The loss of hair from the eyebrows or eyelashes is often dismissed as a minor cosmetic annoyance, but it can indicate an underlying health issue. This loss occurs when the rate of shedding significantly exceeds the regrowth rate, resulting in noticeable thinning or bald patches. While sometimes temporary and reversible, this hair loss can signal a more persistent problem, with causes ranging from internal systemic diseases to external trauma.
Systemic Health Issues
The balance of hormones significantly regulates the hair growth cycle for all follicles. Thyroid disorders are a frequent systemic cause, as both hypothyroidism (underactive) and hyperthyroidism (overactive) disrupt the hair growth phase. With hypothyroidism, a classic sign is the specific thinning or loss of hair from the outer third of the eyebrows, known as Hertoghe’s sign. When thyroid hormones are imbalanced, hair follicles may prematurely enter the resting phase (telogen effluvium), leading to diffuse thinning.
Autoimmune diseases are another systemic cause where the body mistakenly attacks healthy hair follicles. Conditions like Systemic Lupus Erythematosus (SLE) cause inflammation that damages the hair structure, potentially leading to irreversible hair loss in the brow area.
Nutritional status also directly affects hair structure and growth. Severe deficiencies in specific micronutrients interrupt the production of keratin, the protein that forms hair shafts. Inadequate intake or absorption of Iron, Zinc, or Biotin can lead to shedding and fragility in the eyelashes and eyebrows. Iron deficiency impacts the hair cycle due to its role in DNA synthesis for hair growth.
Localized Skin and Follicle Conditions
Many causes of hair loss are confined to the skin and follicles immediately surrounding the eye area, often stemming from inflammation or a localized immune response. Alopecia Areata, where the immune system attacks hair follicles, can specifically target the eyebrows and eyelashes, even when the scalp remains unaffected. This typically presents as smooth, round patches of hair loss that occur rapidly.
Inflammatory Skin Conditions
Chronic inflammatory skin conditions affecting the face and scalp can extend to the delicate eyelid and brow skin. Eczema (Atopic Dermatitis), Psoriasis, and Seborrheic Dermatitis cause persistent irritation, scaling, and redness that disrupt the normal hair cycle. The inflammation associated with these conditions can damage the hair follicle, resulting in temporary or long-term hair thinning.
Blepharitis and Infections
A common local cause of eyelash loss is Blepharitis, which is inflammation of the eyelid margins. This condition is often related to bacterial overgrowth or an excessive accumulation of oil and skin flakes at the base of the lashes. The resulting crusting, irritation, and rubbing associated with Blepharitis can lead to the loosening and loss of eyelashes. Infections like fungal strains or infestations with Demodex mites can also colonize the lash base, causing irritation and subsequent hair loss.
External and Cosmetic Triggers
Physical stress and chemical exposure from daily routines and cosmetic practices are significant contributors to hair loss around the eyes.
Physical Trauma and Grooming
Traction Alopecia is hair loss caused by chronic, repetitive pulling or tension on the hair follicle. This is frequently seen with the use of eyelash extensions that are too heavy or improperly applied, placing excessive strain on the natural lash roots. Habitual plucking or aggressive grooming of the eyebrows over many years can permanently damage the hair follicle, leading to sparse growth that fails to recover. Constant rubbing of the eyes, often due to allergies, can physically dislodge hairs or trigger an inflammatory response. The harsh removal of waterproof makeup or repeated use of strong adhesives can also traumatize the delicate hair shafts and follicles.
Medication Side Effects
Certain prescription medications disrupt the hair growth cycle as a side effect. Chemotherapy drugs are a well-known cause, as they target rapidly dividing cells, leading to widespread hair loss. Other drug classes can also trigger a premature resting phase in the hair cycle. These include high-dose retinoids used for acne, anticoagulants like Warfarin, and certain blood pressure medications. The antidepressant Bupropion and the anticonvulsant Valproate are also associated with documented cases of hair thinning in the eyebrow and eyelash areas.
Consulting a Specialist
Identifying the precise cause of eyebrow or eyelash loss requires medical evaluation, as treatment depends entirely on the underlying issue. It is advisable to consult a healthcare provider, such as a dermatologist or primary care physician, when hair loss is sudden, asymmetrical, or accompanied by other symptoms like fatigue, unexplained weight changes, or a rash. Losing hair without an obvious external trigger signals that internal processes may be at play.
Diagnosis
The diagnostic process often begins with blood work to screen for common systemic causes. These tests typically include a full thyroid panel and checks for nutritional deficiencies, such as Iron and Zinc levels. If a localized skin condition is suspected, a specialist may perform a close examination of the hair follicles or a small skin biopsy to look for signs of inflammation or scarring.
Treatment
Treatment focuses on addressing the root cause. This may involve stabilizing thyroid hormone levels with medication or correcting a nutritional deficiency with targeted supplements. For localized inflammation, prescription anti-inflammatory creams or specialized eyelid hygiene regimens may be recommended to calm the skin and allow the follicles to recover. Stopping an offending medication or modifying cosmetic habits can often resolve the issue, allowing for eventual hair regrowth.