Hormones are cyclical. Testosterone levels in some men drop by 10 percent each decade after thirty. Women's hormone levels decline as menopause approaches and drop sharply during menopause and beyond. The cyclic nature of both our hair and hormones is one reason hair loss can increase in the short term even when you are experiencing a long-term slowdown of hair loss (and a long-term increase in hair growth) while on a treatment that controls hair loss.

Androgenic alopecia, hair loss when androgen levels are not too high, is an indicator of inflammation. Hair loss is just one sign of inflammatory issues like Celiac disease or gluten intolerance. Naturopathic Doctor Lara Bridden says, “Inflammation hyper-sensitizes your hair follicles to a normal amount of androgen. Reduce inflammation by avoiding food sensitivities such as wheat and/or dairy, and by correcting intestinal permeability.”
When the thyroid is under stress or poorly nourished—the thyroid is highly dependent on optimal levels of vitamins and nutrients to function optimally—it starts to focus its efforts on supporting the bodily processes (like breathing and regulating heart rate) that support and sustain life—and it stops paying as much attention to less vital functions, like hair growth.

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. 

Eating too many high-glycemic foods for too long (often in combination with other lifestyle factors, like being sedentary and experiencing chronic, unremitting stress) can cause an overload of insulin in the body—and too much insulin disrupts ovulation and signals the ovaries to make testosterone. More testosterone predisposes the body to more DHT conversion, and, hence, more hair loss.


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.
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. 
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.
Scurf refers to the scales and greasy crusts that accumulate along the hair shaft and indicates the presence of seborrhea.[26,27] Collarettes are composed of hard fibrinous scales[25,28] surrounding each individual eyelash. They travel upward along with the growth of the lashes and are indicative of staphylococcal infection. Sleeves or cylindrical dandruff comprise scales that form a cuff around the lash root and are connected with it, in contrast to greasy scales which are not connected to the lash root.[29] Sleeves indicate infestation with Demodex folliculorum.
Most women with pattern hair loss don't get a receding hairline or bald spot on top of the scalp as is common in men. Instead, there is visible thinning over the crown. In men and women, hairs are miniaturized because of a shortened growth cycle where the hair stays on the head for a shorter period of time. These wispy hairs, which resemble forearm hairs, do not achieve their usual length.
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]

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.


Yes. If you wear pigtails or cornrows or use tight hair rollers, the pull on your hair can cause a type of hair loss called traction alopecia (say: al-oh-pee-sha). If the pulling is stopped before scarring of the scalp develops, your hair will grow back normally. However, scarring can cause permanent hair loss. Hot oil hair treatments or chemicals used in permanents (also called “perms”) may cause inflammation (swelling) of the hair follicle, which can result in scarring and hair loss.
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. 
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.
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.

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).

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.


Trichotillomania is a hair pulling disorder associated with anxiety, stress, depression, boredom and frustration. It is where a person manually removes hairs with their finger, either a few strands throughout the day or sometimes many strands at one time during an emotional outburst. This behavior is usually a means of coping with stress or emotional turmoil. However, it can sometimes become a habit that is difficult to break. The eyebrows is a commonly targeted area as is the scalp.

But there’s load of hope! Just know it takes time and first and foremost it takes knowing the cause of the hair loss. That’s the only way to get on top of the issue. The type of hair loss you have (all over, patchy, thinning, losing only at temples, lack of new hair growth after shedding, etc.) points to the underlying cause of your shedding locks. So always start there. 

Both of these hairy issues are related to excess androgens that are part of PCOS.  Our hair follicles respond overzealously to testosterone creating both hair loss and hair growth. This is because the follicles on the face tend to stretch and grow causing the hair to get stuck and not fall out when they should. Conversely, the scalp hair follicles actually shrink in response to androgens and the hair can fall out or just not be as robust.

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]
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.
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:
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.
Trichotillomania is a hair pulling disorder associated with anxiety, stress, depression, boredom and frustration. It is where a person manually removes hairs with their finger, either a few strands throughout the day or sometimes many strands at one time during an emotional outburst. This behavior is usually a means of coping with stress or emotional turmoil. However, it can sometimes become a habit that is difficult to break. The eyebrows is a commonly targeted area as is the scalp.

Reproductive hormone changes can also play a part, and dermatologists believe the same factors that cause hair loss from the scalp, a common problem for women as they age, may contribute to thinning brows. Nanette Santoro, M.D., ob/gyn and professor of reproductive endocrinology at the University of Colorado at Denver, says, “Abrupt hormone changes can cause sudden hair loss (telogen effluvium) that recovers over about six months' time. It happens postpartum to many women and can happen at menopause.” 

Complete Belgravia's online consultation if you are unable to visit one of our London clinics. The questionnaire should take no more than 10 minutes to complete and will provide our hair loss specialists with all the information required to recommend an effective course of home-use treatment. For those who live in or around London, we always recommend a clinical consultation.

Telogen effluvium is a condition where a large number of hair follicles enter the resting phase known as telogen. As these hairs may fall off, it is not replaced with new hair at the same area and this leads to a bald patch on the eyebrows. A number of hormonal factors (like with hypothyroidism and pregnancy) may be responsible and it is also related to certain diseases, nutritional deficiencies, chronic medication use and even metal toxicity. It is now also known that stress can push many more hair follicles than normal into this phase.
Also called “chastetree,” Vitex is an herb which is typically prescribed to treat estrogen dominance. It seems to be recommended as a remedy for especially low levels of estrogen as well however, and does seem to have a general balancing effect on the overall ratio of estrogen to progesterone. Vitex’s balancing effect is thought to result from the stimulation of dopamine production.
*Photograph used with permission of the Journal of the American Academy of Dermatology. This photograph was published in the Journal of the American Academy of Dermatology, Vol. # 60, Gathers RC, Jankowski M, Eide M, et al. “Hair grooming practices and central centrifugal cicatricial alopecia,” 660-8. Copyright Elsevier (2009). Journal of the American Academy of Dermatology.   
If you’re stressed out on a regular basis, you may experience excessive hair shedding. Though this is not typically a permanent problem, physical and emotional stress can cause your eyebrow hair follicles to go into a resting phase. After resting phase, follicles enter telogen, or shedding phase, and will begin to shed. Usually, there is a delay between the stress and the shedding phase, sometimes up to 3-4 months. Thankfully, your hair growth should go back to normal again after your stress decreases. However, it can take several months.
Try out new hairstyles to disguise your thinning hair whilst you recover your hormonal balance. You may also want to consider a hair piece or clip-in extensions if your hair loss is very bad, but these should be used with care in order to prevent traction alopecia. You may also like to try using rollers or a hair volumizer, to add lift to your locks, or instantly hide thin patches with a good hair loss concealer.

Diet and supplements. Hair loss caused by a vitamin deficiency or eczema can be addressed with a healthy diet and targeted vitamins and supplements. Make sure you’re getting plenty of vitamins A, B and D by eating leafy greens, nuts and seeds, fish, eggs and whole grains. If you have any gaps in your diet, take the necessary supplements to promote hair growth. Your doctor can give you direction about what to eat and take for support.
Medicines may also help slow or prevent the development of common baldness. One medicine, minoxidil (brand name: Rogaine), is available without a prescription. It is applied to the scalp. Both men and women can use it. Another medicine, finasteride (brand name: Propecia) is available with a prescription. It comes in pills and is only for men. It may take up to 6 months before you can tell if one of these medicines is working.
MICHAEL REED, MD: Over-the-counter minoxidil, which is the brand Rogaine, is FDA approved. It's been shown to be effective in scientific studies. Propecia is the new drug on the block, and that probably is more effective. It's a pill that you take once a day, and that has been shown to slow down hair loss and grow hair in a significant number of individuals. Most of the other preparations that are heavily advertised or marketed are not proven to be effective.
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