Model Chrissy Teigen has enviably perfect, bushy eyebrows – but it wasn’t always so.
Back in 2021 Teigen took to social media to reveal that she had had an eyebrow transplant, where hairs from the back of the scalp are used to fill in sparse brows.
Ms Teigen said years of overplucking had caused such significant thinning to her brows that pre-transplant she had to resort to pencilling them in every morning – and urged her followers to learn from her mistakes.
But it isn’t only overplucking – just as the hair on your head can thin with age, so too can the hair of your eyebrows, and it can be a sign of a medical condition. It can also occur without losing any hair on your head.
Whatever the cause, when it does happen, for many the impact of losing their eyebrows is greater than being ‘just’ a cosmetic issue – dermatologists and trichologists (non-medical specialists in hair and scalp health) report increasing concern about this among their patients – which is fuelling a growing demand for eyebrow transplants. In fact, 11 per cent of all hair transplant surgeries in women are now for eyebrow transplants, according to 2022 figures from the International Society of Hair Restoration Surgery.
‘The [psychological] impact on patients is often significant, as eyebrow loss can greatly affect self-confidence and body image,’ says Dr Ellie Rashid, a consultant dermatologist at Guy’s and St Thomas’ NHS Foundation Trust and OneWelbeck Health in London.
‘Eyebrows are a key feature in framing the face, and their thinning can leave people feeling less expressive or less polished.
‘Many patients report spending more time trying to fill in their brows with makeup or seeking out cosmetic procedures to restore the fullness they’ve lost, which can add stress to their daily routine.’
Back in 2021, model Chrissy Teigen took to social media to reveal that she had had an eyebrow transplant, where hairs from the back of the scalp are used to fill in sparse brows.
Although men and women can be affected eyebrow loss ‘tends to affect women more frequently, particularly from their 30s and 40s onward, often due to hormonal changes such as those associated with menopause,’ says Dr Rashid.
‘However, men can also experience this condition, and it’s seen more commonly as people get older… [when] hair follicles [the type of pore from which a hair grows] become less productive, leading to finer and less pigmented hairs.’
Eyebrow loss can happen whether or not someone is suffering hair loss from their head.
In some cases, the hair loss is gradual, in other instances, it can happen over a matter of months.
‘Patients often describe gaps, or thinning of the eyebrows, or thinning of a particular part of the eyebrows such as the outer third of the brows, or overall sparse brow hairs, and in more severe cases, the absence of eyebrows,’ says Dr Rashid.
The concern about this goes beyond its psychological impact as losing your brows specifically could be a sign of an underlying health issue, adds Dr Rashid.
These range from autoimmune conditions, thyroid or inflammatory skin conditions to nutritional deficiencies, particularly in iron and zinc (although in the case of nutrient deficiencies, it’s likely you’d also see thinning hair elsewhere too).
‘Autoimmune conditions such as alopecia areata can cause patchy hair loss that includes the brows,’ says Dr Rashid.
Dr Ellie Rashid, a consultant dermatologist, says eyebrow loss can greatly affect people’s self-confidence and body image
This is caused by the immune system becoming overactive and mistakenly attacking the hair follicles, causing inflammation and damage, which leads the hair to fall out.
It is not known what causes alopecia areata, but both genetic and environmental factors may contribute.
For some women, the menopause can be a trigger and while this normally only leads to hair loss from the scalp, in some cases the eyebrows can be impacted too.
There is also a lesser-known form of alopecia which is even more likely to affect the brows, says Dr Rashid.
‘Another cause for loss of eyebrow hair is frontal fibrosing alopecia (FFA), a scarring form of hair loss [which means the hair cannot grow back] that usually affects postmenopausal women and involves inflammation that leads to the immune system attacking hair follicles, causing complete loss of eyebrow hair, especially at the outer edges.’
Unlike alopecia areata, which tends to cause patchy hair loss all over, FFA primarily affects the front of the scalp and forehead, appearing like a band of receding hair across this area. A study in the Journal of the American Academy of Dermatology in 2022 found that as many as 96 per cent of patients with FFA experience hair loss from their eyebrows. And cases of the condition are increasingly being reported, according to a 2020 Review published in the Journal Advances In Dermatology And Allergology. Hormone changes are thought to be a factor in FFA, but a definitive cause is not known.
Thinning brows can also be the first outward sign of other underlying health problems – as 53-year-old Sally Woods found out.
‘I started losing the ends of my eyebrows about seven years ago… I was really conscious of them initially, as at that point I wasn’t wearing glasses so it was really noticeable,’ says Sally, a legal secretarial supervisor from Bedfordshire. ‘I just felt really exposed. I used to draw them on with eyebrow pencil.’
She initially accepted it as merely a part of ageing. Then, earlier this year, she heard a doctor on TV mention that thinning brows can be a sign of a thyroid problem.
This isn’t uncommon, says Dr Rashid. ‘Hormonal changes, particularly thyroid dysfunction or menopause, can play a significant role, with hypothyroidism [an underactive thyroid gland] being a common cause for thinning of the outer third of the brows.’
This occurs when the thyroid gland in the neck stops producing enough of the hormones that control how our bodies use energy. The symptoms can be subtle – alongside eyebrow loss, they include dry skin, low mood, and feeling cold and tired – but left untreated it can lead to heart disease, infertility and a rare but life-threatening condition called myxedema coma, when the organs begin to fail due to the deficiency of thyroid hormone.
Sally had already had ‘borderline’ results from blood tests indicating an underactive thyroid, but it wasn’t until after she heard the link with eyebrow loss that it ‘made sense’ to her. Two months ago, she went back to her doctor and her hypothyroidism was confirmed.
She started levothyroxine, a drug which replaces the missing hormone, thyroxine, to treat the condition. ‘We are waiting to see if things improve… but I can definitely see my eyebrows growing!’ she says.
So what can you do if you’re losing your eyebrows? You may be tempted to buy over-the-counter eyebrow serums which promise to help brows grow back, or book in for microblading – a type of eyebrow tattoo to disguise missing hairs – or even a brow transplant, at a cost of thousands privately. But while these might improve the ‘look’ of your brows, none are medical solutions to any underlying medical problem. For a treatment which gets to the root of the problem rather than focussing on improving appearance alone, see your GP.
‘For some, topical treatments like minoxidil [a solution applied to the skin once or twice a day] can help stimulate regrowth, while patients with alopecia areata may benefit from steroid creams or injections to encourage hair to return,’ says Dr Rashid.
This is because steroids can reduce the inflammation driving hair loss.
‘If the cause is related to a medical condition like thyroid dysfunction [or a nutrient deficiency], addressing the underlying issue is important,’ she adds.
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