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.
Balancing your hormones is not an easy process, whether you are in perimenopause, menopause, or post-menopause. You may find that just one of these herbs is sufficient to do the trick, but in many cases you will achieve the best results by taking a combination of herbs. Start gradually and track your results carefully to make sure you are choosing the right products to balance and adjust your particular hormone profile.
Skin infections can cause hair loss at the affected area. One of the more common causes is a fungal infection of the skin, also sometimes referred to as a ringworm. Eyebrow fungus is more likely to be related to a scalp fungus (tinea capitis) and both areas are often affected at the same time. A bacterial infection is another possible cause. Folliculitis for example is a condition where the hair follicle becomes infected usually with bacteria like Staphylococcus aureus. Eventually this can lead to loss of the hair in the infected follicle.
Another reason that you have thinning eyebrows might be low thyroid (which is called hypothyroidism. The thyroid gland controls the rate of use of energy sources, protein synthesis by producing thyroid hormones. I the thyroid gland does not produce enough hormones, you might feel tired, freeze in the cold, gain weight or lose your hair. The most common cause of hypothyroidism is iodine deficiency.
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.
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.

Eight of 69 eyes receiving intra-arterial chemotherapy with melphalan for retinoblastoma were found to develop a cutaneous periocular erythema with partial loss of eyelashes.[110] Gobin et al. also reported a 12.6% incidence of madarosis following intra-arterial chemotherapy for retinoblastoma.[111] Moti and Fausel described a case of cyclical alopecia areata including the eyebrows and eyelashes after treatment with paclitaxel and carboplatin.[112] Other drugs which have been implicated in hair loss due to anagen effluvium are adriamycin, cyclophosphamide, daunorubicin, epirubicin, etoposide, ifosfamide, irinotecan, topotecan, vindesine, and vinorelbine.[98,113]

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.
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.
 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.

Cyproterone acetate works in several ways. It not only competitively blocks DHT from binding to its receptors at target tissue (Gilman et al., 1990), but it is also a progestogen that lowers testosterone levels by decreasing the release of luteinizing and follicle-stimulating hormones through pituitary-mediated supression (Gilman et al., 1990, Varothai and Bergfeld, 2014). An open intervention study of 80 women who received treatment with spironolactone (200 mg daily) or cyproterone acetate (50 mg daily or 100 mg for 10 days per month if premenopausal) showed that three of four patients demonstrated an improvement or stabilization of their disease with no difference of effect between the therapies received (Sinclair et al., 2005).


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.
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. 

At Hair Club, you can be part of a well-established, stable company with more than 40 years of success. We are the industry leader in providing hair loss solutions. Our company culture is fun, fast-paced, empathetic and comes with a conscience. Not only do we make a difference in the lives of our clients every day, we also contribute to the community locally through our charitable and volunteer programs. If you’re enthusiastic, motivated and confident, we’d love to talk to you about joining our team of hair restoration professionals.


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.
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.
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.   

Taking estrogen supplements as part of a hormone replacement therapy regime has its effects on your hair as well. Women can treat a type of hair loss called androgenic alopecia, associated with low estrogen and progesterone, by replacing these hormones artificially. Dosages of synthetic estrogen should be monitored regularly -- abnormal hair growth is a possible side effect of one kind of hormone replacement therapy, called esterified estrogens.
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.
Also, what we tend to forget is that while it’s easy for most women to recognize financial, emotional or overwhelm type stress, we also have internal metabolic and biochemical stresses like anemia, inflammation and nutrient deficiencies that we are often less aware of. Diet and exercise can also become stresses. It is well known that low calorie dieting or excessive exercise are commonly associated with hair loss.
At Hair Club, you can be part of a well-established, stable company with more than 40 years of success. We are the industry leader in providing hair loss solutions. Our company culture is fun, fast-paced, empathetic and comes with a conscience. Not only do we make a difference in the lives of our clients every day, we also contribute to the community locally through our charitable and volunteer programs. If you’re enthusiastic, motivated and confident, we’d love to talk to you about joining our team of hair restoration professionals.
Giorgos Tsetis: In the beginning, we left three factories because we didn't feel confident that they could do the job at our standard. These type of factories are sourcing the ingredients for you, but you have no clue where these ingredients are coming from. You don't know the efficacy, if they're clinically tested, and what about absorption? As a company, we decided to identify these root triggers that play a role in disrupting the hair growth cycle, then rigorously tested how we can target them and what specific ingredients solve for each trigger. Then, we developed individual partnerships with top suppliers all over the world that specialized in single ingredients that actually have that efficacy. We decided to source our own ingredients because we wanted to control the entire process. At least nine of the ten companies we consulted with said we couldn't do that, because the ingredients we chose to use were incredibly expensive. That's one main reason others can't do the work we do. For example, we purchase our primary ingredient for $600 per kilo, and you can buy the standard version of that ingredient in China for $30 per kilo. Same ingredients, but ours is clinically tested and proven to be effective. We only use patented ingredients, which made others think we're crazy, but creating the absolute best product is our top priority.
That's why I've designed a system I call The Gottfried Protocol, a step-by-step, integrative approach to natural hormone healing that emphasizes lifestyle design first and foremost. It's based on decades of research, my education at Harvard Medical School, my own experiences with hormonal imbalances, my belief in peer-reviewed, well-performed randomized trials to support my recommendations, and what I've learned from patients over the past 20-plus years of practicing medicine. The Gottfried Protocol engages only the top hierarchy of scientific evidence and has been proven in scores of women in my practice.
Additionally, two other considerations are important for a patient who receives treatment for FPHL. First, there is a set of reasonable expectations in patients. Maintaining the current hair density can be considered a successful treatment because women tend to have further thinning as they age (Harfmann and Bechtel, 2015). Second, it is important to ensure that patients understand that progress is slow, and months or years can be required to see a significant improvement (Boersma et al., 2014, Yeon et al., 2011). In our practice, we wait at least 6 months to assess treatment efficacy.
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.
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.
Cyproterone acetate works in several ways. It not only competitively blocks DHT from binding to its receptors at target tissue (Gilman et al., 1990), but it is also a progestogen that lowers testosterone levels by decreasing the release of luteinizing and follicle-stimulating hormones through pituitary-mediated supression (Gilman et al., 1990, Varothai and Bergfeld, 2014). An open intervention study of 80 women who received treatment with spironolactone (200 mg daily) or cyproterone acetate (50 mg daily or 100 mg for 10 days per month if premenopausal) showed that three of four patients demonstrated an improvement or stabilization of their disease with no difference of effect between the therapies received (Sinclair et al., 2005).
Taking estrogen supplements as part of a hormone replacement therapy regime has its effects on your hair as well. Women can treat a type of hair loss called androgenic alopecia, associated with low estrogen and progesterone, by replacing these hormones artificially. Dosages of synthetic estrogen should be monitored regularly -- abnormal hair growth is a possible side effect of one kind of hormone replacement therapy, called esterified estrogens.

Dr. Kimberly Langdon Cull is a University-trained Obstetrician/Gynecologist with 19-years of clinical experience. She delivered over 2000 babies and specializes in gynecologic diseases such as menstrual disorders, infertility diagnosis and treatment especially pertaining to tubal blockage and polycystic ovarian syndrome (PCOS). Dr. Langdon is the inventor of 6 patent pending medical devices, and attended Ohio State University from 1987-1995 receiving her Medical Doctorate Degree (M.D.) with Honors in Obstetrics and Gynecology.
It is known that during pregnancy, because of an increased level of estrogen, there is a tremendous growth of new hair. However, during menopause it is noticeable that the reduced level of estrogen hormone tends to cause hair loss. When the estrogen hormone levels tend to drop, the hair follicles fall under the influence of the male sex hormone or the testosterone, which cause the shortening of the growth phase of hair. Subsequently there is a noticeable hair loss. This hair loss caused due to the drop down of estrogen levels may cause patchy hair loss or complete baldness.
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.

I can't tell you how many women come into my office fretting about the fact that they've over-plucked. While this is certainly a possibility (plucking the eyebrows damages the hair follicle, and with repeated plucking, the follicle can get damaged to the point that it can no longer produce a hair), there are actually a number of both external and internal causes and conditions that can lead to temporary or permanent loss of eyebrows.

Male pattern hair loss has been established as androgen-dependent because it is associated with changes in the androgen receptor and responds to antiandrogen therapy (Ellis et al., 2002). With FPHL, genes that encode aromatase, which converts testosterone to estradiol, are also implicated (Yazdabadi et al., 2008, Yip et al., 2009). The process of androgen biosynthesis is depicted in Figure 1.
There’s no doubt that estrogen and hair loss are connected, but there are certain factors that determine how much of an effect estrogen levels have on your hair. As one of the main visible measures of your health, hair growth is often one of the first areas affected when hormones are off-balance. Let’s take a look at the links between estrogen hormonal imbalance and hair loss.
×