It is perfectly normal for people to shed 50 to 100 hairs per day. This generally doesn't cause noticeable thinning of scalp hair because new hair is growing in at the same time that hair is shedding. However, hair loss occurs when this hair growth cycle and shedding is disrupted or when the hair follicle becomes destroyed and replaced with scar tissue. Female pattern hair loss (androgenetic alopecia) is the most common form of hair loss in women. This occurs gradually and is caused by genetics (from either side of the family), age, and the action of a specific male hormone, dihydrotestosterone (DHT). This hormone is found in lesser amounts in women and it preys on the hair follicles, preventing them from receiving vital nutrients for proper hair follicle growth, leading to the hairs shrinking, and resulting in a shorter lifespan. Interestingly, DHT does not need to be elevated to generate hair loss. Estrogen, when lowered as commonly seen in menopause, creates a change in the ratio of male to female hormones, giving an edge to these male hormones. Compounded with the sensitivity of DHT to the hair follicles, heredity can affect the age at which a woman begins to lose her hair, as well as the rate of hair loss and the extent of baldness.
There is pilosebaceous inflammation with both scarring and non-scarring alopecia depending on the degree of inflammation. Most commonly, there is involvement of the head and neck, though widespread involvement is also seen. Eyebrow loss is a prominent finding and may be the presenting symptom when the eyebrow region is involved in the acute benign form of follicular mucinosis.
Eyebrows frame your face and play an important role in your facial appearance and expressions. If the hair in your eyebrows starts falling out, you are sure to see a difference in your appearance, which you may want to rectify. Many conditions can cause eyebrow loss. However, you can usually take steps to reverse the effects, such as eating a healthy diet and adjusting your beauty routine or lifestyle to account for the natural aging process.
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DLE is an autoimmune condition and is the most common form of chronic cutaneous lupus erythematosus. Clinically, the lesions start as discoid erythematous patches which then develop into plaques with follicular plugging and scaling. Eyelid findings include blepharitis, lid scarring, entropion, and ectropion. Scaly plaques on the eyelids with loss of hair follicles results in madarosis [Figure 3]. Numerous studies have reported the mimicking of a chronic blepharitis by DLE.[35,61–63] A high index of suspicion is necessary in such cases, where the diagnosis is very often delayed by months to years. Biopsy with histopathological examination should be done to confirm the diagnosis. Treatment with hydroxychloroquine results in a regrowth of the eyelashes.