Eyebrow alopecia

Ageing

As with scalp hair and body hair, eyebrow hair tends to grow more slowly with age and becomes shorter and finer over time. This process usually results in a gradual loss of density rather than true eyebrow alopecia.

Hair pulling

Patients with trichotillomania — a behavioural disorder characterised by compulsive hair pulling — as well as individuals who have undergone prolonged and repeated traction-based hair removal methods (particularly tweezing or waxing) may experience permanent eyebrow hair loss.

Oncological therapies

Both radiotherapy and chemotherapy may cause eyebrow hair loss, sometimes leading to persistent or permanent changes even after cancer treatment has been completed.

Alopecia areata

This autoimmune form of alopecia affects hair follicles and leads to hair loss. In its universal variant, alopecia areata may also involve the eyebrows and eyelashes.

Frontal fibrosing alopecia

This type of scarring alopecia primarily affects the frontal and temporal scalp (the so-called “headband” area), but may also involve the eyebrows, eyelashes and sideburns.

Other causes of eyebrow alopecia

In addition to the conditions listed above, there are less common causes that must also be considered when evaluating eyebrow alopecia and its treatment options. These include hypothyroidism, leprosy, vitiligo, atopic dermatitis, ichthyosis (a group of disorders characterised by dry, scaly skin), psoriasis, ulerythema ophryogenes (follicular hyperkeratosis) and lupus, an autoimmune disease that can affect the skin among other tissues.

The diagnosis of eyebrow alopecia is made during the clinical consultation through direct examination of the affected area, the use of digital trichoscopy — a microscopic technique that allows detailed visualisation of hair follicles and hair shafts — and a thorough review of the patient’s medical history. Eyebrow alopecia is frequently associated with other forms of alopecia, dermatological conditions, inflammatory or autoimmune diseases, as well as emotional factors such as stress or anxiety, and psychological disorders such as trichotillomania. For this reason, a comprehensive diagnostic approach is essential.

The importance of differential diagnosis lies not only in stopping eyebrow hair loss, but also in identifying any underlying condition that may be contributing to the problem. When present, treating the underlying cause is key to improving eyebrow alopecia at its origin.

Treatments for eyebrow alopecia involve different active ingredients, some of which are also commonly used in other forms of alopecia. These medications improve blood flow and oxygen delivery to the hair follicle, increase hair shaft thickness and enhance overall hair health, thereby promoting regrowth. These treatments may be complemented by topical prostanoids formulated for home use, depending on the individual case.

When eyebrow alopecia is related to inflammatory or autoimmune processes, dermatologists specialised in hair disorders may consider prescribing topical or injectable medication aimed at modulating these mechanisms and improving eyebrow hair loss.

These are cosmetic solutions that may be used alone or as a complement to medical treatments for eyebrow alopecia, particularly to fill in areas where hair regrowth has not been achieved or to improve density in sparse eyebrows.

These procedures involve designing and pigmenting the eyebrow area using permanent or semi-permanent make-up, carefully reproducing the original eyebrow shape and colour. Pigmentation techniques have evolved significantly in recent years, with the aim of achieving harmonious and natural-looking results.

Eyebrow design is adapted to the patient’s facial structure and takes into account whether the patient is male or female. Pigment colour is selected according to eye colour, skin tone and hair colour. In general, microblading tends to produce more natural results, as it recreates eyebrows hair by hair. It is a non-permanent technique and requires periodic maintenance.

Eyebrow transplantation is a surgical option when an increase in eyebrow density cannot be achieved with medical treatments or when a permanent solution is desired.

This procedure is currently more frequently requested by women, as eyebrow alopecia is more common in females than in males, and women often perceive the aesthetic impact of eyebrow loss more negatively.

The content of this page has been prepared by the Communication Department and the Medical Team of Grupo Pedro Jaén, in line with our editorial commitment to ensuring the accuracy and up-to-date nature of the information provided.

References on eyebrow alopecia:

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2. Sabanciogullarindan S, Tunc S. Cicatricial eyebrow restoration using the follicular unit extraction technique. J Cosmet Dermatol. 2022 Mar;21(3):1098-1105. doi: 10.1111/jocd.14226. Epub 2021 Oct 26. PMID: 34114737.

3. Wang J, Fan J. [Aesthetic eyebrow reconstruction by using follicular-unit hair grafting technique]. Zhonghua Zheng Xing Wai Ke Za Zhi. 2002 Mar;18(2):101-3. Chinese. PMID: 12192759.

4. Jiang W, Wang M, Wang B. Clinical outcomes and technical tips for eyebrow restoration using single-follicular-unit hair transplantation: A case series review. J Cosmet Dermatol. 2020 Aug;19(8):2057-2060. doi: 10.1111/jocd.13242. Epub 2019 Dec 9. PMID: 31820550.

5. Wang J, Fan J. Cicatricial eyebrow reconstruction with a dense-packing one- to two-hair grafting technique. Plast Reconstr Surg. 2004 Nov;114(6):1420-6. doi: 10.1097/01.prs.0000138727.17753.73. PMID: 15509928.

6. Liu LY, King BA, Ko JM. Eyebrows Are Important in the Treatment of Alopecia Areata. J Investig Dermatol Symp Proc. 2020 Nov;20(1):S37-S40. doi: 10.1016/j.jisp.2020.04.006. PMID: 33099382.

7. Fertig R, Tosti A. Frontal fibrosing alopecia treatment options. Intractable Rare Dis Res. 2016 Nov;5(4):314-315. doi: 10.5582/irdr.2016.01065. PMID: 27904832; PMCID: PMC5116872.