Giorgos Tsetis: I am an entrepreneur and have an engineering background that allows me to think in strategic ways to solve complex problems. Of course, I did have this very personal experience. But, to be honest with you, getting into this category wasn't directly a choice, it felt more like destiny. I say that, because their are literally millions who suffer from what I was suffering from. Aside from being a model, I owned an engineering company in New York, and business was steadily growing. The tipping point came when I found out the University of Washington published research that said my issue could cause permanent sexual dysfunction without the specific drug I was taking. That's when I panicked, reached out to my business partner and dear friend, and we begun to dig deeper into the issue. As we started diving deep, we recognized there was a tremendous white space.
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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.

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
Other conditions, which can cause eyebrow hair loss, include infection by a number of fungal infection, which are common, both on your scalp and eyebrow areas, affliction by pests such as lice, which will cause itching, and scratching. Infiltrating disorders such as scars, alopecia mucinosis, and sclerosing disorder could also cause brow hair loss. If you are heavily using any of the following drugs, they could also cause eyebrow hair loss: 

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.


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.
Accurate placement of the grafts is necessary to ensure a good cosmetic result. In the medial third, the needles should be inserted parallel to the brow axis.[203] The follicles should point toward the tip of the nose and the hairs should converge toward each other in the other two segments, that is, the bulbs in the upper part point toward the forehead and in the lower part toward the other eyebrow.[204] 

Testosterone converts to DHT with the aid of the enzyme Type II 5-alpha reductase, which is held in a hair follicle's oil glands. Scientists now believe that it's not the amount of circulating testosterone that's the problem but the level of DHT binding to receptors in scalp follicles. DHT shrinks hair follicles, making it impossible for healthy hair to survive.
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. 

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).
Alopecia areata is a chronic autoimmune disease in which the immune system erroneously attacks the hair follicles, causing inflammation and temporary hair loss. Any hair-bearing skin site can be affected by alopecia areata, including the eyebrows. Treatment commonly involves corticosteroid injections into the site of eyebrow loss. Eyebrow hairs usually grow back, but may be a different color or texture than the lost hairs.
Eyebrow thinning that manifests in irregular patches, especially accompanied by red and itchy skin, may indicate atopic dermatitis. This condition—commonly called eczema—can occur just about anywhere on the body and is usually hereditary. People with atopic dermatitis may be more sensitive to topical irritants, but eczema just from topical irritants is called allergic contact dermatitis or irritant contact dermatitis. While you wait on the appointment with your dermatologist, you can help ease eczema around the eyebrows by switching to mild soaps or a soap-free facial cleanser, and applying an intensive facial moisturizer within three minutes after bathing.
Menopause is a natural biological process that all women experience at some point in their lives. During this time, the body goes through numerous physical changes as it adjusts to fluctuating hormone levels. Many women have unpleasant symptoms during menopause, including hot flashes, mood swings, and insomnia. Hair loss is another common occurrence.

Menopause is a natural biological process that all women experience at some point in their lives. During this time, the body goes through numerous physical changes as it adjusts to fluctuating hormone levels. Many women have unpleasant symptoms during menopause, including hot flashes, mood swings, and insomnia. Hair loss is another common occurrence.
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.

Hormones don’t just affect your mood, they are also common culprits of hair loss. A hormone imbalance caused by thyroid disease, pregnancy, menopause, or hormone medication (like birth control pills) can lead to eyebrow loss. Thankfully, once you identify the source of the hormone imbalance and address the problem, your hair will likely grow back naturally.
If you are in Maryland, especially in Rockville, Maryland, you could schedule an appointment with us and have your consultation. We would provide you with answers and treatments available for you and your skin condition. Contact us and let us know about your skin dilemma. Katz Dermatology has been serving Maryland for 40 years now and continues to provide quality of dermatology services especially in general dermatology, cosmetic dermatology, surgical dermatology and aesthetic dermatology.

Hormone Replacement Therapy: You may be advised to go for hormone replacement therapy or may take supplementary estrogen in case your doctor suspects that the hair loss is caused because of low or lack of estrogen hormone. These supplements may either be taken orally or may be applied topically to the skin as a gel. However it must be mentioned that not all women are benefited with this type of treatment for low estrogen levels causing hair loss.

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.
At Hair Club, we’ll support you throughout your entire hair restoration journey because we know from personal experience what you’re going through. We understand the emotions you’re feeling and we know the questions you have. We’re here for you, every step of the way, offering advice, education and a welcoming space where you can feel comfortable being yourself. Rest assured, we have the answers you need and the solution you want. That’s why we’re the trusted leader in hair restoration.
Alopecia areata: Researchers believe that this is an autoimmune disease. Autoimmune means the body attacks itself. In this case, the body attacks its own hair. This causes smooth, round patches of hair loss on the scalp and other areas of the body. People with alopecia areata are often in excellent health. Most people see their hair re-grow. Dermatologists treat people with this disorder to help the hair re-grow more quickly.
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]
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.

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.
The recipient sites in the eyebrow can be conveniently made with 20 to 22-gauge needles parallel to the skin, so that hair grows flat on the skin and does not stick out from the face. About 150 hairs are required for a full eyebrow graft. Poddar et al. described good results with a technique of creating recipient tracks with the erbium yttrium aluminium garnet laser.[202]
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:
Yeah right! The way Policing works in this country now if you stopped someone giving a cop a good hiding the same cop would then nick you for assaulting his attacker. NO CHANCE! The police got themselves into this by not doing their jobs properly and PROTECTING innocent people. Now? What trust and support there ever was for them is almost gone.....by their own hand.
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.
Scalp hair loss may be a common complaint among men and women, but in my practice, loss of eyebrow hair is a major concern among my female patients. Because eyebrows frame the face, hair loss in this area can dramatically change one's appearance, and since eyebrow hair loss is not easily concealed, it can be, for some women, an even more devastating loss than scalp hair loss.
 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.
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.
Other important vitamins for eyebrow hair growth to consider include vitamin B complex especially vitamin B-12, B-7 (biotin), can ensure healthy hair and skin. In addition, vitamin D can help in hair growth by creating new pore and thus a possibility of more hair (see more on Stem Cells Translational Medicine. Finally ensure you have zinc, enough protein, and omega 3 fatty acids.
There are numerous nonsurgical treatments that when combined, can offer significant hair improvements. Dr. Yaker’s TCHR Volumizing Glycolic Acid Shampoo and Conditioner help restore vitality to the hair by deep cleaning the scalp and reestablishing lost moisture content and physiological pH to the scalp and hair. Dr. Yaker has also formulated his own oral supplement, which is a blend of Aminoplex hair repair vitamins. This is made up of amino acids (building blocks of protein) that produce keratin, which makes up close to 97% of our hair. In addition, Dr. Yaker’s specially compounded FDA approved topical medication, Minoxidil (brand name: Rogaine®), is clinically proven to help slow down, stop and even reverse hair loss in women. Other nonsurgical therapies offered are Low Level Laser Therapy (LLLT) using the advanced LaserCap®, and Platelet Rich Plasma (PRP) with placenta-derived extracellular matrix therapy to help restore thinning hair. Lastly, Dr. Yaker offers scalp and facial micropigmentation where permanent ink is applied to the skin, creating micro dots that replicate the natural appearance of hair. This is used for the scalp and eyebrows.
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.
Hair loss on the eyebrows can be partial where the hair falls off in patches or the eyebrow thins and shortens abnormally. It may occur on one side or both sides. It can also be complete where all the hair on one or both eyebrows are lost. These patterns of eyebrow hair loss can give some indication of the underlying cause even when there are no other symptoms. Some of these conditions may be specific to the eyebrows (the hair follicles and skin in that region) or can be an extension of problems affecting surrounding skin like the face, forehead or scalp.
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]
Hair loss in women isn't always as straightforward as it is in most men. In men, about 95 percent of all cases are caused by male pattern baldness. In women, however, hair loss can be triggered by a multitude of conditions and circumstances. During the consultation, Dr. Yaker utilizes specialized hair and scalp scanning technology to assess the distribution of hair loss, hair thickness, and how much hair is present in a particular area. It is important to note, that for women, a proper diagnosis begins with a process of elimination. More than one cause for the hair loss may coexist and need to be recognized or excluded. A comprehensive medical history, which includes a list of all medications, history of hair loss, a thorough scalp exam, a discussion of medical and skin disorders, and a complete nutritional evaluation will be needed. Blood work analysis may be required, and a scalp biopsy may also be performed if the cause of hair loss is uncertain or there is a concern for scarring alopecia.

Eyebrow thinning that manifests in irregular patches, especially accompanied by red and itchy skin, may indicate atopic dermatitis. This condition—commonly called eczema—can occur just about anywhere on the body and is usually hereditary. People with atopic dermatitis may be more sensitive to topical irritants, but eczema just from topical irritants is called allergic contact dermatitis or irritant contact dermatitis. While you wait on the appointment with your dermatologist, you can help ease eczema around the eyebrows by switching to mild soaps or a soap-free facial cleanser, and applying an intensive facial moisturizer within three minutes after bathing. 

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.
It is known that estrogen plays a great role in reducing bodily hair, in promoting the growth of the hair on your head, controlling height, reducing the muscle mass, promoting the breast growth, keeping the skin smooth, keeping away from wrinkles, regulating menstrual cycle in women, preventing fatigue, keeping away depression etc. From all these it can be known that estrogen hormone is important for the overall health of an individual.

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).


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).
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.
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.

Hair loss in women can be related to genetics, hormones and age. Androgenetic alopecia, also known as female pattern hair loss, is one of the most common causes of hair loss in women. Hair loss in women may be caused by a serious medical condition that needs proper attention and treatment as early as possible. The hair loss patterns in women usually differ from those in men. Find out more about hair loss in women.
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.  
Exercise is a key component of a healthy lifestyle. You’ll feel stronger and happier once you incorporate exercise into your daily routine. It also helps prevent some of the other symptoms of menopause, including mood swings, weight gain, and insomnia. All of these factors are important for maintaining hormonal balance, which promotes healthy hair growth.
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