During pregnancy, high concentration of estrogen levels in women result in the development of thicker, stronger, longer and healthier looking hair. Following pregnancy however, women tend to fret and think that they’re losing their hair when in fact they’re merely shedding the excess hair that the excess oestrogen created. The hair that was in a prolonged anagen stage are now all shifting into telogen (resting phase) to make way for new hair growth. This type of hair loss is comes under the condition known as telogen effluvium but the good news is that when oestrogen levels have returned to normal, your hair will too.
I’m no Frida Kahlo, but since my teenage years, I’ve been blessed with thick, full eyebrows. But as soon as I turned 30, I noticed something was amiss. My beautiful brows were looking, let’s say, sparse. Every time my brow specialist handed me a magnified mirror after my monthly wax, it seemed I had more patchy spots. My low-maintenance morning routine—a quick brush-up and pencil fill-in—was suddenly taking up a lot more time. I found myself on a constant quest for the best brow powders, pencils, and gels, and started researching microblading in hopes of finding a solution.
Mistakenly thought to be an exclusively male disease, women make up a significant percentage of hair loss sufferers all around the world. Forty percent of women have visible hair loss by the time they are age 40. After menopause, that number increases even more. Hair loss in women can be absolutely devastating for self-confidence, self-image and emotional well-being. Although it is not a life threatening disease and sometimes underestimated by physicians, hair loss can take an emotional toll that directly affects physical health. Hair is an important part of woman’s face and beauty, therefore it is not easy for any woman to face changes that affect the quality and especially the quantity of her hair. Hair loss in women is a serious life-altering condition that shouldn’t be ignored and has to be diagnosed and treated in the best possible way.
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.
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]

Eyebrows protect the eyes from sweat that trickles down the forehead. They also protect the bony ridges above the eyes. In addition to the above, the eyebrows play a very important function in facial expression and body language. Eyelashes protect the eyeball from small foreign bodies and irritants and stimulate the closing reflex. Both eyebrows and eyelashes play a very important cosmetic function, and thus contribute greatly to the self esteem of an individual.[9]
I’m no Frida Kahlo, but since my teenage years, I’ve been blessed with thick, full eyebrows. But as soon as I turned 30, I noticed something was amiss. My beautiful brows were looking, let’s say, sparse. Every time my brow specialist handed me a magnified mirror after my monthly wax, it seemed I had more patchy spots. My low-maintenance morning routine—a quick brush-up and pencil fill-in—was suddenly taking up a lot more time. I found myself on a constant quest for the best brow powders, pencils, and gels, and started researching microblading in hopes of finding a solution.
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.
Toxic alopecia occurs when there is a disruption of hair growth in the anagen phase. This usually occurs following chemotherapy and radiotherapy.[94] Radiotherapy for various types of ocular tumors, eyelid and choroidal tumors have been reported to produce madarosis.[95–97] Hair loss due to radiation is usually reversible, but may be permanent when the dose of radiation is in the range of 50 to 60 Gy.[94]
You can buy minoxidil over the counter, for about $25 for a three-month supply. But you’ll also need to invest some patience. Minoxidil can take six months or even a year to work. Dr. Avram estimates that the drug, which must be applied twice a day, stops hair loss in 80 percent of the women who use it properly and it can actually stimulate hair regrowth in about half the users.
The hormonal process of testosterone converting to DHT, which then harms hair follicles, happens in both men and women. Under normal conditions, women have a minute fraction of the level of testosterone that men have, but even a lower level can cause DHT- triggered hair loss in women. And certainly when those levels rise, DHT is even more of a problem. Those levels can rise and still be within what doctors consider "normal" on a blood test, even though they are high enough to cause a problem. The levels may not rise at all and still be a problem if you have the kind of body chemistry that is overly sensitive to even its regular levels of chemicals, including hormones.
Liver support: is necessary to eliminate unneeded wastes from the body. Everything we take in is processed through the liver and toxins are broken down into water soluble byproducts so they can be moved into the intestine and pulled into the stool for elimination. Foods like cruciferous vegetables (kale, broccoli, collard greens) and lemon support the liver detox pathways. Herbs like milk thistle, dandelion root, and burdock root help to support  liver cleansing.
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).
 Because too much insulin (which is released by the pancreas in large amounts when we consume foods high in sugar or refined flour) signals the ovaries to produce more testosterone, and because an overload of testosterone increases the likelihood that our bodies may make more of the hair-thinning hormone DHT, work to keep blood sugar steady by eating fiber-rich whole foods.  In addition, the Saw Palmetto herb has shown promise for its ability to block the conversion of testosterone into DHT, so it may help androgen-related hair loss. To date, research on saw palmetto for hair loss is limited, but the research that has been done is promising.

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.
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
I’m no Frida Kahlo, but since my teenage years, I’ve been blessed with thick, full eyebrows. But as soon as I turned 30, I noticed something was amiss. My beautiful brows were looking, let’s say, sparse. Every time my brow specialist handed me a magnified mirror after my monthly wax, it seemed I had more patchy spots. My low-maintenance morning routine—a quick brush-up and pencil fill-in—was suddenly taking up a lot more time. I found myself on a constant quest for the best brow powders, pencils, and gels, and started researching microblading in hopes of finding a solution.
Lichen planopilaris and frontal fibrosing alopecia inflammatory conditions, in which the inflammation destroys the hair follicle, can cause a scar or permanent hair loss (usually present as red patches with redness and scale around each hair follicle). In the very advanced stages, they may appear as smooth, bald patches where the hair follicles have been destroyed. Androgenetic hair loss is another non-scarring type. The most common type of hair loss, it is due to the complex interplay of genes, hormones, and age.
Telogen effluvium is the second most common type of hair loss. It is predominantly seen in women between the ages of 40-70, but may occur at any age. Its symptoms include excessive thinning, shedding, and balding and it may happen abruptly. Common causes of sudden hair loss include changes in hormone levels such as with child birth, menopause, poor nutrition, medical conditions such as iron deficiency anemia and hypothyroidism, medications, severe illness or infection, major surgery, and even extreme levels of stress.
“The biggest mistake I see is people being too heavy handed with their eyebrow products,” says Megan Studabaker, a registered nurse and owner of Finespun Brow Design in Scottsdale, Arizona. “I recommend applying products in hair-like strokes, versus just filling in with powder because it often gets smeared and messy which isn’t achieving the polished look you are going for.” I’ve had good luck using Benefit Precisely, My Brow Pencil ($24) and Foolproof Brow Powder ($24).
No one wants to lose their hair, but for women it is especially traumatic. Men can shave their heads and look hip, even sexy. Most women don’t want to be bald. Though it is more common — and visible — in men, many women lose their hair. According to the American Academy of Dermatology, 30 million women in this country have hereditary hair loss, compared with 50 million men. But many additional women experience thinning hair that results from menopause or health problems. 

When men have hereditary hair loss, they often get a receding hairline. Many men see bald patches, especially on the top of the head. Women, on the other hand, tend to keep their hairline. They see noticeably thinning hair. The first sign of hair loss for many women is a widening part. In rare cases, men see noticeably thinning hair. And in rare cases, women can see a receding hairline or bald patches. The reasons for this are unknown.
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. 
For women going through menopause, the cause of hair loss is almost always related to hormonal changes. However, there are many other factors that can contribute to hair loss during menopause. These include extremely high levels of stress, illness, or a lack of certain nutrients. Diagnostic blood tests that can help rule out other causes of hair loss include thyroid tests, and/or a complete blood count.
Low iron and low B12 can arise from a variety of causes including autoimmunity, poor intake, depletion due to medications (i.e. antacids) or bad digestion and are common causes of hair loss. But other common nutrient deficiencies can arise as part of a less than stellar diet low in zinc, protein (especially the amino acid lysine) or a deficiency of vitamin B6 (a very common issue with women taking hormones like the birth control pill). Low vitamin D has also been linked to excessive hair loss as has excessive vitamin A intake (less common.)
Like with low thyroid, there can be a myriad of imbalances at play with PCOS related hair loss making it a complex issue that’s often written off as merely high testosterone. While androgen excess and hypersensitivity of the hair follicles to these hormones are part of the issue, these are other contributing factors to PCOS related hair loss as well:
Optimal levels of estrogen help to grow full thick hair, while low estrogen levels lead to thin and stalled hair growth, which eventually leads to hair loss. Through the years, a women will go through various cycles of highs and lows in estrogen levels. Puberty is typically associated with high estrogen levels as a woman starts to cycle through menstruation. Pregnancy typically increases hormone production, but once the baby has been delivered the mother can experience a drop in estrogen levels, which can result in thinning and loss of hair. Typically, this corrects itself as the woman's body heals and hormonal regulation returns to normal.  The largest decline in estrogen levels is during menopause. Estrogen is secreted through the ovaries and adrenal glands. When a woman hits menopause, the ovaries’ estrogen production is significantly diminished, which puts an excess burden on the adrenals to produce it. However, as the adrenals are typically overburdened due to stress, symptoms of menopauses like hair loss and hot flashes occur prematurely and excessively for some. Nourishing the body and balancing stress levels will support gentle and graceful transitions.  
The WHI was a very large, very prominent long-term study which looked at the health effects of HRT. While the study did find a few benefits (women who used HRT had fewer hip or bone fractures and were less likely to develop colorectal cancer), it found a number of risks, including an increased chance of heart attack, stroke, cancer, and blood clots.

Other drugs commonly attributed to causing madarosis are miotics, anticoagulants, anti-cholesterol drugs, antithyroid drugs, propranolol, valproic acid, boric acid, and bromocriptine.[21,99] Anticoagulants in high doses have been found to produce loss of scalp, pubic, axillary, and facial hair with loss of eyebrows after a latent period of a few weeks of treatment with dextran and heparin.[100] Propranolol can cause diffuse alopecia along with loss of eyebrows due to telogen effluvium,[101] usually after three months of therapy.[44] Loss of medial aspect of eyebrows can be seen in fetuses exposed to valproic acid.[102] Diffuse alopecia including that of eyebrows has been described due to chronic ingestion of mouthwashes containing boric acid. There was complete reversal following stopping the practice.[103] Levodopa has been noted to cause severe diffuse alopecia within three months of daily use.[104] Hair loss can occur soon after starting topical minoxidil therapy (due to detachment of club hairs following resting hairs reentering anagen), and after cessation of therapy (due to telogen effluvium).[98]
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.  
You will need to check with your health insurance company to find out if hormone replacement therapy will be fully or partially covered, or how much your copayment will be. If you don't have health insurance, costs can still vary greatly depending on the type of medication you get, and whether you take brand name or generic drugs. Prices may range from as little as about $7 per month to as high as $150 a month for hormone replacement therapy.
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.

A. Steroids are not for female pattern hair loss but are sometimes used for alopecia areata (spotty hair loss that is different than hair loss due to genetics and aging). Laser combs? There are some reports that low-level light therapy could stimulate hair growth in some people. It's something to try when people feel like they have no other good options. At $350, it's expensive and I'm not sure it's worth the money, but it is safe.
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.[1] 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.
Growth on Eyebrows – Some common growths on brow aresa such as warts or any unusual growth could hamper eyebrow growth. Skin growth cause a thick barrier that is shell like and it will make it impossible for eyebrows to penetrate them thus you will not have regrowth. Some of the common growths include moles, hemangiomas, seborrheic keratosis among many others.
Your doctor might also suggest the prescription pill finasteride, sold under the brand name Propecia and also in generic versions. Although the drug is not federally approved for use in female patients, some doctors have observed good results in postmenopausal women. But women who are planning to have children should not take this drug because it can cause birth defects.
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.
Women using oestrogen supplementation or taking birth control pills will also experience hair loss when they cease supplying their body with extra oestrogen. These forms of hair loss may be temporary but this, however, does not mean that there is no link between oestrogen and permanent hair loss. Scientists have noted up to 30 hormones that could play a role in female pattern hair loss – the genetic kind of hair loss – and oestrogen, whilst poorly explored, may be one of them. It’s alright if the excess hairs are the ones that are lost but when normal hair falls out, there’s a problem.
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.

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.[1] 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.

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.


Low iron and low B12 can arise from a variety of causes including autoimmunity, poor intake, depletion due to medications (i.e. antacids) or bad digestion and are common causes of hair loss. But other common nutrient deficiencies can arise as part of a less than stellar diet low in zinc, protein (especially the amino acid lysine) or a deficiency of vitamin B6 (a very common issue with women taking hormones like the birth control pill). Low vitamin D has also been linked to excessive hair loss as has excessive vitamin A intake (less common.)
Eyebrows protect the eyes from sweat that trickles down the forehead. They also protect the bony ridges above the eyes. In addition to the above, the eyebrows play a very important function in facial expression and body language. Eyelashes protect the eyeball from small foreign bodies and irritants and stimulate the closing reflex. Both eyebrows and eyelashes play a very important cosmetic function, and thus contribute greatly to the self esteem of an individual.[9]
Madarosis of non-scarring type is commonly seen in alopecia areata which is a hair-specific autoimmune disease associated with patchy loss of hair.[56] It presents as round or oval patches of non-scarring hair loss. Madarosis occurs as isolated involvement [Figure 2] or as a part of alopecia universalis.[57] When alopecia areata involves the eyelashes exclusively, there is rarely involvement of other parts of the body.[58] Alopecia areata can involve both the eyelids without scalp involvement also.[59] Short exclamation mark hairs are pathognomonic for alopecia areata.
No one wants to lose their hair, but for women it is especially traumatic. Men can shave their heads and look hip, even sexy. Most women don’t want to be bald. Though it is more common — and visible — in men, many women lose their hair. According to the American Academy of Dermatology, 30 million women in this country have hereditary hair loss, compared with 50 million men. But many additional women experience thinning hair that results from menopause or health problems.
Thyroid hormone receptors were detected in both dermal and epithelial compartments of the human pilosebaceous unit.[48] T4 and T3 decrease the apoptosis of hair follicles and T4 prolongs the duration of anagen in vitro.[49] Thyroidectomy delays initiation of anagen. Administration of thyroxine advances anagen, initiation of which is however delayed once toxic doses are given. Therefore, ratio of telogen to anagen hairs is increased in hypothyroidism as well as hyperthyroidism.[50] Thus, the hair follicles are affected in thyroid disorders, and madarosis is caused due to disturbances in hair cell kinetics. Hypothyroidism is associated with generalized hair loss probably due to coarse, dull, and brittle hair with reduced diameter.[51] The eyebrows and eyelashes may also be lost. Loss of lateral one-third of eyebrows known as Hertoghe sign[38] is a characteristic sign of hypothyroidism.[52] Some people also refer to it as Queen Anne's sign,[53] after Anne of Denmark whose portrait with shortened eyebrows has been interpreted by some as indicative of the presence of goiter, even though such a fact has not been proved by any known sources of information. Madarosis may even be the presenting sign in hyperthyroidism.[21] In hyperthyroidism, there is thinning with breaking off and shortening of hair.[54] Madarosis can also occur in hypopituitarism, hypoparathyroidism,[21] and hyperparathyroidism.[55]
I’m no Frida Kahlo, but since my teenage years, I’ve been blessed with thick, full eyebrows. But as soon as I turned 30, I noticed something was amiss. My beautiful brows were looking, let’s say, sparse. Every time my brow specialist handed me a magnified mirror after my monthly wax, it seemed I had more patchy spots. My low-maintenance morning routine—a quick brush-up and pencil fill-in—was suddenly taking up a lot more time. I found myself on a constant quest for the best brow powders, pencils, and gels, and started researching microblading in hopes of finding a solution.
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.
There is also a different in the form of 5AR enzyme (5 alpha reductase) found on the facial hair follicles vs. the scalp hair follicles. This enzyme converts testosterone into that more problematic DHT. Type I DHT is found in sebaceous glands on the face and genital area whereas Type II is found in hair follicles of the scalp. Type II DHT is typically more of a problem in men, but Type II is increased in disorders with high testosterone like PCOS.
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 are numerous diseases that can affect the hair and scalp. Hair loss can be caused by a variety of conditions. Diseases such as alopecia areata, anemia, male/female pattern baldness, and infections of the scalp can all cause significant difficulty and loss of daily well-being. Stanford Dermatology has established a special clinic focusing on the diagnosis and treatment of these disorders of the hair.
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