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).
If, however, you aren’t so sure that any of the causes listed above are a problem for you, then a good place to start may be to talk with your healthcare provider about testing. It is important to learn the root cause – especially if dealing with infertility – because that which is causing hair thinning and shedding may also be contributing to your inability to conceive.
“When I went in for my Bosley consultation, my senior counselor was the one who walked me through the procedure. He also had had the procedure done, and his results were phenomenal. And I was thinking, ‘Wow, if I can get that, that’s what I’m looking for.’ He really got it — he understood me. He understood what I went through, and that was really important to me.
Over-plucking or nutrient deficiency can be easily solved on your own with behavioral changes and nutritional supplements, but if you suspect that your thinning eyebrows are caused by a health problem, please see a doctor right away for treatment. Do not attempt to address hypothyroidism, eczema, or alopecia areata without the guidance of a medical professional.
Estrogen is the dominant female sex hormone which is essential for the development of female characteristics. It can however be also found in men as well, but in lower quantities. Likewise there are also few quantities of the male sex hormones Testosterone, in female body. Estrogen is not a single hormone but actually a group of female sex hormones which include estradiol, estriol and estrone hormones. Estrogen is made in the ovaries and to a lesser extent in other bodily tissues.
Before you start hormone replacement therapy, it's important to talk to your doctor about the possible risks and negative effects versus the benefits of HRT. If you're already at an increased risk for health conditions like heart disease, cancer, and blood clots, HRT may not be the best hair loss treatment for you. If you are prescribed HRT, it important to take the lowest doses that are effective, and to only take the drugs for the shortest amount of time needed to control symptoms.
See a dermatologist for itchy skin or rashes around your brows. These patches may indicate a skin infection or interaction with a new beauty product or environmental trigger. You could also have inflammation from dermatitis or psoriasis.[32] These conditions don’t actually cause hair loss, but they can lead to it if you rub and scratch the affected areas.
Some cancer chemotherapy drugs cause temporary hair loss, which affects all body hair. Along with the loss of scalp hair, people undergoing chemotherapy also commonly lose their eyebrows and eyelashes. Chemotherapy drugs that frequently cause hair loss include paclitaxel, 5-fluorouracil, carboplatin, cisplatin, actinomycin-D, bleomycin, vincristine, cyclophosphamide, altretamine, etoposide, docetaxel and doxorubicin. Hair loss typically begins 2 to 3 weeks after the start of chemotherapy. Lost eyebrow hair regrows in the weeks to months following completion of treatment.
NEIL SADICK, MD: Dermatologists are experts in the field of hair disorders. All dermatologists are trained in the general knowledge and treatment of hair loss disorders, but not all dermatologists choose to do this. A dermatologist will often refer to a specialist. Most dermatologists who are trained and have some expertise in this area usually deal both with men and women.
Blow dryers, flat irons, and other devices: Frequent use of a blow dryer tends to damage hair. The high heat from a blow dryer can boil the water in the hair shaft leaving the hair brittle and prone to breakage. Dermatologists recommend that you allow your hair to air dry. Then style your hair when it is dry. Dermatologists also recommend limiting the use of flat irons (these straighten hair by using high heat) and curling irons.
If you’ve gotten through this list and still don’t know what’s going on, it’s time to talk to your doc. Unfortunately, madarosis–typically used to mean the loss of eyelashes, but also referring to the loss of brows–may be due to many, many things, including a number of vision and life-threatening conditions, like herpes zoster, leprosy, HIV/AIDS, trachoma, malignant eyelid tumors, discoid lupus, scleroderma, and hypothyroidism (Khong, Casson, Huilgal, Selva; Survey of Opthamology, 2006). Brow and lash loss are both indicators of underlying diseases, so yes get to your doc stat.
See the doctor for sudden hair loss. If you suddenly lose your eyebrows, that could be a sign of a more serious problem, particularly if you only lose your eyebrows or eyelashes and not other hair. Sudden loss of eyebrows can be a symptom of eye conditions, skin conditions, systematic disorders, infections, and nutritional deficiencies. Seeing your doctor can help you narrow down the condition.[30]
This plant is native to North America and has been used for centuries by indigenous people to treat menstrual and menopausal disorders. While modern research results are mixed, some studies do indicate that black cohosh can be effective as a treatment in menopause. While the research focuses on hot flashes and other symptoms of menopause that get more attention than hair loss, it follows that black cohosh could also help to improve hair growth when estrogen levels decline.

These important micronutrients, which are all essential for hair health, are part of my Balance Supplements. And even if you eat a healthy, phytonutrient rich diet, you might not have optimal levels of the vitamins and minerals you need to promote hair health. Environmental factors beyond our control, from the mineral-depleted soil in which most of our food is now grown to shifts in growing practices that have reduced the amount of vitamins and minerals in various foods, can leave us eating a picture-perfect diet and still deficient in certain micronutrients.


Another reason why hair falls out is lupus. Lupus is an autoimmune disease that may make your immunity system begin attacking your various healthy body tissues. According to Medical News Today, “this results in symptoms such as inflammation, swelling, and damage to joints, skin, kidneys, blood, the heart, and lungs”. It can also attack eyebrow follicle resulting sudden hair loss and including brows.


However, the effects of alopecia reach far beyond symptoms of depression and include anxiety, obsessions, dissatisfaction with one’s appearance, and low self-esteem (Al-Mutairi and Eldin, 2011, Dlova et al., 2016, Hunt and McHale, 2005, Schmidt et al., 2001). There can be significant disturbance in a patient’s social life because they may change their hair style, clothing, or avoid social meetings (Al-Mutairi and Eldin, 2011). One study reported that 40% of surveyed women described marital problems and 63% had career-related issues that they ascribed to their hair loss (Hunt and McHale, 2005). These effects seem to occur regardless of patients’ age, race, or degree of hair loss (Dlova et al., 2016, Hunt and McHale, 2005, Schmidt et al., 2001). Another study of more than 200 women found that this psychologic morbidity occurs with equal frequency in women whose hair is typically covered by a headscarf (Erol et al., 2012).
Hair loss may also occur due to dieting. Franchised diet programs which are designed or administered under the direction of a physician with prescribed meals, dietary supplements and vitamin ingestion have become popular. Sometimes the client is told that vitamins are a necessary part of the program to prevent hair loss associated with dieting. From a dermatologists’s standpoint, however, the vitamins cannot prevent hair loss associated with rapid, significant weight loss. Furthermore, many of these supplements are high in vitamin A which can magnify the hair loss.
Take extra care in looking after your hair. Use a gentle, nourishing shampoo (we love Bumble and Bumble Gentle Shampoo) to promote good condition and prevent breakage. Try using a silk or satin pillowcase. Avoid harsh styling products and techniques that apply heat to the hair (blow drying, curling irons etc) as these can cause more damage to fragile hair.

Insulin, that helper hormone in charge of regulating blood sugar levels, also affects a number of different body processes, including fat storage, heart health and, you guessed it, hair growth. One study published in the European Journal of Cardiovascular Risk found that women with some markers of insulin resistance have a greater risk for androgenic alopecia (AGA), or female pattern baldness.


Cut the fast-food diet and start getting some whole food in your life. The less processed the better; as my mom says “as close to nature as possible.” Healthy skin and hair start with a healthy diet. Aim for a diet rich in Vitamin C, Vitamin A, Vitamin E, B Vitamins, lean protein and Essential Fatty Acids. EFAs can be found in walnuts, salmon, flax seed, and most seeds. EFAs have been shown to increase prostaglandin production in those with a deficiency; prostaglandin is what prompts your lashes and brows to grow.
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.
Thyroid Dysfunction: Since the thyroid gland regulates many body functions by releasing hormones, any disruption in its functioning can cause loss of hair, including eyebrow hair. If your thyroid is underactive, it could cause you to lose the outer third of your eyebrow. The only way to treat thyroid dysfunction is through medication. However, there’s still no guarantee that your eyebrow hair will grow back.

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.


The Hair Wellness Group’s mission is to provide each client with a personal experience that will leave them “Uplifted” and “ Inspired”. Our unique approach integrates wellness, relaxation, and beauty into one’s lifestyle at all levels. We call this the “Total Approach”. The Hair Wellness Group educates, empowers, and enriches the lifestyle of all seeking optimum results in hair restoration, hair replacement, and scalp rejuvenation.
Your body needs to be hydrated in order to function properly. Load up on H2O all day long and pass on juices, sodas, and other flavored drinks that contain more sugar than your body needs. The amount of water needed varies from person to person and depends on various factors, including overall health and exercise intensity. As a general rule, however, you should aim to have eight 8-ounce glasses of water per day.
Karen Hellesvig-Gaskell is a broadcast journalist who began writing professionally in 1980. Her writing focuses on parenting and health, and has appeared in “Spirituality & Health Magazine" and “Essential Wellness.” Hellesvig-Gaskell has worked with autistic children at the Fraser School in Minneapolis and as a child care assistant for toddlers and preschoolers at the International School of Minnesota, Eden Prairie.

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Flutamide is an oral anti-androgen that acts by competitively inhibiting the uptake of androgen and its nuclear binding in target tissues (Varothai and Bergfeld, 2014; Watson Pharma, 2011). It has been shown to be effective for the treatment of FPHL in hyperandrogenic women at a dose of 250 mg per day. One case report showed that treatment with flutamide was effective in a patient who had already failed to improve with spironolactone and minoxidil (Carmina and Lobo, 2003, Yazdabadi and Sinclair, 2011). After 2 years of therapy, 80% of patients were satisfied or highly satisfied with their treatment effect regardless whether they were taking concomitant oral contraceptives (Paradisi et al., 2011). Flutamide can cause hepatotoxicity and serial monitoring of liver function tests is recommended during treatment (Watson Pharma, 2011) even though data from one study on the safety and tolerability of flutamide showed that patient transaminase values returned to normal after treatment was discontinued and that levels did not rise while patients were treated with doses of 62.5 mg or 125 mg. Flutamide is classified as pregnancy category D.
Check for hypothyroidism. If you also notice unexplained weight gain, chronic fatigue, feeling depressed, or feeling colder than usual in low temperatures, your thyroid gland may not be producing enough hormones. You may also notice your periods getting heavier or becoming sporadic. Hypothyroidism is most common in women, especially over age 50, and it can be treated with a synthetic hormone.[31]

Both benign and malignant tumors such as seborrhoeic keratosis, molluscum contagiosum, basal cell carcinoma, squamous-cell carcinoma, sebaceous cell carcinoma, and sclerosing sweat duct carcinoma have been shown to be associated with loss of eyelashes.[1,111–113,119,120] A sebaceous cell carcinoma very often presents as a recurrent chalazion. An associated madarosis (due to lid infiltration and follicle destruction) would help to differentiate the two.[121,122] Tsuji et al. reported a rare case of primary epithelioid hemangioendothelioma of the eyelid associated with madarosis.[123] Primary leiomyoma of the eyelid has been reported with madarosis.[124] Kuan[125] described a case of lacrimal gland tumor masquerading as blepharitis with madarosis.
When your body goes through something traumatic like child birth, malnutrition, a severe infection, major surgery, or extreme stress, many of the 90 percent or so of the hair in the anagen (growing) phase or catagen (resting) phase can shift all at once into the shedding (telogen) phase. About 6 weeks to three month after the stressful event is usually when the phenomenon called telogen effluvium can begin. It is possible to lose handful of hair at time when in full-blown telogen effluvium. For most who suffer with TE complete remission is probable as long as severely stressful events can be avoided. For some women however, telogen effluvium is a mysterious chronic disorder and can persist for months or even years without any true understanding of any triggering factors or stressors.
There can be any number of different factors contributing to your hair loss. If you’re reading this and thinking, “well I have that and that, and am going through that,” then you may already have an idea of what is a contributing cause for you. You may already be doing much of what is suggested here and may learn of additional ideas to consider trying.
Staphylococcal blepharitis causes lid margin inflammation and folliculitis which destroys the hair follicle resulting in madarosis[30] which is usually non-scarring,[10] but occasionally may be scarring, especially if long standing.[15] Seborrhoeic blepharitis is very often associated with secondary bacterial infections and can result in madarosis either due to associated staphylococcal infection or due to rubbing caused by itching.

A. I'd say 25 percent get very good results. For another group, it just means that the situation is not getting worse, which no one ever considers a success. If you are thinking about it, you should start early. Minoxidil is not for everyone. … It can take at least six months to work — which doesn't fit most patients' time frames. It can stimulate facial hair or cause a rash on the scalp. It's not a miracle, but it's the only FDA-approved medication we have and it's been that way for 30 years. These are things we struggle with.


These important micronutrients, which are all essential for hair health, are part of my Balance Supplements. And even if you eat a healthy, phytonutrient rich diet, you might not have optimal levels of the vitamins and minerals you need to promote hair health. Environmental factors beyond our control, from the mineral-depleted soil in which most of our food is now grown to shifts in growing practices that have reduced the amount of vitamins and minerals in various foods, can leave us eating a picture-perfect diet and still deficient in certain micronutrients.
If you’ve gotten through this list and still don’t know what’s going on, it’s time to talk to your doc. Unfortunately, madarosis–typically used to mean the loss of eyelashes, but also referring to the loss of brows–may be due to many, many things, including a number of vision and life-threatening conditions, like herpes zoster, leprosy, HIV/AIDS, trachoma, malignant eyelid tumors, discoid lupus, scleroderma, and hypothyroidism (Khong, Casson, Huilgal, Selva; Survey of Opthamology, 2006). Brow and lash loss are both indicators of underlying diseases, so yes get to your doc stat. 

Because there are a number of different factors that can contribute to hair loss, it’s best to ask your doctor for a few different tests. I recommend checking: fasting glucose, iron levels and complete blood count (which can determine if you have anemia), as well as thyroid, estrogen and testosterone levels. These assessments should give you a better understanding of what hormonal issues may be at the root of your problem.
Also new is the HairMax Laser Comb. It's a red light therapy hairbrush-like device that increases circulation and the biological march that makes hair. It's only approved in men (though some women are using it) and in my experience, is not as good as minoxidil. But in one study, 45% of users reported improvement after eight weeks, and 90% saw improvement after 16 weeks.
So, if you have a similar paranoia—fear not! Losing strands is totally normal. But Dr. Wexler is quick to add that things like over-tweezing (it causes scarring to the follicles), waxing, severe weight-loss, stress, excessive touching, hormonal changes, and auto immune disease can cause irregular brow hair loss. If you believe your case may be extreme, it's best to see a specialist.

Also new is the HairMax Laser Comb. It's a red light therapy hairbrush-like device that increases circulation and the biological march that makes hair. It's only approved in men (though some women are using it) and in my experience, is not as good as minoxidil. But in one study, 45% of users reported improvement after eight weeks, and 90% saw improvement after 16 weeks.
There is some evidence of a link between baldness and prostate cancer and other diseases. Harvard Medical School reports that men with vertex baldness have 1.5 times more of a risk of developing prostate cancer than men without bald spots. The risk of coronary artery disease is also more than 23 percent higher in men with vertex bald spots. Investigations are ongoing as to whether there is a link between DHT levels and metabolic syndrome, diabetes, and other health conditions.

This is most commonly found in women wearing ponytails, tight braids or any hairstyles that typically pull on hair with excessive force. In addition, rigorous brushing, heat styling and rough scalp massage can damage the cuticle, the hard outer casing of the hair. This causes individual strands to become weak and break off, reducing overall hair volume.
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