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.)
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.
Our professionally-trained people, products and services can help any person of any age or ethnicity, with any hair type or level of hair loss—whether it’s just beginning, it’s all gone or somewhere in between. We’re constantly innovating, using cutting-edge technologies and the latest proven hair restoration methods. We combine that innovation and technology with decades of first-hand experience in helping people deal with the issue of hair loss.

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]


The leading cause of hair loss in men is male pattern baldness, also known as androgenetic alopecia. This occurs in men whose hair follicles are sensitive to the hormone dihydrotestosterone, or DHT. Over time, DHT-sensitive hair (usually found on the top and front of the head) becomes weaker and finer and eventually stops growing. Most men have DHT-resistant, healthy hair follicles around the sides and back of their head. This is why so many men have a horseshoe pattern on their head.
Blepharitis is a chronic primary eyelid inflammation. It is fairly common in occurrence and being a condition with remissions and relapses, results in a decreased quality of life if adequate measures are not taken. Chronic blepharitis is the most common condition associated with madarosis.[10] Though there are various ways of classifying blepharitis, the most useful is the one proposed by Wilhelm,[24] wherein blepharitis can be classified based on whether there is a predominant involvement of the part of the eyelid anterior to the gray line (anterior blepharitis), or posterior to the gray line (posterior blepharitis). The gray line is an imaginary line dividing the eyelid into an anterior part consisting of the skin and muscle, and a posterior part consisting of the tarsus and conjunctiva.
Additionally, two other considerations are important for a patient who receives treatment for FPHL. First, there is a set of reasonable expectations in patients. Maintaining the current hair density can be considered a successful treatment because women tend to have further thinning as they age (Harfmann and Bechtel, 2015). Second, it is important to ensure that patients understand that progress is slow, and months or years can be required to see a significant improvement (Boersma et al., 2014, Yeon et al., 2011). In our practice, we wait at least 6 months to assess treatment efficacy.
Giorgos Tsetis: Consumers are lost, and that's the sad part about it. You have a serious problem, you go on the internet and see thousands of products making similar claims, and you can't choose. Most likely, you're going to try the cheapest product with the most compelling claims, realize it doesn't work, and only add further stress. When an industry is not properly regulated, this is the result. Education is such a big component of what we do. Reverse engineering a solution requires a tremendous amount of time and research. What we did was connect all these dots reading hundreds of pages of scientific literature. Education, when it comes to this, is broken into education for the physicians and education for the consumers. It's always hard to educate, because what you're really doing is changing behavior. Slowly but surely, we're actively changing the mindset of physicians and consumers, evolving the way they view and treat hair loss. That is huge, and one of the key reasons Unilever invested in the company. What we did was raise the bar by introducing a new category in the medical channel that remained untapped. That's how we disrupted the market, where now you see hundreds of doctors using Nutrafol as a trusted alternative for men and women. We also have several writers in the company who imagine how we can make this world simple and digestible for people. We want consumers to make smart choices.

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.
The first step in treatment is to identify the cause of the hair loss. Then, treat it appropriately. If an internal cause is the culprit, it should be addressed — for example, thyroid medication for thyroid disease or supplements for a nutritional deficiency. External skin conditions are often treated with topical medications, and, once treated, the hair loss usually recovers. I often recommend Latisse as an adjunctive treatment. Though frequently associated with eyelash lengthening, it is a great option for thickening brows. In fact, people with brows that thin with aging (I typically don't see this in women under 50) may want to opt for Latisse.
It’s common for women to experience shedding hair after pregnancy. Usually, this is in response to estrogen levels returning to normal, shedding the extra hair grown during pregnancy. Usually, the hair will return to the same thickness it was before you got pregnant. New moms who are not breastfeeding should consider taking hair growth vitamins post-pregnancy too to balance out their hair growth cycle.

It is an impulse-controlled disorder characterized by compulsive plucking or breakage of hair.[91] The most frequent site of hair pulling is the scalp, but the eyebrows, eyelashes, and pubic hair may also be involved. Trichotillomania manifests in eyelashes and eyebrows as irregular patches of alopecia containing hairs of varying lengths. Inflammation, scarring, and atrophy are conspicuous by their absence. Patients often attempt to conceal their alopecia by cosmetological camouflage. In case of a diagnostic dilemma, histological features such as increased numbers of catagen hairs, pigment casts, and traumatized hair bulbs provide a clue.

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.


Both of these hairy issues are related to excess androgens that are part of PCOS.  Our hair follicles respond overzealously to testosterone creating both hair loss and hair growth. This is because the follicles on the face tend to stretch and grow causing the hair to get stuck and not fall out when they should. Conversely, the scalp hair follicles actually shrink in response to androgens and the hair can fall out or just not be as robust.
Thallium poisoning should be suspected in any patient manifesting nervous system and gastrointestinal symptoms along with alopecia. The hair loss affects the scalp, periocular hair, limbs, and sometimes the axillae. Examination of the hair roots under a microscope using polarized light shows distorted anagen roots and several black zones in continued poisoning.[118]
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. 
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.
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.
Testosterone converts to DHT with the aid of the enzyme Type II 5-alpha reductase, which is held in a hair follicle's oil glands. Scientists now believe that it's not the amount of circulating testosterone that's the problem but the level of DHT binding to receptors in scalp follicles. DHT shrinks hair follicles, making it impossible for healthy hair to survive.

Skin Problems That Cause Eyebrow Loss How to Reverse Traction Alopecia How to Regrow Hair on a Receding Hairline What Would Be Some Reasons for My Hair Falling Out in Clumps? What Are the Causes of Itchy Scalp in Women? Causes of a Rash on the Scalp Skin Why Is My Hair Falling Out Every Time I Run My Fingers Through It? Reasons for Thinning Hair in Young Men How to Get Rid of White Spots on the Scalp Eyebrow Growth Rate How to Remove Hair Bumps Quickly What Causes Hair to Fall Out of a Beard? How to Scratch Out Flakes of Dandruff Oily Scalp Solutions Can Low-Carb Diets Cause Hair Loss? Why Is My Hair Suddenly Dry? Causes of Painful Acne on My Scalp What Are the Causes of Fine Thin Hair? Anxiety & Pulse LATISSE as a Treatment for Thinning Hair
Elizabeth Willett is the Senior Herbalist and Lead Educator at NaturalFertilityInfo.com. She holds a BS in Mass Communications (2000) from Minnesota State University, and a Master of Arts degree (MA, 2010) in Holistic Health Studies with a specialization is herbalism from St. Catherine University in St. Paul, MN. Liz has written over 200 articles on women’s fertility and brings a vast wealth of knowledge and expertise in holistic health and healing to Natural Fertility Info.com
Blepharitis is a chronic primary eyelid inflammation. It is fairly common in occurrence and being a condition with remissions and relapses, results in a decreased quality of life if adequate measures are not taken. Chronic blepharitis is the most common condition associated with madarosis.[10] Though there are various ways of classifying blepharitis, the most useful is the one proposed by Wilhelm,[24] wherein blepharitis can be classified based on whether there is a predominant involvement of the part of the eyelid anterior to the gray line (anterior blepharitis), or posterior to the gray line (posterior blepharitis). The gray line is an imaginary line dividing the eyelid into an anterior part consisting of the skin and muscle, and a posterior part consisting of the tarsus and conjunctiva.
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.
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. 

There is pilosebaceous inflammation[45] with both scarring and non-scarring alopecia depending on the degree of inflammation. Most commonly, there is involvement of the head and neck, though widespread involvement is also seen. Eyebrow loss is a prominent finding and may be the presenting symptom when the eyebrow region is involved in the acute benign form of follicular mucinosis.[46]
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.
If you’ve overplucked your brows too many times, you may have caused trauma to the follicles in the meantime, signalling not only those hairs you plucked to stop growing back, but also the hairs in surrounding areas. The good news: If the hair follicles aren’t dead, they can possibly be shaken from their resting state with a good brow enhancer. (like WINK  yes of course, we have to say it). There’s no sure bets, but it’s worth a try–plus Wink has a money-back guarantee!
A number of skin and hair disorders can lead to eyebrow hair loss and sometimes it may be linked to systemic diseases like lupus. Specific skin and hair disorders that are most likely to lead to eyebrow thinning and hair loss have been discussed below but other conditions like psoriasis may also be involved if it occurs on the eyebrow or forehead. Eyebrow hair loss may occur in people on chemotherapy (cancer medication) and with radiation therapy to the head.
In extreme cases, such as disordered eating and anemia, an iron deficiency may be to blame for thinning brows. “Even if you don’t have anemia, and you have low levels of stored iron, that could contribute to hair loss,” says Rajani Katta, M.D., a dermatologist and clinical assistant professor of medicine at Baylor College of Medicine, who studies the link between nutrition and hair loss. Iron is found in meat, fish, and other animal products, plus beans and legumes, so vegans and vegetarians might be more likely to be low in iron. Your derm can do a ferritin blood test to check your iron levels. But don’t start an iron supplement without medical recommendation. Too much iron can also have negative effects, says Dr. Katta.
Balancing your hormones is not an easy process, whether you are in perimenopause, menopause, or post-menopause. You may find that just one of these herbs is sufficient to do the trick, but in many cases you will achieve the best results by taking a combination of herbs. Start gradually and track your results carefully to make sure you are choosing the right products to balance and adjust your particular hormone profile.
Distress can also come from more than a change in body image. Dlova et al. (2016) found that in a group of black South African women, 52% reported serious worry that others would mistakenly assume that their hair loss was secondary to HIV infection or AIDS. It is critical that clinicians who care for such patients be compassionate and understanding but also have a solid understanding of hair loss so that reasonable expectations can be established and a therapeutic relationship can develop.
Testosterone converts to DHT with the aid of the enzyme Type II 5-alpha reductase, which is held in a hair follicle's oil glands. Scientists now believe that it's not the amount of circulating testosterone that's the problem but the level of DHT binding to receptors in scalp follicles. DHT shrinks hair follicles, making it impossible for healthy hair to survive.
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]

Hair loss in women is not easy to diagnose because it is very often multifactorial in etiology and thus requires well-designed specific steps so that the patient is evaluated properly. The best way to do this is to evaluate the patient in person (rather than sending photos via email or Skype) because the patient gets a chance to meet her doctor to permit the development of a trusting relationship- critical because very often the treatment of hair loss is an involved process that requires a strong doctor-patient relationship.
Hair loss is a condition that can affect any area of the body, including the eyebrows. Approximately three million Americans experience brow hair thinning and loss. Trauma, grooming habits, disease, and genetic predisposition all can contribute to this concern. Our experienced hair restoration surgeons at Leonard Hair Transplant Associates, Dr. Robert Leonard and Dr. Matthew Lopresti, often see individuals with eyebrow hair loss for which they offer a comprehensive selection of restorative options that can help you address this problem.
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