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


*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.   

The majority of women with androgenic alopecia have diffuse thinning on all areas of the scalp. Men on the other hand, rarely have diffuse thinning but instead have more distinct patterns of baldness. Some women may have a combination of two pattern types. Androgenic alopecia in women is due to the action of androgens, male hormones that are typically present in only small amounts. Androgenic alopecia can be caused by a variety of factors tied to the actions of hormones, including, ovarian cysts, the taking of high androgen index birth control pills, pregnancy, and menopause. Just like in men the hormone DHT appears to be at least partially to blame for the miniaturization of hair follicles in women suffering with female pattern baldness. Heredity plays a major factor in the disease.
Some cancer chemotherapy drugs cause temporary hair loss, which affects all body hair. Along with the loss of scalp hair, people undergoing chemotherapy also commonly lose their eyebrows and eyelashes. Chemotherapy drugs that frequently cause hair loss include paclitaxel, 5-fluorouracil, carboplatin, cisplatin, actinomycin-D, bleomycin, vincristine, cyclophosphamide, altretamine, etoposide, docetaxel and doxorubicin. Hair loss typically begins 2 to 3 weeks after the start of chemotherapy. Lost eyebrow hair regrows in the weeks to months following completion of treatment.

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.
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.
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.
A new entity variously called as trichodysplasia spinulosa,[128] trichodysplasia of immunosuppression,[129] and cyclosporine-induced folliculodystrophy[130] has been described in immunocompromised patients, usually organ transplant recipients on immunosuppression. It involves the development of alopecia predominantly of the face with indurated spinous papules. There is a profound loss of eyebrows[131] and sometimes eyelashes. The histopathologic picture is that of abnormal follicles with hyperkeratotic infundibula and absence of normal hair shafts. The inner root sheath epithelium showed proliferation in the cells and dystrophic trichohyaline granules. Electron microscopy of skin showed presence of intracellular viral particles.[132] This entity has lately been reported in immunosuppressive states in patients without organ transplantation such as leukemias and lymphoma.[133–136] van der Meijden et al. described the discovery of a new polyoma virus in a patient with trichodysplasia spinulosa.[131] Histopathological examination can reveal the diagnosis. A recent simple pull-test wherein the spicules can be plucked and examined under the microscope for inner root sheath keratinization has been described.[136] Some successful treatments described are cessation of cyclosporine therapy[130] and oral valganciclovir[137,138] and topical cidofovir.[131]
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. 

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.

According to the International Society of Hair Restoration Surgery, since 2004, the number of female surgical hair restoration patients worldwide increased 24 percent. Modern surgical hair restoration procedures such as Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) allow surgeons to take hair from the back of the head (genetically permanent hair zone) and transplant it to the areas where balding has occurred. The reason why the hair does not fall out once transplanted in its new location is because those hair follicles take on the same characteristics as the hair in the area where it originated, the genetically permanent zone. Both approaches result in lasting outcomes. In order to know if you are a candidate, Dr. Yaker will go over your medical history and examine your hair and scalp. He will determine if you have ample, good quality hair in the permanent hair zone in order to be able to relocate those hair follicles to the areas of hair loss.
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.
Following your consultation at Sussex Trichology, Shuna Hammocks and her clinical assistant Kelly are able to sympathetically manage your concerns and guide you and your hair back to health. We are passionate about being a support to those most upset, any type of hair loss is frightening and aside from treating with your bespoke regimen at home, you may need to call, text or email on occasion to ‘check in’.
It’s common for women to experience shedding hair after pregnancy. Usually, this is in response to estrogen levels returning to normal, shedding the extra hair grown during pregnancy. Usually, the hair will return to the same thickness it was before you got pregnant. New moms who are not breastfeeding should consider taking hair growth vitamins post-pregnancy too to balance out their hair growth cycle.
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.
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.  
Madarosis has also been described in phthiriasis of the eyelid. Phthiriasis palpebrarum is the term used to denote infestation of the eyelashes by the pubic louse or Phthirus pubis, also known as crab louse. The parasite is usually transmitted by sexual contact or through fomites. Heavy infestation may result in involvement of axillae, eyebrows, and scalp. When eyebrows and lashes are involved, blue-gray macules or maculae caeruleae may be found on the shoulders, arms, and trunk.[89] The louse can be identified under the microscope as having a wide body and strong second and third pair of legs.[90]
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.
Topic prostaglandin analogues are used for the treatment of glaucoma. Uniocular increase in length, thickness, and pigmentation of the lashes were described by Johnstone in 1997 by patients using latanoprost in one eye.[184] There are reports of a response of alopecia of eyelashes to cutaneously administered latanoprost,[185,186] though others report limited success.[187] Eyelash growth has also been reported following bimatoprost 0.03% topically to the base of the eyelashes in healthy individuals[188–190] and in individuals with alopecia areata.[191] Bimatoprost ophthalmic solution 0.03% is the only Food and drug administration (FDA)-approved product to safely and effectively enhance the growth of a patient's own eyelashes.[192,193]
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.
Low Level Laser Therapy (LLLT) is a non-invasive, non-surgical scientific approach to fighting hair loss. It is effective against multiple levels and types of hair loss including thinning hair, receding hair line, male and female pattern baldness and various scalp issues. LLLT has been rigorously tested for both safety and effectiveness for well over 30 years and has been in use in many countries throughout the world for over 30 years.
A. I think it's a personal preference, but why is a cosmetic solution such a big deal? To use sprays, powders and hair extensions? It doesn't address the problem, but it can do wonders for your self-esteem. I see patients who are extremely depressed, and this is ruining their life. We always have hope for that miracle solution, but it's very hard to do research studies. … As much as this affects people's mentality, there's not a lot of (National Institutes of Health) funding because hair loss isn't killing anyone.
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).
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.
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.  
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