Sinclair Scale: The 5-point Sinclair Scale is a modified visual grading scale. Grade 1 is normal. This pattern is found in all girls prior to puberty, but in only half of women age 80 or over. Grade 2 shows a widening of the central part. Grade 3 shows a widening of the central part and thinning of the hair on either side of the central part. Grade 4 reveals the emergence of diffuse hair loss over the top of the scalp. Grade 5 indicates advanced hair loss. This grade is uncommon, occurring in less than 1% of women.
FPHL or androgenetic alopecia is the most common cause of hair loss in women and one of the most common chronic problems seen by dermatologists worldwide (Varothai and Bergfeld, 2014). FPHL is a nonscarring form of alopecia in which the frontal hairline is maintained, but there is progressive hair thinning at the vertex of the scalp. Thinning of the hair is secondary to alteration of the hair cycle with shortening of the anagen phase and simultaneous lengthening of telogen. This increase in the resting phase and decrease in the growth phase of the hair cycle results in the miniaturization of hair because long terminal hairs are gradually replaced by short vellus hairs (Messenger and Sinclair, 2006, Sinclair et al., 2011).
I’m no Frida Kahlo, but since my teenage years, I’ve been blessed with thick, full eyebrows. But as soon as I turned 30, I noticed something was amiss. My beautiful brows were looking, let’s say, sparse. Every time my brow specialist handed me a magnified mirror after my monthly wax, it seemed I had more patchy spots. My low-maintenance morning routine—a quick brush-up and pencil fill-in—was suddenly taking up a lot more time. I found myself on a constant quest for the best brow powders, pencils, and gels, and started researching microblading in hopes of finding a solution.
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.
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.”
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).
“The biggest mistake I see is people being too heavy handed with their eyebrow products,” says Megan Studabaker, a registered nurse and owner of Finespun Brow Design in Scottsdale, Arizona. “I recommend applying products in hair-like strokes, versus just filling in with powder because it often gets smeared and messy which isn’t achieving the polished look you are going for.” I’ve had good luck using Benefit Precisely, My Brow Pencil ($24) and Foolproof Brow Powder ($24).
This is a diverse group of rare disorders that destroy the hair follicle, replace it with scar tissue and cause permanent hair loss. The hair loss may be accompanied by severe itching, pain and burning, and may progress rapidly. In other cases, the hair loss is gradual, has no symptoms and is unnoticed for long periods. It is also sometimes known as scarring alopecia and can occur in otherwise healthy men and women of all ages.
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.
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.