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 role of estrogen and progestogen drugs in the treatment of hair loss and growth is also unclear. Estrogen is made when androstenedione or testosterone are modified by the enzyme aromatase. It is synthesized in the ovary and other peripheral tissues and then travels to its receptors, some of which are located in scalp hair follicles (Thornton et al., 2003a, Thornton et al., 2003b). At the scalp follicle, estradiol has been reported to induce aromatase activity (Hoffmann et al., 2002). Estrogen has been hypothesized to have a protective role against hair loss on the basis of the observation that patients with lower estrogen levels during menopause, postpartum, or treatment with aromatase inhibitors or selective estrogen receptor modulators are more likely to develop FPHL (Atanaskova Mesinkovska and Bergfeld, 2013, Park et al., 2014). Another supporting observation is that in the frontal hairline of women, which tends to be spared with FPHL, there is a higher level of aromatase enzyme when compared with the rest of the scalp (Levy and Emer, 2013). This variation in hair loss could be the result of locally increased levels of estradiol or decreased levels of testosterone and DHT that is secondary to greater amounts of conversion.
Contrary to popular belief, hair does not grow continuously but actually grows in cycles. It starts at the follicles which are embedded in the skin and the visible part, the shaft, is a consequence of active growth at the follicles over time. The living part of the hair in the skin has blood and nerve supply while the hair shaft is made up of dead cells and protein and does not have a blood or nerve supply. Therefore it can be easily cut without any bleeding or pain.
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.
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]
Dutasteride is a 5-alpha-reductase inhibitor that binds both types I and II enzymes. Compared with finasteride, its inhibition of type II enzymes is three times more potent; its inhibition of type I enzymes is 100 times more potent (Clark et al., 2004). Dutasteride is not approved for the treatment of FPHL by the FDA, and ongoing studies on the efficacy of the inhibitor are promising but largely focus on male patients (Gupta and Charrette, 2014, Olsen et al., 2006). A study of women after 3 years of therapy showed that dutasteride may be more effective than finasteride in women under 50 years of age as measured by hair thickness (not hair density) at the center and vertex scalp (Boersma et al., 2014). One case report of a 46-year-old female with FPHL showed some response after 6 months of treatment with a dose of 0.5-mg dutasteride daily despite a minimal response to treatment with finasteride and minoxidil (Olszewska and Rudnicka, 2005). Data with regard to the treatment side effects in women is extremely limited. Dutasteride is classified as pregnancy category X because of teratogenicity and should have the same theoretical risk of breast cancer as mentioned in relation to finasteride (Kelly et al., 2016).
Like with low thyroid, there can be a myriad of imbalances at play with PCOS related hair loss making it a complex issue that’s often written off as merely high testosterone. While androgen excess and hypersensitivity of the hair follicles to these hormones are part of the issue, these are other contributing factors to PCOS related hair loss as well:
This plant is native to North America and has been used for centuries by indigenous people to treat menstrual and menopausal disorders. While modern research results are mixed, some studies do indicate that black cohosh can be effective as a treatment in menopause. While the research focuses on hot flashes and other symptoms of menopause that get more attention than hair loss, it follows that black cohosh could also help to improve hair growth when estrogen levels decline.
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.
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.

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.  
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.
If you’re experiencing hair loss, topical treatments like minoxidil (Rogaine) and others tend to only be partially effective, if they are effective at all; they don’t address the root causes of hair loss; they target androgenic alopecia (which only accounts for some cases of hair loss); and they come with a host of unpleasant side effects—side effects that can worsen the aesthetic problem you were hoping to fix. Rogaine can cause hair to grow in different colors and textures than the surrounding hair and can cause unwanted hair to grow on your cheeks and forehead.
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.

Unlike other companies, we’ve provided one-on-one guidance, professional advice and custom-tailored solutions for our clients’ hair loss needs from the beginning. This personal touch is what made Hair Club successful then. And it’s still the secret to our success today. We continue to grow every year and have expanded to nearly 120 locations across the U.S., Canada and Puerto Rico.
Prevention is better than cure, so they. Can you really prevent or stop losing your brows? Is there a way to prevent eyebrow hair loss? Depending on the cause, it is possible to prevent them. You need to stop the causative reason. For instance, if you have been over plucking, tweezing or threading, you need to stop it until your eyebrows have grown again. If your eyebrow loss is caused by some medications you are using, whenever possible, stop using them. However, if you are attending chemotherapy session for instance, it is not practical to stop your sessions as a ways of preventing this loss.
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 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.
Also called “chastetree,” Vitex is an herb which is typically prescribed to treat estrogen dominance. It seems to be recommended as a remedy for especially low levels of estrogen as well however, and does seem to have a general balancing effect on the overall ratio of estrogen to progesterone. Vitex’s balancing effect is thought to result from the stimulation of dopamine production.
Many unpleasant things can happen to your body as you age. Losing eyebrow hairs is one of them. When you get older, your eyebrows may naturally become thinner as you experience hair loss. Though aging is inevitable, there are some ways you can help to prevent hair loss as you get older. Managing your stress, maintaining good nutrition, hydrating your skin and not exposing your eyebrows to excessive trauma, such as waxing, plucking, or threading, should help prevent eyebrow loss.
Your doctor might also suggest the prescription pill finasteride, sold under the brand name Propecia and also in generic versions. Although the drug is not federally approved for use in female patients, some doctors have observed good results in postmenopausal women. But women who are planning to have children should not take this drug because it can cause birth defects.
Everyone’s hair loss is different. Which is why, at Hair Club, we don’t provide a one-size-fits-all solution to restore your hair. Instead, we consult one-on-one with you to understand what’s needed to fit your taste and lifestyle. Only then will we custom tailor a solution that works best for you, so you can get the results you want. It’s what we’ve done for 600,000+ satisfied clients. It’s what we’ll proudly do for you.
Eating a balanced, low-fat diet is your best defense against hair loss. Make sure you include an adequate amount of whole grains, fruits, and vegetables in every meal. It’s also important to incorporate mono-saturated oils, such as olive oil and sesame oil, into your diet. Drinking green tea and taking vitamin B6 and folic acid supplements may help restore hair growth as well. Essential fatty acids also play a crucial role in maintaining hair health. These fatty acids can be found in the following foods:

EYES AND VISIONEARS, NOSE AND THROATSKIN, HAIR, NAILSHEART AND VESSELSKIDNEYS AND URINARY TRACTBLOOD AND IMMUNITYLIVER AND GALLBLADDERLUNGS AND AIRWAYSUPPER AND LOWER LIMBWOMEN’S HEALTH AND PREGNANCYWOMEN’S HEALTHKIDS HEALTHMEN’S HEALTHABCD – FIRST AID: INJURIES, POISONINGNEWBORNS BABIESHORMONES AND METABOLISMMEDICATION, SUPPLEMENTSMEDICAL TERMINOLOGYNUTRITIONSURGERY AND OTHER PROCEDURES
An unhealthy gut is also a common source of inflammation and that alone can contribute to hair loss. But lack of robust digestion and a healthy gut bacterial environment will not only lead to nutrient deficiencies that impact hair health but an imbalanced impacting all other hormones related to hair loss such as low thyroid, poor estrogen metabolism and elevated cortisol.

“A scalp biopsy is the gold standard for diagnosing hair loss,” said Dr. Marc Avram, a dermatologist in private practice with offices in Manhattan and Brooklyn. “The test examines the follicles themselves and can help determine whether the hair loss is genetic, inflammatory, infectious or due to an unusual physical or emotional shock to the system.”

Eyebrows frame your face and play an important role in your facial appearance and expressions. If the hair in your eyebrows starts falling out, you are sure to see a difference in your appearance, which you may want to rectify. Many conditions can cause eyebrow loss.[1] However, you can usually take steps to reverse the effects, such as eating a healthy diet and adjusting your beauty routine or lifestyle to account for the natural aging process.
When this process is disrupted you end up with thinner hair, increased hair loss, a failure to regrow new hair and all in all a super sad experience! No one love losing their hair and it’s such a huge source of upset for women I work with but I’ll be honest, it is often the last thing to change as we work through getting your hormones and metabolism more balanced. It’s simply not your body’s priority.
Also called “chastetree,” Vitex is an herb which is typically prescribed to treat estrogen dominance. It seems to be recommended as a remedy for especially low levels of estrogen as well however, and does seem to have a general balancing effect on the overall ratio of estrogen to progesterone. Vitex’s balancing effect is thought to result from the stimulation of dopamine production.
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.
Giorgos Tsetis: There are really two industries at work here that have to be separated. First, there's the drugs, the pharma, which is the FDA world. Then, you have the naturals, the formulas, and the actual supplements industry. The supplement industry is really not properly regulated in this country. More surprisingly, starting a supplement company is very easy. That's why you see all of these supplements popping up, and the FDA doesn't even have the capacity to monitor them all and make sure people are able to substantiate proper claims. As a supplement manufacturer, all you have to do is create your products in a FDA approved facility, and there thousands of them in the United States. That means anyone can put a formula together and get away with claims until they get challenged by consumers or competitors. When you step into these factories, you see it's messy. You're not talking about state-of-the-art factories where people are doing the work. It's really scary.
There are a couple of other reasons why soy is a great choice too. For one, it is really good for you, protecting your cardiovascular health by reducing your LDL cholesterol levels. For another, soy is an easy, cost-effective choice. Instead of searching everywhere for quality herbal supplements you are unfamiliar with, you can simply add some soy milk to your diet or eat some tofu.
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.
The term “common baldness” usually means male-pattern baldness, or permanent-pattern baldness. Male-pattern baldness is the most common cause of hair loss in men. Men who have this type of hair loss usually have inherited the trait. Men who start losing their hair at an early age tend to develop more extensive baldness. In male-pattern baldness, hair loss typically results in a receding hair line and baldness on the top of the head.

Women using oestrogen supplementation or taking birth control pills will also experience hair loss when they cease supplying their body with extra oestrogen. These forms of hair loss may be temporary but this, however, does not mean that there is no link between oestrogen and permanent hair loss. Scientists have noted up to 30 hormones that could play a role in female pattern hair loss – the genetic kind of hair loss – and oestrogen, whilst poorly explored, may be one of them. It’s alright if the excess hairs are the ones that are lost but when normal hair falls out, there’s a problem.
Scalp hair loss may be a common complaint among men and women, but in my practice, loss of eyebrow hair is a major concern among my female patients. Because eyebrows frame the face, hair loss in this area can dramatically change one's appearance, and since eyebrow hair loss is not easily concealed, it can be, for some women, an even more devastating loss than scalp hair loss.
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.
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“…a beauty editor told me she had been using Viviscal... Since beauty editors see truckloads of products every week, I was immediately convinced when she said it worked – so I bought it myself. I started taking it twice a day for the first six months and saw dramatic results within three to four months. My hair was less thinned out …and it was also less brittle. I’ve gone to the same hairdresser since I was 19, and he was the first to comment on how full and strong my hair looked…”
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.
During pregnancy, high concentration of estrogen levels in women result in the development of thicker, stronger, longer and healthier looking hair. Following pregnancy however, women tend to fret and think that they’re losing their hair when in fact they’re merely shedding the excess hair that the excess oestrogen created. The hair that was in a prolonged anagen stage are now all shifting into telogen (resting phase) to make way for new hair growth. This type of hair loss is comes under the condition known as telogen effluvium but the good news is that when oestrogen levels have returned to normal, your hair will too. 

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.
It’s precisely because vitamins and minerals are SO critical to hormonal healing—and to healing the devastating side effects that come with it, like thinning hair—that I created the FLOLiving Balance Supplements. The supplement industry has very little oversight and I saw so many women waste money on supplements that at best didn’t work and at worse contained dangerous ingredients.
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’.
“A scalp biopsy is the gold standard for diagnosing hair loss,” said Dr. Marc Avram, a dermatologist in private practice with offices in Manhattan and Brooklyn. “The test examines the follicles themselves and can help determine whether the hair loss is genetic, inflammatory, infectious or due to an unusual physical or emotional shock to the system.”
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.
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. 

Thank goodness! I am a teacher which requires me to get up about 5:30 during the school year. This summer, I will turn 62 and although I’ve always had problems waking up early in the morning – he it is so severe that I am sleeping 12 to 14 hours a day! This is terrifying as school starts in less than two weeks. I am postmenopausal for close to 20 years now and recently found out that my estrogen level is elevated. Your article is a godsend; I will now be able to have an intelligent discussion with my gynecologist and hopefully become a morning person for the first time in my adult life!

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Sara Gottfried, MD is the New York Times bestselling author of the new book, Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, and Turn Back the Clock 10 Years. Her previous New York Times bestsellers are The Hormone Cure and The Hormone Reset Diet. After graduating from Harvard Medical School and MIT, Dr. Gottfried completed her residency at the University of California at San Francisco. She is a board-certified gynecologist who teaches natural hormone balancing in her novel online programs so that women can lose weight, detoxify, and slow down aging. Dr. Gottfried lives in Berkeley, CA with her husband and two daughters.
If you’ve gotten through this list and still don’t know what’s going on, it’s time to talk to your doc. Unfortunately, madarosis–typically used to mean the loss of eyelashes, but also referring to the loss of brows–may be due to many, many things, including a number of vision and life-threatening conditions, like herpes zoster, leprosy, HIV/AIDS, trachoma, malignant eyelid tumors, discoid lupus, scleroderma, and hypothyroidism (Khong, Casson, Huilgal, Selva; Survey of Opthamology, 2006). Brow and lash loss are both indicators of underlying diseases, so yes get to your doc stat.
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