DLE is an autoimmune condition and is the most common form of chronic cutaneous lupus erythematosus. Clinically, the lesions start as discoid erythematous patches which then develop into plaques with follicular plugging and scaling. Eyelid findings include blepharitis, lid scarring, entropion, and ectropion. Scaly plaques on the eyelids with loss of hair follicles results in madarosis [Figure 3]. Numerous studies have reported the mimicking of a chronic blepharitis by DLE.[35,61–63] A high index of suspicion is necessary in such cases, where the diagnosis is very often delayed by months to years. Biopsy with histopathological examination should be done to confirm the diagnosis. Treatment with hydroxychloroquine results in a regrowth of the eyelashes.
Around 30 million U.S. women will experience hereditary hair loss, or female pattern baldness (androgenetic alopecia), while others will struggle with situational hair loss, brought on by medical conditions, medications, poor health and nutrition, environmental factors such as smoking and sun damage, or even from adverse reactions to hair care products or treatments.
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.
Madarosis is a clinical sign that has become pathognomonic of leprosy in countries like India. However, this apparently benign clinical sign has wider ramifications in many systemic and dermatological disorders. Hence, establishing a proper diagnosis and appropriate management is mandatory. Though management of the primary disease results in regrowth of eyebrows and eyelashes, many require surgical management. Thus, the management of a patient with madarosis requires a coordinated effort from the dermatologist, ophthalmologist, internist, and reconstructive surgeon.
Toxic alopecia occurs when there is a disruption of hair growth in the anagen phase. This usually occurs following chemotherapy and radiotherapy. Radiotherapy for various types of ocular tumors, eyelid and choroidal tumors have been reported to produce madarosis.[95–97] Hair loss due to radiation is usually reversible, but may be permanent when the dose of radiation is in the range of 50 to 60 Gy.
Hair loss on the eyebrows can be partial where the hair falls off in patches or the eyebrow thins and shortens abnormally. It may occur on one side or both sides. It can also be complete where all the hair on one or both eyebrows are lost. These patterns of eyebrow hair loss can give some indication of the underlying cause even when there are no other symptoms. Some of these conditions may be specific to the eyebrows (the hair follicles and skin in that region) or can be an extension of problems affecting surrounding skin like the face, forehead or scalp.
Androgenetic alopecia, commonly called male or female pattern baldness, was only partially understood until the last few decades. For many years, scientists thought that androgenetic alopecia was caused by the predominance of the male sex hormone, testosterone, which women also have in trace amounts under normal conditions. While testosterone is at the core of the balding process, DHT is thought to be the main culprit.
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.