Estrogen and combined oral contraceptive (COC) drugs with estrogen or progestogen have been reported as effective, but data are limited (Adenuga et al., 2012, Raudrant and Rabe, 2003, Scheinfeld, 2008). They are thought to function through several mechanisms. Both components of COC drugs increase the levels of sex-hormone-binding globulin (Schindler, 2013). They also send negative feedback signals that suppress the hypothalamic secretion of gonadotropin and releases the hormone and pituitary secretion of the luteinizing and follicle-stimulating hormones, which results in a decreased androgen production (Gilman et al., 1990, Varothai and Bergfeld, 2014). These actions decrease androgen secretion from the ovary and the quantity of free, biologically active androgens, which reduces their effects on the hair follicles (Schindler, 2013). Our practice when prescribing COC drugs is a combination of ethinyl estradiol 20 mcg plus drospirenone 3 mg. Drospirenone is an analogue of spironolactone. This treatment combination is approved by the FDA for the treatment of acne but not alopecia.
Giorgos Tsetis: When you want to solve an issue, you must first thoroughly understand the problem. A lot of times, especially in the pharma world, everybody is trying to identify the magic pill that targets a single trigger. But, that's the exact reason there hasn't been a drug that holistically and indefinitely ends the problem. You can't zero in on one specific trait or symptom, you really have to solve for the many causes. When it comes to hair loss for men and women, there are several causes that disrupt the natural hair growth cycle. Basic vitamins and minerals only act as a temporary bandaid for hair health deficiencies, which is simply not enough. Hair loss and thinning hair means your body is imbalanced and there's something off, because hair follicles are mini organs.
"Others are taking hair follicles out of human scalp and growing them with dermal papilla cells," Cotsarelis says. "If they grow in culture, you might be able to recombine them with skin cells and form new follicles. This would let you expand the number of follicles you get for a hair transplant. This may not be that far off -- five to 10 years, maybe. There's very good evidence you will be able to do that."
NEIL SADICK, MD: Dermatologists are experts in the field of hair disorders. All dermatologists are trained in the general knowledge and treatment of hair loss disorders, but not all dermatologists choose to do this. A dermatologist will often refer to a specialist. Most dermatologists who are trained and have some expertise in this area usually deal both with men and women.
Contact dermatitis causes skin inflammation and when severe it can affect the hair follicles as well. It can either be due to some irritant making contact with the skin of the eyebrows or due to a substance to which a person has an allergy. This gives rise to the two types of contact dermatitis – irritant contact dermatitis or allergic contact dermatitis. Substances that could cause contact dermatitis at the eyebrow includes eye makeup including eyebrow pencils, hair removal creams and waxes, other cosmetics, hair dyes and scalp hair styling products.
Anagen effluvium occurs after any insult to the hair follicle that impairs its mitotic or metabolic activity. This hair loss is commonly associated with chemotherapy. Since chemotherapy targets your body’s rapidly dividing cancer cells, your body’s other rapidly dividing cells such as hair follicles in the growing (anagen) phase, are also greatly affected. Soon after chemotherapy begins approximately 90 percent or more of the hairs can fall out while still in the anagen phase.
Another reason why hair falls out is lupus. Lupus is an autoimmune disease that may make your immunity system begin attacking your various healthy body tissues. According to Medical News Today, “this results in symptoms such as inflammation, swelling, and damage to joints, skin, kidneys, blood, the heart, and lungs”. It can also attack eyebrow follicle resulting sudden hair loss and including brows.

The normal cycle of hair growth lasts for 2 to 6 years. Each hair grows approximately 1 centimeter (less than half an inch) per month during this phase. About 90 percent of the hair on your scalp is growing at any one time. About 10 percent of the hair on your scalp, at any one time, is in a resting phase. After 2 to 3 months, the resting hair falls out and new hair starts to grow in its place.


Several skin conditions, including psoriasis, eczema, and seborrheic dermatitis, don't directly lead to hair loss, but cause inflammation (a symptom of these conditions) near the brow that may be to blame. The urge to scratch and rub the inflamed area can indirectly cause eyebrow hairs to fall out. Loss that occurs in this manner is usually patchy, but as it is generally non-scarring (the hair follicle is intact), eyebrows can and often do grow back.


Posterior blepharitis is characterized by either excessive foam in the tear film in the hypersecretory type, or plugging of the meibomian orifices in the obstructive type. Expression of the secretions reveals a turbid or toothpaste-like material.[32] If there is spillover inflammation of the anterior lid margin, there may be a loss of eyelashes.[33]
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.
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.
Some medications have side effects that include hair loss. Talk to your doctor if you are experiencing significant hair loss and you think that your medication might be the cause. Your doctor might be able to switch you over to another type of medicine without any reported side effects. Don’t stop taking your medications until you’ve spoken with your doctor, as this could be dangerous for your health.
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. 

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.
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.
What’s more likely is that telogen effluvium is at play (again). In addition to hormone fluctuations, this type of hair loss happens when there is a drastic dip in protein in the diet or sudden weight loss. For example, if you are sick and can only consume liquids for a month. “If you have protein levels that drop dramatically, your hair follicles go into hibernation, and you can see sudden acute hair loss that shows up three to six months later,” says Dr. Katta.
Over Plucking: I know the temptation of tweezing your eyebrows when you don’t want to endure the pain of threading. But when you pluck your eyebrow hair, you’re pulling it out from the follicle and essentially damaging it. And repeatedly plucking your hair eyebrow hair can permanently damage your follicles over time and prevent them from producing new hair.
Thinning hair, noticeable bald spots, receding hair line, large clumps of hair showing up in your hair brush or shower drain, these are typically things you hear about from men, not women. More and more though, we are contacted by women who are experiencing hair loss who want to know if this is a sign of something wrong with their hormones and how they can fix the problem. Fortunately, hair loss is not a sign of infertility, but is a side effect of hormonal imbalance which can impact your fertility.
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.
If you’ve overplucked your brows too many times, you may have caused trauma to the follicles in the meantime, signalling not only those hairs you plucked to stop growing back, but also the hairs in surrounding areas. The good news: If the hair follicles aren’t dead, they can possibly be shaken from their resting state with a good brow enhancer. (like WINK  yes of course, we have to say it). There’s no sure bets, but it’s worth a try–plus Wink has a money-back guarantee!

Eyebrow loss, also known as superciliary madarosis, can occur with a variety of medical conditions. Madarosis can affect one or both eyebrows with partial or complete hair loss. Infections, chronic skin disorders, hormone disturbances, autoimmune diseases and medications are among the many medical reasons for eyebrow loss. In most cases, identification and treatment of the underlying condition leads to regrowth of the eyebrows. Permanent eyebrow loss can occur with disorders that permanently damage the hair follicles.
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).
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.

Another reason why hair falls out is lupus. Lupus is an autoimmune disease that may make your immunity system begin attacking your various healthy body tissues. According to Medical News Today, “this results in symptoms such as inflammation, swelling, and damage to joints, skin, kidneys, blood, the heart, and lungs”. It can also attack eyebrow follicle resulting sudden hair loss and including brows.
You basically have two major choices here: hormone replacement therapy (HRT) or phytotherapy (herbal remedies). You may wish there were more options, but there really are not. You can of course take other approaches to treating hair loss, but if low estrogen levels are one of the major causes of your hair loss, the results you will see treating the problem through other means are going to be quite limited if you are failing to treat the cause.

Since our founding more than 40 years ago, Hair Club’s unique story has been regularly featured in the media. And because we’re the trusted provider of all-proven hair loss solutions in North America, we continue to receive lots of coverage today. With your help, we’re still writing the story of Hair Club every day, so we welcome you to follow us and stay up to date with the latest Hair Club news, press releases and more.
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.
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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.
This manifests in childhood with chronic lower eyelid dermatitis and is often associated with other types of allergic disorders.[36,37] The ocular features are eyelid dermatitis, Dennie-Morgan fold (an infraorbital fold or line due to lid edema in atopic dermatitis), keratitis, and a frequent association with keratoconus and cataracts. Loss of lateral third of eyebrows (Hertoghe sign)[38] is seen in atopic dermatitis due to constant scratching and rubbing.
The study in question, which was first published in the journal PLOS Genetics earlier this year, analyzed the hair growth of 52,000 men between the ages of 40 and 69 in the UK. The numbers: 32% of the men said they did not experience any hair loss at all. 23% said they experienced a little bit. 27% had moderate hair loss, and the last 18% said they were suffering from severe hair loss.

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.
Big and bold brows can give great shape to your face. The last thing you want is to see your eyebrow hairs start falling out. Unfortunately, you can experience eyebrow loss just like you experience hair loss. It’s important to understand what is causing your eyebrows to shed so that you can work on stopping the hair loss and promoting hair growth. Here are the most common causes of eyebrow loss.
While these factors contribute to hair loss for any woman, it’s particularly dicey for those of us with PCOS because when the follicle is exposed to our elevated androgens such as DHT (di-hydro testosterone, an active metabolite of testosterone) it gets damaged. Whenever a cell is damaged it generates oxidative stress which further alters the androgen receptor in the follicle perpetuating the issue.
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