deal with everyone looking at you. You have to be strong, and a lot of women look at this as a weapon to allow them to do that.”

The majority of people who use Fukuribi’s services are women, but Iwaoka says more and more men are coming to them for advice.

“In the past, men would just shave their hair off and be done with it, but recently a lot of them are concerned about it,” she said. “You might have an older man whose daughter is getting married and he doesn’t want to turn up with a skinhead. Or young men who are trying to get a job.

“A lot of men feel embarrassed to ask for advice about their nails. They’re embarrassed to wear anything glossy. You can get stuff without gloss, but they won’t know that unless they ask for advice.”

Yakata has now finished her chemotherapy and radiation treatment, and for the next few years she will be undergoing hormone therapy. She has also become a familiar face on TV, appearing on various shows to discuss her experience and give advice to others.

She says she has realized that “how you feel inside is more important than looking perfect,” but she is also grateful for Fukuribi’s support and she appears as a model in the NPO’s promotional material.

Iwaoka believes there is much work still to be done.

“I think this job is very necessary,” she said. “As far as we’re concerned, people should be able to go into any beauty salon and get advice on wigs to deal with chemotherapy. I don’t think you should need a special place to go for that, but that’s still not a part of Japanese culture, so a place like this is still necessary.

“If what we do becomes the standard in the future, there will be no need for us to exist.”

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