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).


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.
Hair loss in women is not easy to diagnose because it is very often multifactorial in etiology and thus requires well-designed specific steps so that the patient is evaluated properly. The best way to do this is to evaluate the patient in person (rather than sending photos via email or Skype) because the patient gets a chance to meet her doctor to permit the development of a trusting relationship- critical because very often the treatment of hair loss is an involved process that requires a strong doctor-patient relationship.
Trichotillomania is common and 3-5 % of the world pull out their own eyebrows due to underlying psychological factors. For some, the pulling is temporary and for others is a chronic condition. Treatment of the underlying psychological factors (stress, depression, anxiety, obsessive compulsive disorder) can lead to improvement. Hair transplants are not an options if the patient is actively pulling his or her eyebrows
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.
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FPHL or androgenetic alopecia is the most common cause of hair loss in women and one of the most common chronic problems seen by dermatologists worldwide (Varothai and Bergfeld, 2014). FPHL is a nonscarring form of alopecia in which the frontal hairline is maintained, but there is progressive hair thinning at the vertex of the scalp. Thinning of the hair is secondary to alteration of the hair cycle with shortening of the anagen phase and simultaneous lengthening of telogen. This increase in the resting phase and decrease in the growth phase of the hair cycle results in the miniaturization of hair because long terminal hairs are gradually replaced by short vellus hairs (Messenger and Sinclair, 2006, Sinclair et al., 2011).
Another cause of eyebrow hair loss is genetic predisposition. Many patients naturally have thinner eyebrows that run in their family. This is one of the biggest reasons patients seek our services. Medical conditions such as hypothyroidism, eczema, and alopecia areata (spot baldness) can also lead to brow hair falling out. It’s important to determine the cause of your condition to find an effective treatment.
If you are suffering from hair loss on your head AND your brows, you might be suffering from a protein deficiency of some sort. A supplement like Viviscal (available here), which is packed with marine protein, could help your condition. Viviscal has been shown to treat alopecia areata, as well as androgen-related hair loss (Journal of International Medical Research, 1992; FutureDerm). It will take some time, though: changes in protein in the diet have been shown to correspond with protein in the hair within 6-12 months (American Journal of Physical Anthropology, 1999; Futurederm).
The complex actions of genetics, DHT, shifting of hormone ratios and age-related volume loss can commonly occur in women in their 40’s and 50’s. However, just like in men, genetic hair loss can appear at all ages after puberty.  In fact, hair loss occurs with relatively high frequency even in women in their 20’s and 30’s. The majority of women with female pattern hair loss initially develop diffuse thinning over the front and top of the scalp, while maintaining the frontal hairline. This thinning may present with a widening through the central part line while others may present initially with either episodic or continuous hair shedding, prior to any noticeable decrease in hair volume. In addition, thinning may also be seen throughout the scalp, including the temple areas as well as the back and sides.
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.
Madarosis is the hallmark of lepromatous leprosy. It was reported in 76% of patients with multibacillary leprosy.[76] Bilateral symmetric cicatricial madarosis occurs in lepromatous leprosy due to histiocytic infiltration of hair follicles[77,78] [Figure 4]. It occurs in multibacillary leprosy after at least 5 to 10 years of untreated disease.[79] Loss or atrophy of the eyelashes may follow. Madarosis adds to the cosmetic disfigurement caused by leprosy. Absence of madarosis is a good prognostic sign in long-standing cases.[80] Unilateral madarosis may occur in tuberculoid leprosy due to the facial patch in the eyebrow region. In tuberculoid leprosy, madarosis occurs due to granulomatous infiltration of hair follicles leading to their destruction.
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.
During and after pregnancy, estrogen levels may frequently rise and then dip back down quickly. This sudden dip is what leads to hair loss after giving birth, which can be normal and should stop as hormone levels balance again. If hair loss is accompanied by a myriad of other symptoms post pregnancy, there may be a deeper issue beyond normal hormone fluctuations, such as thyroid function. “But exhaustion, feeling down, difficulty losing weight, intense struggle to produce enough breast milk, and hair loss aren’t always just a normal part of having had a baby,” says Dr. Aviva Romm. If you are experiencing any of these issues post pregnancy, do talk to your doctor about what you are going through.
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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.
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.
Furthermore, Penn dermatopathologists developed an even more advanced method called the HoVert technique for diagnosing hair loss and other disorders from a scalp biopsy. The technique uses a unique horizontal and vertical testing approach that provides a greater amount of information to the referring dermatologist than standard industry longitudinal scalp biopsies.

Eating a balanced, low-fat diet is your best defense against hair loss. Make sure you include an adequate amount of whole grains, fruits, and vegetables in every meal. It’s also important to incorporate mono-saturated oils, such as olive oil and sesame oil, into your diet. Drinking green tea and taking vitamin B6 and folic acid supplements may help restore hair growth as well. Essential fatty acids also play a crucial role in maintaining hair health. These fatty acids can be found in the following foods:
Androgenetic alopecia, commonly called male or female pattern baldness, was only partially understood until the last few decades. For many years, scientists thought that androgenetic alopecia was caused by the predominance of the male sex hormone, testosterone, which women also have in trace amounts under normal conditions. While testosterone is at the core of the balding process, DHT is thought to be the main culprit.
These are only a few of the common myths heard by physicians and other hair loss specialists on a daily basis. The American Hair Loss Council suggests that you first have your hair loss diagnosed by a competent dermatologist who sees hair loss patients on a regular basis. Once you know the diagnosis you will have a better understanding of exactly which treatment option may be best for you.
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.
Topical estrogen and progesterone creams and oral medications are generally the forms prescribed for post-menopausal women with androgenetic alopecia. But HRT will rarely, if ever, be prescribed for treatment of hair loss alone.] If you have other bothersome symptoms which might warrant HRT, in addition to hair loss, you'll first need to undergo a thorough gynecologic and physical exam, and will likely have blood tests done to measure hormone levels before these drugs are prescribed.
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. 
Blepharitis is a chronic primary eyelid inflammation. It is fairly common in occurrence and being a condition with remissions and relapses, results in a decreased quality of life if adequate measures are not taken. Chronic blepharitis is the most common condition associated with madarosis.[10] Though there are various ways of classifying blepharitis, the most useful is the one proposed by Wilhelm,[24] wherein blepharitis can be classified based on whether there is a predominant involvement of the part of the eyelid anterior to the gray line (anterior blepharitis), or posterior to the gray line (posterior blepharitis). The gray line is an imaginary line dividing the eyelid into an anterior part consisting of the skin and muscle, and a posterior part consisting of the tarsus and conjunctiva.
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.
If you have a case of estrogen dominance, you can help bring your levels down to normal by keeping your gut healthy and avoiding refined carbohydrates like white bread and white rice. Also, avoid eating any meat that has been treated with hormones. If you have low levels of estrogen, solutions include minimizing your stress, practicing a healthy diet, and exercising regularly.
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.
Yes. Hyperandrogenism, a medical condition characterized by excessive production of male hormones called androgens, can cause hair loss in affected women. The most common cause of hyperandrogenism in women is functional ovarian hyperandrogenism, also known as polycystic ovary syndrome. In addition to hair loss, other signs include obesity, acne, and irregular menstruation, and it is one of the most common causes of infertility.
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.
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.
This “mature” hairline is not considered balding; the Norwood III is considered the first evidence of balding in androgenetic alopecia (male pattern baldness). In studying the Norwood charts, we see that usually the most advanced balding is known as a class VII, and that there are also Type “A” variants in which the forelock in the middle tends to recede along with the fronto-temporal areas, and in which there is be less overt crown loss than in the regular III, IV, and V patterns.
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 is a terminology that refers to loss of eyebrows or eyelashes. This clinical sign occurs in various diseases ranging from local dermatological disorders to complex systemic diseases. Madarosis can be scarring or non-scarring depending upon the etiology. Appropriate diagnosis is essential for management. Follicular unit transplantation has been found to be a useful method of treating scarring madarosis and the procedure relevant to eyebrow and eyelash reconstruction has been discussed. A useful clinical approach to madarosis has also been included for bedside diagnosis. The literature search was conducted with Pubmed, Medline, and Google scholar using the keywords madarosis, eyebrow loss, and eyelash loss for articles from 1960 to September 2011. Relevant material was also searched in textbooks and used wherever appropriate.
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