Your eyebrows and eyelashes play an important role in shaping your appearance and losing them can significantly impact your self-esteem. But unfortunately madarosis — the clinical name for any condition that causes eyebrow or eyelash hair loss — is fairly common, as it can be a symptom of multiple conditions [1].
The good news is that in most cases, your eyelashes and eyebrows grow back on their own, once the underlying cause has been resolved. If that does not happen, there are effective treatment options you can try, ranging from hair loss medications to an eyebrow transplant. Keep reading this article to find out all you need to know about:
Madarosis is a medical term used to describe eyelash and/or eyebrow hair loss [2]. This can happen as a result of a variety of conditions, ranging from genetic disorders to systemic illnesses or improper cosmetic practices.
Most types of madarosis resolve themselves once the underlying cause has been treated or has subsided on its own. However, others require treatment to achieve hair regrowth. In more advanced cases, a facial hair transplant can be the best option to get your eyebrows or eyelashes restored.
If you are experiencing madarosis and you’re not sure why, the best thing you can do is to see a trichologist to assess and diagnose your eyebrow or eyelash hair loss. That is because while in most cases this condition is temporary and benign, it can also be a symptom of a more serious underlying condition.
Numerous conditions can lead to the development of eyebrow or eyelash hair loss. Here are some of the main categories [1][2][3]:
Just like common scalp problems can lead to hair thinning in the affected area, facial skin problems can lead to madarosis. Conditions such as seborrheic dermatitis, eczema, or scalp psoriasis can involve your eyebrows and/or eyelashes, making them fall out. Moreover, scratching your eyes or brows vigorously due to itchy skin in the area can pull out even more strands.
Alopecia areata can cause patchy hair loss on your scalp, but some forms can also involve your facial hair. Thus, it can also produce bald spots in your beard, eyebrows or eyelashes. Moreover, alopecia totalis involves complete hair loss on your head and face.
Madarosis is also one of the defining symptoms of frontal fibrosing alopecia, an autoimmune type of scarring alopecia that mostly affects women. It manifests with frontal balding and loss of eyebrow hair.
Physical trauma can make your eyebrows and eyelashes fall out (or stop growing) in several ways. The most common one is by using invasive styling practices. Plucking your eyebrows out extensively and repeatedly for cosmetic reasons can damage the hair follicles and disrupt the brow hair growth cycle [3]. However, some people also pull their eyebrows and eyelashes out due to a psychological condition called trichotillomania.
Bacterial, fungal or viral infections can cause madarosis. Among the conditions which present this symptom are folliculitis, eye problems such as blepharitis, herpes simplex or zoster, or, rarely, HIV.
The inflammation often caused by your immune system’s reaction to these conditions damages the hair follicles, making any strands in the affected area fall out. Moreover, some severe infections can cause permanent damage, leading to scarring alopecia of the eyebrows and/or eyelids.
Certain medications, such as chemotherapy, can cause madarosis. Some antithyroid, cholesterol-lowering, and anticoagulant treatments can also contribute to eyebrow loss, as can certain substances used in cosmetic therapies, such as Botox [4] (though this is very rare).
Moreover, illegal drug use (e.g. cocaine or barbiturate abuse) can also sometimes lead to madarosis.
Several systemic conditions can cause madarosis. Thyroid disorders that can cause hair loss, such as hyperthyroidism or hypothyroidism are among the best known. Discoid lupus erythematosus [5] is another good example, as this form of lupus can also cause hair loss on your scalp.
Very rarely, some forms of cancer can also manifest with eyebrow and/or eyelash hair loss.
Some nutrient and vitamin deficiencies can cause hair loss, which can include facial hair. For example, iron deficiency anaemia can cause hair loss, as can zinc, protein and biotin deficiencies [2]. And while supplementation may reverse the madarosis in some cases, this does not always happen, so eating well-balanced meals is very important.
Vitamin excess is not good for you either, as excessive vitamin A can cause hair loss on the scalp as well as madarosis. Heavy metal poisoning (e.g. with thallium, arsenic, mercury, or gold) can make your eyebrows and eyelashes fall out as well, often alongside the rest of your hair [9]. This type of toxicity usually occurs either by working or living in areas where repeated exposure is likely (e.g. industrial pollution of air and/or water) or by eating too many food types that contain heavy metals (e.g. some fish can contain mercury).
Certain genetically inherited syndromes, such as Netherton syndrome, Clouston syndrome or pili torti, can cause partial or total madarosis. These conditions are very rare and often manifest with many other symptoms alongside absent or sparse eyebrows or eyelashes.
There are several classifications of eyebrow or eyelash hair loss. Here are some of the most common ways it has been categorised [1][2]:
While each of the conditions that cause it has its own specific set of signs and symptoms, madarosis is simply characterised by eyebrow and/or eyelash hair loss. That is because it is, more often than not, a symptom of an underlying medical problem rather than a disease in itself [1].
For example, when caused by an infection, it can be accompanied by localised redness, inflammation, rash, itchiness, and/or pain. When caused by an iron deficiency, it can occur alongside anaemia and scalp hair loss. And when caused by alopecia areata, it can manifest with short, broken hairs shaped like question marks.
This multitude of potential coexisting symptoms and presentations make the underlying cause of madarosis difficult to self-diagnose. It is, thus, important to see a dermatologist or a hair doctor who can use the proper tools and techniques to reveal the true cause of your eyebrow or eyelash loss.
Your dermatologist or trichologist will first get an account of your health history and ask about current symptoms. Then they will perform a visual examination of your eyebrows and eyelashes. Finally, they may use one or more of the following diagnostic trichology tests:
Treating madarosis normally involves curing or controlling the underlying condition that is causing it. Once you have an accurate diagnosis, your healthcare provider may recommend one or more of the following types of treatment [1][2][3]:
Studies show that the popular hair loss drug Minoxidil works on eyebrows as well as scalp hair [6], especially when caused by alopecia areata or by physical trauma. Red light therapy for hair loss has also yielded good results in making brows grow back. If you are experiencing autoimmune madarosis, steroid creams for hair may help to restore your brows.
If your madarosis is caused by an infection, it may resolve itself in a few days. However, if it doesn’t or it becomes worse, you may need to use topical or systemic medications.
Milder infections can often be treated with topical treatments, such as medicated creams. However, more severe cases often require oral treatment to effectively remove the bacteria, fungi or viruses from your system.
If you have a systemic illness, your GP or specialist will prescribe the necessary treatment to control your condition and its symptoms.
Be sure to mention to your healthcare provider that madarosis is a problem for you. In some cases, they might be able to avoid prescribing medications that can cause further hair loss. Once the underlying condition is treated, your madarosis should also start to subside in a few weeks or months.
If your madarosis does not respond to non-surgical treatment, you could still be a good candidate for an eyebrow transplant. This procedure is usually performed with the Follicular Unit Extraction (FUE) technique (though you can also opt for FUT instead).
An eyebrow transplant involves harvesting healthy hair follicles from your scalp or from other parts of your eyebrow and implanting them in your balding spots. Just like a scalp hair transplant is permanent, so is an eyebrow/eyelash restoration, so opting for this procedure can be an excellent long-term solution to madarosis.
Considering the great variety of potential causes for eyebrow and/or eyelash loss, anyone may be affected by this condition, regardless of age, gender or other socio-demographic characteristics. However, you may be more likely to develop madarosis if you:
Here are some good options to cover up your eyebrow or eyelash loss until they’ve had a chance to grow back:
How long it takes for your eyebrows to grow back once they have fallen out largely depends on the reason they did so in the first place. In mild, non-scarring cases, you can expect to see new hair growth 3-4 months after the hair shedding cause has resolved [7]. However, more advanced cases may require specific treatment before your brows start to grow back.
Scarring madarosis is the most difficult to treat non-surgically. In some cases, it may respond to corticosteroid treatment (especially intralesional steroid injections for hair loss). However, your best chance to get fuller brows may be an eyebrow transplant (although not all forms of madarosis can be treated, even surgically).
If you are experiencing madarosis and non-surgical treatments haven’t helped, an eyebrow transplant may be the best solution to your facial hair loss. Book a consultation now with one of our highly skilled surgeons and they will assess whether you can benefit from surgical eyebrow restoration.
If you are a good candidate for this procedure, they will walk you through every step of the process, from the preparation stage to eyebrow transplant aftercare tips. Then, they will work with you to create a detailed and realistic surgical plan that helps the results meet your aesthetic expectations. The Wimpole Clinic proudly reports almost perfect success rates for this procedure, so you can feel confident that your eyebrows are in the best of hands.
Have more questions about madarosis? Find the answers you need below.
Yes, chronic zinc deficiency has been known to cause madarosis. However, clinical deficiency of this nutrient is very rare and it is mostly encountered in people with severely restrictive diets (e.g. people with anorexia nervosa), certain genetic disorders or in those who receive nutrition through a gastric tube or an IV for extended periods [1]. Healthy people who eat well-balanced meals don’t normally experience zinc deficiencies so severe as to cause eyebrow or eyelash loss.
Madarosis is a form of alopecia. Alopecia refers to any type of hair loss, regardless of the body part it manifests on (scalp, face or body). Madarosis, however, is a term used to describe only the loss of your eyebrows and eyelashes. Basically, it provides added specificity regarding the location of your hair shedding.
While certain forms of cancer (most involving the area surrounding the eye) can sometimes manifest with madarosis, in the vast majority of cases, eyebrow and eyelash hair loss is not a sign of cancer.
However, if you have a suspicious lesion on your eyelid and you are also experiencing madarosis, it is best to get a biopsy. That is because the chances of developing eyelash hair loss are higher in cancerous lesions than in non-cancerous ones [9].
While not everyone who undergoes chemotherapy loses their scalp and facial hair, most patients do. The average chemotherapy-induced madarosis rate depends on the type of medication you use. A study conducted on 838 breast cancer survivors who underwent chemotherapy revealed eyebrow loss in 89% of the cases and eyelash loss in 87% [10].
However, this facial hair loss is temporary and will grow back within a few weeks or months after treatment completion.
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