A. I think it's a personal preference, but why is a cosmetic solution such a big deal? To use sprays, powders and hair extensions? It doesn't address the problem, but it can do wonders for your self-esteem. I see patients who are extremely depressed, and this is ruining their life. We always have hope for that miracle solution, but it's very hard to do research studies. … As much as this affects people's mentality, there's not a lot of (National Institutes of Health) funding because hair loss isn't killing anyone.
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.
The most common type of hair loss seen in women is androgenetic alopecia, also known as female pattern alopecia or baldness. This is seen as hair thinning predominantly over the top and sides of the head. It affects approximately one-third of all susceptible women, but is most commonly seen after menopause, although it may begin as early as puberty. Normal hair fall is approximately 100-125 hairs per day. Fortunately, these hairs are replaced. True hair loss occurs when lost hairs are not regrown or when the daily hair shed exceeds 125 hairs. Genetically, hair loss can come from either parents side of the family.
When this process is disrupted you end up with thinner hair, increased hair loss, a failure to regrow new hair and all in all a super sad experience! No one love losing their hair and it’s such a huge source of upset for women I work with but I’ll be honest, it is often the last thing to change as we work through getting your hormones and metabolism more balanced. It’s simply not your body’s priority.

While you wait for your doctor’s recommendations to take effect, you can mask the problem with a high-quality eyebrow gel. Unlike eyebrow pencils that can lead to a brow that looks drawn on, an eyebrow gel enhances your eyebrow shape with a soft color and strong hold. We like Laura Mercier Eye Brow Gel, available at Nordstrom for $20. Prior to using the gel, pencil in small sections of the brow that may be entirely bare of hair. Using a pencil sparingly will prevent a brow line that’s too harsh for your face.

Alopecia is a common issue that can cause significant morbidity because even though scalp hair is not biologically essential, it can have great psychological and social significance. The results of a 1993 Glamour magazine survey showed that more than half of women said, “If my hair looks good, I look attractive no matter what I’m wearing or how I look otherwise,” and “If my hair isn’t right, nothing else can make me feel that I look good” (Cash, 2001). Add to this the fact that more than 21 million women in the United States alone experience female pattern hair loss (FPHL), and it is not surprising that hair loss in women can be a serious cause of psychological stress and morbidity (Pickard-Holley, 1995, van Zuuren et al., 2016). In one study, 55% of affected women displayed symptoms of depression (Camacho and Garcia-Hernandez, 2002). In that same group, 89% of women experienced an improvement of those symptoms after treatment for hair loss (Camacho and Garcia-Hernandez, 2002).
It is an impulse-controlled disorder characterized by compulsive plucking or breakage of hair.[91] The most frequent site of hair pulling is the scalp, but the eyebrows, eyelashes, and pubic hair may also be involved. Trichotillomania manifests in eyelashes and eyebrows as irregular patches of alopecia containing hairs of varying lengths. Inflammation, scarring, and atrophy are conspicuous by their absence. Patients often attempt to conceal their alopecia by cosmetological camouflage. In case of a diagnostic dilemma, histological features such as increased numbers of catagen hairs, pigment casts, and traumatized hair bulbs provide a clue.
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]
The real culprit appears to be dihydrotestosterone (DHT), a more potent form of testosterone. DHT is made from testosterone by a specific enzyme in the body, and while both testosterone and DHT are known to have a weakening effect on hair follicles, there appears to be something unique about the conversion process of testosterone to DHT that relates to thinning hair. This is why some drugs that are marketed for hair loss block the conversion of testosterone to DHT. (It’s important to note, however, that these drugs tend to be less effective in women than men, and that one of them—finasteride—is only approved for hormonal hair loss in men, not women. What’s more, the drug has been associated with increased risk of sexual side effects, depression, nausea, hot flashes, and increased estrogen levels—and too much estrogen is its own risk factor for thinning hair; more on that below.)
In extreme cases, such as disordered eating and anemia, an iron deficiency may be to blame for thinning brows. “Even if you don’t have anemia, and you have low levels of stored iron, that could contribute to hair loss,” says Rajani Katta, M.D., a dermatologist and clinical assistant professor of medicine at Baylor College of Medicine, who studies the link between nutrition and hair loss. Iron is found in meat, fish, and other animal products, plus beans and legumes, so vegans and vegetarians might be more likely to be low in iron. Your derm can do a ferritin blood test to check your iron levels. But don’t start an iron supplement without medical recommendation. Too much iron can also have negative effects, says Dr. Katta.

When this process is disrupted you end up with thinner hair, increased hair loss, a failure to regrow new hair and all in all a super sad experience! No one love losing their hair and it’s such a huge source of upset for women I work with but I’ll be honest, it is often the last thing to change as we work through getting your hormones and metabolism more balanced. It’s simply not your body’s priority.


Skin infections can cause hair loss at the affected area. One of the more common causes is a fungal infection of the skin, also sometimes referred to as a ringworm. Eyebrow fungus is more likely to be related to a scalp fungus (tinea capitis) and both areas are often affected at the same time. A bacterial infection is another possible cause. Folliculitis for example is a condition where the hair follicle becomes infected usually with bacteria like Staphylococcus aureus. Eventually this can lead to loss of the hair in the infected follicle.
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.
If you’re in good health but would like your brows to be a bit fuller, you’ve got plenty of options. Massage a bit of moisturizing coconut oil into your eyebrows about three times weekly, to make for healthier, shinier and more eye-catching hair. Eyebrow pencils remain an effective choice as a go-to filler; go a shade lighter than your brows for a natural look. To shake things up a bit, opt for a brow shadow. These powders, which look like eye shadow, go on with a brush and fill in thin or patchy brows with a soft and subtle fullness.
Ever since Cara Delevingne set the trend for thick eyebrows (although women on the eastern side of the Prime Meridian have been keeping their eyebrows luscious and strong since the dawn of time), the quest to keep your eyebrow hair supremely groomed and in shape has become the primary beauty concern of all women. So now that eyebrows have come into the razor sharp focus of beauty standards that women (again) need to adhere to, it can come as quite a shock for some when they start losing their eyebrow hair. One day you’re lovingly brushing out your thick luscious eyebrows and the next moment you find yourself desperately filling them in with every eyebrow pencil you can get your hands on. You’re confused. You’re anxious. You don’t know what’s going on. And you’re trying out every random hack that the internet spews at you to stop losing your eyebrow hair. Lady, you need to calm down for a second. First, figure out why you’re losing your eyebrow hair in the first place. Let’s look at a few possible causes of your eyebrow hair loss.

Ludwig Scale: This is the most common classification for female pattern hair loss. There are 3 stages (ranging from mild hair loss to extensive, severe widespread thinning) and in each stage hair loss occurs on the front and top of the scalp with relative preservation of the frontal hairline. Regardless of the extent of hair loss, only women with stable hair on the back and sides of the scalp are candidates for hair transplant surgery. 

Estrogen and combined oral contraceptive (COC) drugs with estrogen or progestogen have been reported as effective, but data are limited (Adenuga et al., 2012, Raudrant and Rabe, 2003, Scheinfeld, 2008). They are thought to function through several mechanisms. Both components of COC drugs increase the levels of sex-hormone-binding globulin (Schindler, 2013). They also send negative feedback signals that suppress the hypothalamic secretion of gonadotropin and releases the hormone and pituitary secretion of the luteinizing and follicle-stimulating hormones, which results in a decreased androgen production (Gilman et al., 1990, Varothai and Bergfeld, 2014). These actions decrease androgen secretion from the ovary and the quantity of free, biologically active androgens, which reduces their effects on the hair follicles (Schindler, 2013). Our practice when prescribing COC drugs is a combination of ethinyl estradiol 20 mcg plus drospirenone 3 mg. Drospirenone is an analogue of spironolactone. This treatment combination is approved by the FDA for the treatment of acne but not alopecia.
Sinclair Scale: The 5-point Sinclair Scale is a modified visual grading scale. Grade 1 is normal. This pattern is found in all girls prior to puberty, but in only half of women age 80 or over. Grade 2 shows a widening of the central part. Grade 3 shows a widening of the central part and thinning of the hair on either side of the central part. Grade 4 reveals the emergence of diffuse hair loss over the top of the scalp. Grade 5 indicates advanced hair loss. This grade is uncommon, occurring in less than 1% of women.
Unfortunately, there’s no magic solution, pill or product that will correct hair loss entirely. But if you think of your hormones as a cast of characters, knowing which ones are leading the show and which ones are only playing a supporting role can help you get to the bottom of the issue. If you haven’t already, take my free hormone quiz – it can help you determine what tests you may want to request from your doctor and which lifestyle or dietary changes may benefit you most. In the meantime, manage your stress levels and get enough sleep. This will help with general hormone balance and can protect your precious locks from any further damage.
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