Other drugs commonly attributed to causing madarosis are miotics, anticoagulants, anti-cholesterol drugs, antithyroid drugs, propranolol, valproic acid, boric acid, and bromocriptine.[21,99] Anticoagulants in high doses have been found to produce loss of scalp, pubic, axillary, and facial hair with loss of eyebrows after a latent period of a few weeks of treatment with dextran and heparin.[100] Propranolol can cause diffuse alopecia along with loss of eyebrows due to telogen effluvium,[101] usually after three months of therapy.[44] Loss of medial aspect of eyebrows can be seen in fetuses exposed to valproic acid.[102] Diffuse alopecia including that of eyebrows has been described due to chronic ingestion of mouthwashes containing boric acid. There was complete reversal following stopping the practice.[103] Levodopa has been noted to cause severe diffuse alopecia within three months of daily use.[104] Hair loss can occur soon after starting topical minoxidil therapy (due to detachment of club hairs following resting hairs reentering anagen), and after cessation of therapy (due to telogen effluvium).[98]
In your quest for perfectly maintained brows, you probably keep regular maintenance appointments on your calendar. Instead, you might want to embrace a more natural, hands-off approach. “The trauma inflicted on hair follicles during waxing, tweezing, and threading can lead to permanent follicular damage,” explains Dr. Umar. “Women who grew up in the height of the ’90s overplucked, pencil-thin brow trend have begun to notice the difficulty in growing thicker eyebrows after years of this habit.”
Check for hypothyroidism. If you also notice unexplained weight gain, chronic fatigue, feeling depressed, or feeling colder than usual in low temperatures, your thyroid gland may not be producing enough hormones. You may also notice your periods getting heavier or becoming sporadic. Hypothyroidism is most common in women, especially over age 50, and it can be treated with a synthetic hormone.[31]

There are numerous diseases that can affect the hair and scalp. Hair loss can be caused by a variety of conditions. Diseases such as alopecia areata, anemia, male/female pattern baldness, and infections of the scalp can all cause significant difficulty and loss of daily well-being. Stanford Dermatology has established a special clinic focusing on the diagnosis and treatment of these disorders of the hair.
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.
When compared with no treatment, patients who received ethinyl estradiol 50 μg and cyproterone acetate 2 mg with cyproterone acetate 20 mg on days 5 to 20 of the menstrual cycle for 1 year had a significant increase in their percentage of anagen hairs with trends toward a larger shaft diameter of full anagen hairs and a decreased number of hairs that were less than 40 microns (Peereboom-Wynia et al., 1989). A 12-month randomized control trial of 66 women compared treatment with topical minoxidil 2% plus an oral contraceptive (ethinyl estradiol 30 μg + gestodene 75 μg) with treatment with cyproterone acetate 50 mg plus an oral contraceptive (ethinyl estradiol 35 μg + cyproterone acetate 2 mg) and demonstrated that treatment with cyproterone was more effective in hyderandrogenic patients but otherwise less effective (Vexiau et al., 2002). Side effects of cyproterone acetate include weight gain, breast tenderness, and a decreased libido (Kelly et al., 2016). Hepatotoxicity and development of multiple meningiomas may occur when doses exceed 25 mg daily (Medicines and Healthcare products Regulatory Agency, 2009). Cyproterone acetate is used widely in Europe and Canada, either in an isolated form or in combination with ethinyl estradiol, but it is only available in the United States as an orphan drug for the treatment of hirsutism (Carmina and Lobo, 2003, Jurzyk et al., 1992, Kelly et al., 2016). Cyproterone acetate is classified as pregnancy category X.
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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