Surgeries, severe illnesses and emotional stress can cause hair loss. The body simply shuts down production of hair during periods of stress since it is not necessary for survival and instead devotes its energies toward repairing vital body structures. In many cases there is a three month delay between the actual event and the onset of hair loss. Furthermore, there may be another three month delay prior to the return of noticeable hair regrowth. This then means that the total hair loss and regrowth cycle can last 6 months or possibly longer when induced by physical or emotional stress. There are some health conditions which may go undetected that can contribute to hair loss. These include anemia or low blood count and thyroid abnormalities. Both of these conditions can be detected by a simple, inexpensive blood test. 

Testosterone replacement is becoming popular for men. Cotsarelis warns that this may accelerate hair loss. Propecia might help -- but because it prevents testosterone breakdown, it might affect the dose of male hormone replacement therapy. Cotsarelis warns men taking both Propecia and testosterone replacement to make sure their doctor carefully monitors their testosterone levels.
Other hair loss conditions that may be of an autoimmune nature that can involve the loss of eyebrows such as an underactive thyroid or vitiligo are termed “markers of underlying conditions”. It would be a trichologist’s responsibility to highlight these to the GP for further testing, these can also be investigated privately. In addition, there are conditions such as nutritional deficiencies like pernicious anaemia (unable to store B12) and of course anxiety and stress hair loss which can cause an overall reduction in the hair density. Patients attending with this concern often report that their general density is less dense.
The study in question, which was first published in the journal PLOS Genetics earlier this year, analyzed the hair growth of 52,000 men between the ages of 40 and 69 in the UK. The numbers: 32% of the men said they did not experience any hair loss at all. 23% said they experienced a little bit. 27% had moderate hair loss, and the last 18% said they were suffering from severe hair loss.
This is an autoimmune disorder that is also known as “spot baldness” and can result in hair loss ranging from just one location (alopecia areata monolocularis) to the entire scalp (alopecia totalis), or to every hair on the entire body (Alopecia areata universalis). Although it is thought to be caused by hair follicles becoming dormant, what triggers alopecia areata is not exactly known. In most cases, the condition corrects itself.
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.
It is known that during pregnancy, because of an increased level of estrogen, there is a tremendous growth of new hair. However, during menopause it is noticeable that the reduced level of estrogen hormone tends to cause hair loss. When the estrogen hormone levels tend to drop, the hair follicles fall under the influence of the male sex hormone or the testosterone, which cause the shortening of the growth phase of hair. Subsequently there is a noticeable hair loss. This hair loss caused due to the drop down of estrogen levels may cause patchy hair loss or complete baldness.
These important micronutrients, which are all essential for hair health, are part of my Balance Supplements. And even if you eat a healthy, phytonutrient rich diet, you might not have optimal levels of the vitamins and minerals you need to promote hair health. Environmental factors beyond our control, from the mineral-depleted soil in which most of our food is now grown to shifts in growing practices that have reduced the amount of vitamins and minerals in various foods, can leave us eating a picture-perfect diet and still deficient in certain micronutrients.
Eyelash hairs are usually present in two to three rows, and are short, thick, and curved in appearance. They are set obliquely, anterior to the palpebral muscle. The upper eyelashes are more numerous and curve upward, while the lower eyelashes curve down in order to avoid interlacing during eyelid closure. Eyelash cilia are unique in that they have no erector muscles. Eyelash hairs are oval in all races.[7]
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.
There is also a different in the form of 5AR enzyme (5 alpha reductase) found on the facial hair follicles vs. the scalp hair follicles. This enzyme converts testosterone into that more problematic DHT. Type I DHT is found in sebaceous glands on the face and genital area whereas Type II is found in hair follicles of the scalp. Type II DHT is typically more of a problem in men, but Type II is increased in disorders with high testosterone like PCOS.
Interestingly, 40% of the genes causing male pattern baldness were located on the X chromosome. You inherit that chromosome from your mother. By analyzing all these genes, researchers could also make a “scorecard” which predicts what risk a man runs for experiencing hair loss based on his genes. The hope is that in the future, this could be refined and used to prevent early signs of hair loss.
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.
No one wants to lose their hair, but for a woman it is particularly distressing. While men can look perfectly presentable — even sexy — with their exposed scalp, no such options exist for the 30 million American women who grapple with thinning tresses. Dr. Maria Colavincenzo, a dermatologist at Northwestern University Feinberg School of Medicine, has a practice that specializes in preserving those precious strands — especially in cases of androgenetic alopecia, a hereditary condition that causes hair loss, mainly on the top and crown of the scalp. Without an appointment, she answered some of our questions:
It is perfectly normal for people to shed 50 to 100 hairs per day. This generally doesn't cause noticeable thinning of scalp hair because new hair is growing in at the same time that hair is shedding. However, hair loss occurs when this hair growth cycle and shedding is disrupted or when the hair follicle becomes destroyed and replaced with scar tissue. Female pattern hair loss (androgenetic alopecia) is the most common form of hair loss in women. This occurs gradually and is caused by genetics (from either side of the family), age, and the action of a specific male hormone, dihydrotestosterone (DHT). This hormone is found in lesser amounts in women and it preys on the hair follicles, preventing them from receiving vital nutrients for proper hair follicle growth, leading to the hairs shrinking, and resulting in a shorter lifespan. Interestingly, DHT does not need to be elevated to generate hair loss. Estrogen, when lowered as commonly seen in menopause, creates a change in the ratio of male to female hormones, giving an edge to these male hormones. Compounded with the sensitivity of DHT to the hair follicles, heredity can affect the age at which a woman begins to lose her hair, as well as the rate of hair loss and the extent of baldness. 
The hormone imbalance known as hypothyroidism is a common cause of abnormal eyebrow thinning, especially in women; roughly 27 million Americans suffer from thyroid disease, and about 80 percent of them are women. Thinning eyebrows appear as a symptom of both hypothyroidism (underactive thyroid production) and hyperthyroidism (overactive thyroid production), alongside issues such as excessive fatigue, difficulty losing weight and constantly feeling cold. If your brows appear particularly thin around the edges, visit your doctor for a thyroid screening, which should include thorough blood work. With prescription medication, your eyebrows should fill back in over the ensuing months. 

Estrogen and combined oral contraceptive (COC) drugs with estrogen or progestogen have been reported as effective, but data are limited (Adenuga et al., 2012, Raudrant and Rabe, 2003, Scheinfeld, 2008). They are thought to function through several mechanisms. Both components of COC drugs increase the levels of sex-hormone-binding globulin (Schindler, 2013). They also send negative feedback signals that suppress the hypothalamic secretion of gonadotropin and releases the hormone and pituitary secretion of the luteinizing and follicle-stimulating hormones, which results in a decreased androgen production (Gilman et al., 1990, Varothai and Bergfeld, 2014). These actions decrease androgen secretion from the ovary and the quantity of free, biologically active androgens, which reduces their effects on the hair follicles (Schindler, 2013). Our practice when prescribing COC drugs is a combination of ethinyl estradiol 20 mcg plus drospirenone 3 mg. Drospirenone is an analogue of spironolactone. This treatment combination is approved by the FDA for the treatment of acne but not alopecia.
Ludwig Scale: This is the most common classification for female pattern hair loss. There are 3 stages (ranging from mild hair loss to extensive, severe widespread thinning) and in each stage hair loss occurs on the front and top of the scalp with relative preservation of the frontal hairline. Regardless of the extent of hair loss, only women with stable hair on the back and sides of the scalp are candidates for hair transplant surgery.
Hansen's disease, also known as leprosy, is an infection of the skin and nerves caused by the bacterium Mycobacterium leprae. The disease often affects the skin of the eyebrow region, leading to loss of sensation and permanent loss of the eyebrow hairs. There are numerous other rare and uncommon causes of eyebrow hair loss, including vitamin A toxicity, nutritional disorders and other dermatological disorders. If you experience loss of eyebrow hair, see your doctor to evaluate the cause and to discuss a treatment plan.
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.
The eyebrows are two-arched eminences of skin situated above the orbital regions.[3,4] The hairs of the eyebrows are short, thick. and stiff and are set obliquely. The diameter of eyebrow hair is normally thinner than scalp hair in Asians, and the scalp hair in thinner in Caucasians.[5] The eyebrows can be roughly divided into three parts. The medial third is usually below the orbital margin with the hairs in this region oriented vertically. The middle third lies along the orbital margin with hairs oriented obliquely or horizontally. The lateral third usually lies above the orbital margin.[3] Eyebrow hair normally tends to be less dense laterally than medially; thus, hair loss from any cause is apt to be more obvious in the lateral portion.[6]

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.
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.
Taking estrogen supplements as part of a hormone replacement therapy regime has its effects on your hair as well. Women can treat a type of hair loss called androgenic alopecia, associated with low estrogen and progesterone, by replacing these hormones artificially. Dosages of synthetic estrogen should be monitored regularly -- abnormal hair growth is a possible side effect of one kind of hormone replacement therapy, called esterified estrogens.
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!
The eyebrows are two-arched eminences of skin situated above the orbital regions.[3,4] The hairs of the eyebrows are short, thick. and stiff and are set obliquely. The diameter of eyebrow hair is normally thinner than scalp hair in Asians, and the scalp hair in thinner in Caucasians.[5] The eyebrows can be roughly divided into three parts. The medial third is usually below the orbital margin with the hairs in this region oriented vertically. The middle third lies along the orbital margin with hairs oriented obliquely or horizontally. The lateral third usually lies above the orbital margin.[3] Eyebrow hair normally tends to be less dense laterally than medially; thus, hair loss from any cause is apt to be more obvious in the lateral portion.[6]
Giorgos Tsetis: When you want to solve an issue, you must first thoroughly understand the problem. A lot of times, especially in the pharma world, everybody is trying to identify the magic pill that targets a single trigger. But, that's the exact reason there hasn't been a drug that holistically and indefinitely ends the problem. You can't zero in on one specific trait or symptom, you really have to solve for the many causes. When it comes to hair loss for men and women, there are several causes that disrupt the natural hair growth cycle. Basic vitamins and minerals only act as a temporary bandaid for hair health deficiencies, which is simply not enough. Hair loss and thinning hair means your body is imbalanced and there's something off, because hair follicles are mini organs.

That's why I've designed a system I call The Gottfried Protocol, a step-by-step, integrative approach to natural hormone healing that emphasizes lifestyle design first and foremost. It's based on decades of research, my education at Harvard Medical School, my own experiences with hormonal imbalances, my belief in peer-reviewed, well-performed randomized trials to support my recommendations, and what I've learned from patients over the past 20-plus years of practicing medicine. The Gottfried Protocol engages only the top hierarchy of scientific evidence and has been proven in scores of women in my practice.


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.

Madarosis is a terminology that refers to loss of eyebrows or eyelashes. This clinical sign occurs in various diseases ranging from local dermatological disorders to complex systemic diseases. Madarosis can be scarring or non-scarring depending upon the etiology. Appropriate diagnosis is essential for management. Follicular unit transplantation has been found to be a useful method of treating scarring madarosis and the procedure relevant to eyebrow and eyelash reconstruction has been discussed. A useful clinical approach to madarosis has also been included for bedside diagnosis. The literature search was conducted with Pubmed, Medline, and Google scholar using the keywords madarosis, eyebrow loss, and eyelash loss for articles from 1960 to September 2011. Relevant material was also searched in textbooks and used wherever appropriate.
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