Androstenedione, which is mostly produced in the ovary and adrenal glands, is converted to testosterone by 17β-hydroxysteroid dehydrogenase. Testosterone then circulates throughout the body to reach its target tissues. Androgen-metabolizing enzymes have been found in many parts of the hair follicle (Table 1; Bolognia et al., 2012). The presence of those enzymes makes the pilosebaceous unit a site of androgen metabolism and synthesis (Fazekas and Sandor, 1973). Circulating free testosterone either binds to intracellular androgen receptors in the hair bulb and dermal papilla, which facilitates miniaturization of the follicle, or is metabolized into dihydrotestosterone (DHT) by the enzyme 5-alpha-reductase. DHT then binds the same receptor but with much greater affinity (Kaufman, 2002, Levy and Emer, 2013). Of the androgens depicted in Figure 1, only DHT and testosterone bind to androgen receptors (Burger, 2002).
Sara Gottfried, MD is the New York Times bestselling author of the new book, Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, and Turn Back the Clock 10 Years. Her previous New York Times bestsellers are The Hormone Cure and The Hormone Reset Diet. After graduating from Harvard Medical School and MIT, Dr. Gottfried completed her residency at the University of California at San Francisco. She is a board-certified gynecologist who teaches natural hormone balancing in her novel online programs so that women can lose weight, detoxify, and slow down aging. Dr. Gottfried lives in Berkeley, CA with her husband and two daughters.
It’s not the amount of testosterone or DHT that causes baldness; it’s the sensitivity of your hair follicles. That sensitivity is determined by genetics. The AR gene makes the receptor on hair follicles that interact with testosterone and DHT. If your receptors are particularly sensitive, they are more easily triggered by even small amounts of DHT, and hair loss occurs more easily as a result. Other genes may also play a part.
Over Plucking: I know the temptation of tweezing your eyebrows when you don’t want to endure the pain of threading. But when you pluck your eyebrow hair, you’re pulling it out from the follicle and essentially damaging it. And repeatedly plucking your hair eyebrow hair can permanently damage your follicles over time and prevent them from producing new hair.
“…a beauty editor told me she had been using Viviscal... Since beauty editors see truckloads of products every week, I was immediately convinced when she said it worked – so I bought it myself. I started taking it twice a day for the first six months and saw dramatic results within three to four months. My hair was less thinned out …and it was also less brittle. I’ve gone to the same hairdresser since I was 19, and he was the first to comment on how full and strong my hair looked…”
Tames and Goldenring described a case of bilateral loss of eyebrows and eyelashes in a patient with AIDS-related complex who had smoked crack cocaine. This has been attributed to hot vapors during the process of smoking, and which therefore caused singeing of the brows and lashes. There was a complete reversal once the patient abstained from cocaine.[93]
In this section, our Houston Hair Transplant Team discusses current trends in hair loss and restoration research with published experts. We choose our interviewees based on those who have had NIH or Medline indexed published medical research that is peer-reviewed. The list will be organized by country and then alphabetically by physician last name. Click on the name to read about the latest research in thinning hair and hair restoration from around world. We thank our specialists below for giving us the valuable time and sharing of insight. We are deeply grateful and honored to have had the privilege to get the insight provided by these world renown specialists
*Photograph used with permission of the Journal of the American Academy of Dermatology. This photograph was published in the Journal of the American Academy of Dermatology, Vol. # 60, Gathers RC, Jankowski M, Eide M, et al. “Hair grooming practices and central centrifugal cicatricial alopecia,” 660-8. Copyright Elsevier (2009). Journal of the American Academy of Dermatology.   
Modern medical studies and research have not found any cure or possible medication for Alopecia. However, there are various treatments available for hair growth, or at least temporarily. It is recommended to consult a medical expert or dermatologists to gain more knowledge regarding the condition before undergoing through treatment and medications. Listed are treatments and products under cosmetic dermatology and general dermatology which could help you with your skin concern.
Complete Belgravia's online consultation if you are unable to visit one of our London clinics. The questionnaire should take no more than 10 minutes to complete and will provide our hair loss specialists with all the information required to recommend an effective course of home-use treatment. For those who live in or around London, we always recommend a clinical consultation. 

If you’re experiencing hair loss, topical treatments like minoxidil (Rogaine) and others tend to only be partially effective, if they are effective at all; they don’t address the root causes of hair loss; they target androgenic alopecia (which only accounts for some cases of hair loss); and they come with a host of unpleasant side effects—side effects that can worsen the aesthetic problem you were hoping to fix. Rogaine can cause hair to grow in different colors and textures than the surrounding hair and can cause unwanted hair to grow on your cheeks and forehead.
Insulin regulation is also a big factor in hair health, as an imbalance can lead to various hormonal effects. Insulin helps to regulate blood sugar levels, which effects fat storage and hormone balance. Fat storage and hormone balance play a role in hair growth because fat storages will secrete excess estrogen in the body, and can desensitize hormone signals.   

Skin Conditions: There are tons of skin conditions like eczema, psoriasis, seborrheic dermatitis or an infection in the hair follicle that can cause itching, redness, and inflammation around your eyebrows. Scratching the skin around that area can cause your hair to fall out. However, since you’re not damaging your hair follicle in this case, your eyebrow hair can grow back in a few weeks’ time.

Taking estrogen supplements as part of a hormone replacement therapy regime has its effects on your hair as well. Women can treat a type of hair loss called androgenic alopecia, associated with low estrogen and progesterone, by replacing these hormones artificially. Dosages of synthetic estrogen should be monitored regularly -- abnormal hair growth is a possible side effect of one kind of hormone replacement therapy, called esterified estrogens.
Reduce stress. When you are stressed, your body starts shutting down processes that aren’t necessary for survival. This shutdown can occur with physical stressors, like surgery or an illness, and emotional stress, which often manifests as physical symptoms. Loss may occur up to three months after the stressful event and may take another three to grow again.[24]
Sara Gottfried, MD is the New York Times bestselling author of the new book, Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, and Turn Back the Clock 10 Years. Her previous New York Times bestsellers are The Hormone Cure and The Hormone Reset Diet. After graduating from Harvard Medical School and MIT, Dr. Gottfried completed her residency at the University of California at San Francisco. She is a board-certified gynecologist who teaches natural hormone balancing in her novel online programs so that women can lose weight, detoxify, and slow down aging. Dr. Gottfried lives in Berkeley, CA with her husband and two daughters. 

There’s a reason why we’re the leading provider of hair loss solutions in North America. Trust. Many of our 1,100+ licensed cosmetologists and hair loss experts started where you are—as a client themselves. So we truly understand what hair loss feels like and what it takes to get your hair back. It’s why you can trust that we’ll walk you through every step of your hair restoration journey, from consultation and analysis to solution and maintenance. We’ll listen to you and make sure your Hair Club experience is everything you want it to be. We’re here for you, and that makes all the difference.
If you fall into this category, try to go as long as possible in between waxing or threading appointments, or completely give up the habit. I’ve started using the Tinkle Eyebrow Razor ($6) to help cut down on my waxing appointments. And if you must wax, thread, or pluck, Dr. Umar recommends avoiding any hair growing directly over the brow bone. Instead, limit yourself to the hair above and below this zone in order to avoid sparse brow growth in the future.
There’s a reason why we’re the leading provider of hair loss solutions in North America. Trust. Many of our 1,100+ licensed cosmetologists and hair loss experts started where you are—as a client themselves. So we truly understand what hair loss feels like and what it takes to get your hair back. It’s why you can trust that we’ll walk you through every step of your hair restoration journey, from consultation and analysis to solution and maintenance. We’ll listen to you and make sure your Hair Club experience is everything you want it to be. We’re here for you, and that makes all the difference.
Giorgos Tsetis: Another reason Unilever was inspired to partner with us is that we really target three channels. Direct-to-consumer is one, then we target physician channels and salon channels; which are the hardest to convince. There's liability involved, so there's no doctor in the world who is going to recommend or endorse a product they don't believe in. We have about 350-400 physicians currently selling the product. A large amount of these doctors are thought-leaders or experts in the space, so they are known to speak about this issue on a world stage when it comes to new innovations. We also have each of the top 20 hair salons in the country carrying the product. There's a ton of celebrities who use the product as well. It is a premium product, but we've still made it affordable for people. When you look at other products on the market, our price point is comparable. We're also working on special programs for people in need who can't normally afford the product. If somebody is motivated, serious and really needs it -- we work to make sure they can get the product, and seek to serve as many people as possible.
Complete Belgravia's online consultation if you are unable to visit one of our London clinics. The questionnaire should take no more than 10 minutes to complete and will provide our hair loss specialists with all the information required to recommend an effective course of home-use treatment. For those who live in or around London, we always recommend a clinical consultation.
In order to prevent drying and breakage, it’s best to stay away from heat tools, such as hair dryers and straightening irons. Extensions and other styling methods can also weaken your hair and cause early hair loss. If you must dye your hair, choose an all-natural hair color. Artificial chemicals found in dyes and perms can compromise your scalp and hair health. When you wash your hair, always use a nourishing conditioner to keep your scalp healthy and promote healthy hair growth.

Not only that, but plucking, waxing, or threading can also lead to permanent eyebrow loss, ingrown hairs, and infections. With repeated trauma to the hair follicle, your follicle can become damaged and scarred. If this occurs, your hair may never grow back again. Make sure to be extra careful to only pull out the hairs that you want to remove when you are plucking your brows. You should also wash your tweezers with alcohol before you start plucking or seek treatment at a reputable salon to prevent infections.
Testosterone replacement is becoming popular for men. Cotsarelis warns that this may accelerate hair loss. Propecia might help -- but because it prevents testosterone breakdown, it might affect the dose of male hormone replacement therapy. Cotsarelis warns men taking both Propecia and testosterone replacement to make sure their doctor carefully monitors their testosterone levels.
Infestation with the mite D. folliculorum which inhabits the eyelashes is well known. Two species are known to inhabit human beings—D. folliculorum and Demodex brevis.[29] It might either be asymptomatic or may cause symptoms of blepharitis. Kemal et al. report an overall prevalence of 27.4% in their study group.[88] Gao et al. have reported a 100% prevalence of the mite when there is cylindrical dandruff.[29] Patients with demodicosis can develop madarosis.[29]

While these factors contribute to hair loss for any woman, it’s particularly dicey for those of us with PCOS because when the follicle is exposed to our elevated androgens such as DHT (di-hydro testosterone, an active metabolite of testosterone) it gets damaged. Whenever a cell is damaged it generates oxidative stress which further alters the androgen receptor in the follicle perpetuating the issue.
Male pattern baldness (MPB) has a distinctive shape. The front hairline recedes, especially at the sides, forming an M shape. This is frontal baldness. The crown of the head, also known as the vertex, becomes bald as well. Eventually the two areas join into a “U” shape. MPB can even extend to chest hair, which can thin as you age. Oddly enough, hair in different locations on the body can react differently to hormonal changes. For instance, facial hair growth can improve while other areas become bald.
To prove the fact that this does not happen on your scalp alone, Everyday Health notes, “too much thyroid hormone, the hair on your head can become fine, with thinning hair all over the scalp. When there is too little of this hormone, there can be hair loss, not just on the scalp, but also anywhere on the body”. This proves patients with underactive thyroid (low thyroid) can have their eyelashes and eyebrows falling off.
Both of these hairy issues are related to excess androgens that are part of PCOS.  Our hair follicles respond overzealously to testosterone creating both hair loss and hair growth. This is because the follicles on the face tend to stretch and grow causing the hair to get stuck and not fall out when they should. Conversely, the scalp hair follicles actually shrink in response to androgens and the hair can fall out or just not be as robust.
Several skin conditions, including psoriasis, eczema, and seborrheic dermatitis, don't directly lead to hair loss, but cause inflammation (a symptom of these conditions) near the brow that may be to blame. The urge to scratch and rub the inflamed area can indirectly cause eyebrow hairs to fall out. Loss that occurs in this manner is usually patchy, but as it is generally non-scarring (the hair follicle is intact), eyebrows can and often do grow back.
The first thing you'd want to try is to talk to your doctor about stopping the medicine -- ask if there's a substitute. If you can't find a substitute for the medication and you must take it, then you could consider filling in your eyebrows. You can find brow products at any local drugstore. YouTube has many, MANY brow tutorials you could learn from.
Madarosis is a clinical sign that has become pathognomonic of leprosy in countries like India. However, this apparently benign clinical sign has wider ramifications in many systemic and dermatological disorders. Hence, establishing a proper diagnosis and appropriate management is mandatory. Though management of the primary disease results in regrowth of eyebrows and eyelashes, many require surgical management. Thus, the management of a patient with madarosis requires a coordinated effort from the dermatologist, ophthalmologist, internist, and reconstructive surgeon.
Hormones are cyclical. Testosterone levels in some men drop by 10% each decade after age 30. Women's hormone levels decline as menopause approaches and drop sharply during menopause and beyond. The cyclic nature of both our hair and hormones is one reason hair loss can increase in the short term even when you are having a long-term slowdown of hair loss (and a long-term increase in hair growth) while on a treatment that controls hair loss.
The term “common baldness” usually means male-pattern baldness, or permanent-pattern baldness. Male-pattern baldness is the most common cause of hair loss in men. Men who have this type of hair loss usually have inherited the trait. Men who start losing their hair at an early age tend to develop more extensive baldness. In male-pattern baldness, hair loss typically results in a receding hair line and baldness on the top of the head.
If you fall into this category, try to go as long as possible in between waxing or threading appointments, or completely give up the habit. I’ve started using the Tinkle Eyebrow Razor ($6) to help cut down on my waxing appointments. And if you must wax, thread, or pluck, Dr. Umar recommends avoiding any hair growing directly over the brow bone. Instead, limit yourself to the hair above and below this zone in order to avoid sparse brow growth in the future. 

Taking estrogen supplements as part of a hormone replacement therapy regime has its effects on your hair as well. Women can treat a type of hair loss called androgenic alopecia, associated with low estrogen and progesterone, by replacing these hormones artificially. Dosages of synthetic estrogen should be monitored regularly -- abnormal hair growth is a possible side effect of one kind of hormone replacement therapy, called esterified estrogens.
If you’ve overplucked your brows too many times, you may have caused trauma to the follicles in the meantime, signalling not only those hairs you plucked to stop growing back, but also the hairs in surrounding areas. The good news: If the hair follicles aren’t dead, they can possibly be shaken from their resting state with a good brow enhancer. (like WINK  yes of course, we have to say it). There’s no sure bets, but it’s worth a try–plus Wink has a money-back guarantee!
The first thing you'd want to try is to talk to your doctor about stopping the medicine -- ask if there's a substitute. If you can't find a substitute for the medication and you must take it, then you could consider filling in your eyebrows. You can find brow products at any local drugstore. YouTube has many, MANY brow tutorials you could learn from.
Male pattern baldness is connected to the male sex hormone androgen. So naturally, reducing your stress levels will also reduce the risk of suffering from the different symptoms that stress cause. You can reduce stress by practicing mindfulness and yoga. You can also cut down on work and make sure to get enough sleep. Minimize your exposure to negative people or experiences. Spending time in nature and exercising also contribute greatly to your mental health.
Elizabeth Willett is the Senior Herbalist and Lead Educator at NaturalFertilityInfo.com. She holds a BS in Mass Communications (2000) from Minnesota State University, and a Master of Arts degree (MA, 2010) in Holistic Health Studies with a specialization is herbalism from St. Catherine University in St. Paul, MN. Liz has written over 200 articles on women’s fertility and brings a vast wealth of knowledge and expertise in holistic health and healing to Natural Fertility Info.com

Research suggests that hair loss during menopause is the result of a hormonal imbalance. Specifically, it’s related to a lowered production of estrogen and progesterone. These hormones help hair grow faster and stay on the head for longer periods of time. When the levels of estrogen and progesterone drop, hair grows more slowly and becomes much thinner. A decrease in these hormones also triggers an increase in the production of androgens, or a group of male hormones. Androgens shrink hair follicles, resulting in hair loss on the head. In some cases, however, these hormones can cause more hair to grow on the face. This is why some menopausal women develop facial “peach fuzz” and small sprouts of hair on the chin.
Giorgos Tsetis: When you want to solve an issue, you must first thoroughly understand the problem. A lot of times, especially in the pharma world, everybody is trying to identify the magic pill that targets a single trigger. But, that's the exact reason there hasn't been a drug that holistically and indefinitely ends the problem. You can't zero in on one specific trait or symptom, you really have to solve for the many causes. When it comes to hair loss for men and women, there are several causes that disrupt the natural hair growth cycle. Basic vitamins and minerals only act as a temporary bandaid for hair health deficiencies, which is simply not enough. Hair loss and thinning hair means your body is imbalanced and there's something off, because hair follicles are mini organs.
Male pattern hair loss has been established as androgen-dependent because it is associated with changes in the androgen receptor and responds to antiandrogen therapy (Ellis et al., 2002). With FPHL, genes that encode aromatase, which converts testosterone to estradiol, are also implicated (Yazdabadi et al., 2008, Yip et al., 2009). The process of androgen biosynthesis is depicted in Figure 1.
A small study published in 2002 found that applying topical onion juice to the scalp increased hair growth. Two groups of participants were asked to use topical treatments on their scalps twice each day for two months: one group was given onion juice to apply to their scalp. The other was given tap water. After six weeks, hair growth was observed in close to 90 percent of the participants who used onion juice (though the researchers noted that more men in the group than women experienced hair growth). In the tap water group, only 13 percent of the participants experienced hair growth (with no difference between the sexes.) The benefit from onion juice is thought to come from its high sulfur content. Sulfur is found in amino acids, which are the building blocks of proteins, which are needed for robust hair growth. Onion juice may also stimulate collagen production, which in turn stimulates hair growth.
Stress: Emotional and physiological stress can trigger a few hair loss conditions that can affect your eyebrows. Telogen effluvium, for instance, can cause your hair to shed. Then there’s trichotillomania, which is a psychiatric condition caused by stress that is characterized by the urge to pull out your own hair (which could be from your eyebrows, eyelashes or scalp). 

At Hair Club, you can be part of a well-established, stable company with more than 40 years of success. We are the industry leader in providing hair loss solutions. Our company culture is fun, fast-paced, empathetic and comes with a conscience. Not only do we make a difference in the lives of our clients every day, we also contribute to the community locally through our charitable and volunteer programs. If you’re enthusiastic, motivated and confident, we’d love to talk to you about joining our team of hair restoration professionals.
Balancing your hormones is not an easy process, whether you are in perimenopause, menopause, or post-menopause. You may find that just one of these herbs is sufficient to do the trick, but in many cases you will achieve the best results by taking a combination of herbs. Start gradually and track your results carefully to make sure you are choosing the right products to balance and adjust your particular hormone profile.

Skin Conditions: There are tons of skin conditions like eczema, psoriasis, seborrheic dermatitis or an infection in the hair follicle that can cause itching, redness, and inflammation around your eyebrows. Scratching the skin around that area can cause your hair to fall out. However, since you’re not damaging your hair follicle in this case, your eyebrow hair can grow back in a few weeks’ time.


Dutasteride is a 5-alpha-reductase inhibitor that binds both types I and II enzymes. Compared with finasteride, its inhibition of type II enzymes is three times more potent; its inhibition of type I enzymes is 100 times more potent (Clark et al., 2004). Dutasteride is not approved for the treatment of FPHL by the FDA, and ongoing studies on the efficacy of the inhibitor are promising but largely focus on male patients (Gupta and Charrette, 2014, Olsen et al., 2006). A study of women after 3 years of therapy showed that dutasteride may be more effective than finasteride in women under 50 years of age as measured by hair thickness (not hair density) at the center and vertex scalp (Boersma et al., 2014). One case report of a 46-year-old female with FPHL showed some response after 6 months of treatment with a dose of 0.5-mg dutasteride daily despite a minimal response to treatment with finasteride and minoxidil (Olszewska and Rudnicka, 2005). Data with regard to the treatment side effects in women is extremely limited. Dutasteride is classified as pregnancy category X because of teratogenicity and should have the same theoretical risk of breast cancer as mentioned in relation to finasteride (Kelly et al., 2016).
Spironolactone is a potassium-sparing diuretic that functions as a competitive aldosterone antagonist and inhibits the interaction of testosterone and DHT with intracellular androgen receptors in target tissues (van Zuuren et al., 2012, Yazdabadi and Sinclair, 2011). Spironolactone also weakly inhibits androgen synthesis (Price, 2003). The anti-androgen effect is more commonly used in hirsutism and acne but has been used successfully at 100- to 200-mg daily doses to treat FPHL (Sinclair et al., 2005). One retrospective study of survey data showed that nearly 75% of women reported stabilization or improvement of their hair loss after treatment with spironolactone (Famenini et al., 2015). Similar results were obtained in an open intervention study from 2005 (Sinclair et al., 2005). While the vast majority of published data discusses adult patients, one case report described the visible improvement of FPHL in a 9-year-old patient after 6 months of therapy (Yazdabadi et al., 2009).
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