The WHI was a very large, very prominent long-term study which looked at the health effects of HRT. While the study did find a few benefits (women who used HRT had fewer hip or bone fractures and were less likely to develop colorectal cancer), it found a number of risks, including an increased chance of heart attack, stroke, cancer, and blood clots.
The real culprit appears to be dihydrotestosterone (DHT), a more potent form of testosterone. DHT is made from testosterone by a specific enzyme in the body, and while both testosterone and DHT are known to have a weakening effect on hair follicles, there appears to be something unique about the conversion process of testosterone to DHT that relates to thinning hair. This is why some drugs that are marketed for hair loss block the conversion of testosterone to DHT. (It’s important to note, however, that these drugs tend to be less effective in women than men, and that one of them—finasteride—is only approved for hormonal hair loss in men, not women. What’s more, the drug has been associated with increased risk of sexual side effects, depression, nausea, hot flashes, and increased estrogen levels—and too much estrogen is its own risk factor for thinning hair; more on that below.)
Try out new hairstyles to disguise your thinning hair whilst you recover your hormonal balance. You may also want to consider a hair piece or clip-in extensions if your hair loss is very bad, but these should be used with care in order to prevent traction alopecia. You may also like to try using rollers or a hair volumizer, to add lift to your locks, or instantly hide thin patches with a good hair loss concealer.
Trichotillomania is a hair pulling disorder associated with anxiety, stress, depression, boredom and frustration. It is where a person manually removes hairs with their finger, either a few strands throughout the day or sometimes many strands at one time during an emotional outburst. This behavior is usually a means of coping with stress or emotional turmoil. However, it can sometimes become a habit that is difficult to break. The eyebrows is a commonly targeted area as is the scalp.
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.
Although these statistics would suggest a more collective effort amongst industry leaders to proactively find a way to fix this problem, the trends have revealed the opposite. Due to an ecosystem of loose regulations, cheap supplement sourcing, and a business model built on overselling to a dependent audience – the industry has been fueled by driving profits instead of solving problems. When one Wilhelmina model noticed he was quickly losing hair at a pivotal point in his career, the search for an effective product revealed the surprising lack of safe, natural and healthy solutions.
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).
Flutamide is an oral anti-androgen that acts by competitively inhibiting the uptake of androgen and its nuclear binding in target tissues (Varothai and Bergfeld, 2014; Watson Pharma, 2011). It has been shown to be effective for the treatment of FPHL in hyperandrogenic women at a dose of 250 mg per day. One case report showed that treatment with flutamide was effective in a patient who had already failed to improve with spironolactone and minoxidil (Carmina and Lobo, 2003, Yazdabadi and Sinclair, 2011). After 2 years of therapy, 80% of patients were satisfied or highly satisfied with their treatment effect regardless whether they were taking concomitant oral contraceptives (Paradisi et al., 2011). Flutamide can cause hepatotoxicity and serial monitoring of liver function tests is recommended during treatment (Watson Pharma, 2011) even though data from one study on the safety and tolerability of flutamide showed that patient transaminase values returned to normal after treatment was discontinued and that levels did not rise while patients were treated with doses of 62.5 mg or 125 mg. Flutamide is classified as pregnancy category D.
Thyroid Dysfunction: Since the thyroid gland regulates many body functions by releasing hormones, any disruption in its functioning can cause loss of hair, including eyebrow hair. If your thyroid is underactive, it could cause you to lose the outer third of your eyebrow. The only way to treat thyroid dysfunction is through medication. However, there’s still no guarantee that your eyebrow hair will grow back.

The term superciliary madarosis is often used describe abnormal eyebrows and eyelash hair loss which can be partial or total. Depending on the cause, the can be weird since besides the hair breaking and falling out easily, some people may end up with a part, half, inner, outer third or one on or both eyebrow missing. In fact,  thinning at ends is common.

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.


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.
It takes more than just an apple a day to keep the doctor away; if your diet lacks the key vitamins A, B, D and E or nutrients such as iron, calcium or the amino acid L-lysine, your hair may suffer. Nutrient deficiency doesn’t just affect the eyebrows—it may lead to hair loss on the scalp, feelings of fatigue and physical weakness, lightheadedness or inhibited concentration, heart palpitations and pale skin, among other serious symptoms.
Thyroid hormone receptors were detected in both dermal and epithelial compartments of the human pilosebaceous unit.[48] T4 and T3 decrease the apoptosis of hair follicles and T4 prolongs the duration of anagen in vitro.[49] Thyroidectomy delays initiation of anagen. Administration of thyroxine advances anagen, initiation of which is however delayed once toxic doses are given. Therefore, ratio of telogen to anagen hairs is increased in hypothyroidism as well as hyperthyroidism.[50] Thus, the hair follicles are affected in thyroid disorders, and madarosis is caused due to disturbances in hair cell kinetics. Hypothyroidism is associated with generalized hair loss probably due to coarse, dull, and brittle hair with reduced diameter.[51] The eyebrows and eyelashes may also be lost. Loss of lateral one-third of eyebrows known as Hertoghe sign[38] is a characteristic sign of hypothyroidism.[52] Some people also refer to it as Queen Anne's sign,[53] after Anne of Denmark whose portrait with shortened eyebrows has been interpreted by some as indicative of the presence of goiter, even though such a fact has not been proved by any known sources of information. Madarosis may even be the presenting sign in hyperthyroidism.[21] In hyperthyroidism, there is thinning with breaking off and shortening of hair.[54] Madarosis can also occur in hypopituitarism, hypoparathyroidism,[21] and hyperparathyroidism.[55]
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