Eyebrow and Eyelash Loss: Alopecia Areata, Thyroid or Age? Causes and When to See a Dermatologist
Short answer: The most common causes of eyebrow and eyelash loss (medically, madarosis) are alopecia areata, inflammation of the eyelid margin (blepharitis), a hair-pulling habit, cosmetic procedures, medicines and age-related thinning. Thinning of the outer third of the eyebrows can occur with an underactive thyroid, but on its own it does not prove a thyroid problem. If a woman after menopause loses eyebrow hair while her frontal hairline is also receding, she should be assessed early for frontal fibrosing alopecia, which can cause permanent loss.
Eyebrows and eyelashes grow from the same kind of follicle as scalp hair, so most conditions that cause hair loss can affect them too. Because there are relatively few hairs, even a small loss shows on the face. I have covered alopecia areata and scarring alopecias in separate articles.
Why do eyebrows and eyelashes fall out?
Thinning of the outer third of the eyebrow: is it the thyroid?
Loss of the tail of the eyebrow is a classic sign described in hypothyroidism. It is not specific, though: the same picture appears with age, after years of plucking, in atopic dermatitis that makes people rub around the eyes, and in frontal fibrosing alopecia. If you also have tiredness, feeling cold, weight gain or dry skin, thyroid tests are worth doing. The diagnosis comes from a blood test, not from the shape of the eyebrow.
Alopecia areata
In alopecia areata the immune system temporarily targets hair follicles. In the eyebrows it causes patches or loss of the whole brow; in the lashes it causes scattered or complete loss. Sometimes only the brows or lashes are affected. The follicle is not destroyed, so hair can regrow. Small eyebrow patches may be treated with steroid creams or careful local injections; the lash line is not injected, for eye safety. For extensive disease, oral JAK inhibitors (for example baricitinib or ritlecitinib) have regrown eyebrows and eyelashes in randomised trials. Access and reimbursement differ between countries; suitability is assessed at the consultation.
Frontal fibrosing alopecia: watch for it after menopause
This condition is most common in postmenopausal women. The hairline at the forehead and temples slowly moves back, and most patients also lose eyebrow hair; sometimes eyebrow loss starts years before the hairline changes. It is a scarring alopecia: follicles that are lost do not come back. Treatment aims to stop progression, so early diagnosis means keeping the brows and hair you still have. Evidence for the medicines used comes mainly from observational studies.
Hair pulling (trichotillomania)
Eyebrows and lashes are frequent targets of hair-pulling disorder, often during stress or intense concentration and without full awareness. Broken hairs of different lengths in the affected area are typical. Treatment is not about blame; habit-reversal behavioural therapy is the first step.
Blepharitis, seborrhoeic dermatitis and Demodex
If there is crusting, redness and itching at the base of the lashes, the problem usually lies in the eyelid margin. Seborrhoeic dermatitis causes flaking in the eyebrows ("eyebrow dandruff"), while cylindrical dandruff around the lash roots suggests an overgrowth of Demodex mites. Long-standing inflammation can thin the lashes. Treatment combines regular lid hygiene with targeted medicines; if vision is affected, an ophthalmologist is involved. When allergy to mascara or lash glue is suspected, patch testing helps; see my article on eczema and contact dermatitis.
Over-plucking, cosmetic procedures and traction
Years of tweezing or threading can weaken follicles. Eyelash extensions (weight and glue), brow lamination chemicals and permanent brow make-up pigments can cause irritation, allergy and breakage. If the cause is removed early, hair usually returns; traction over many years can leave permanent thinning.
Medicines and nutrition
Chemotherapy also affects brows and lashes; this loss usually recovers after treatment. Retinoids such as isotretinoin and acitretin can thin hairs and dry the eyelids. Iron deficiency and rapid weight loss can disturb the hair cycle. Supplements do not help if there is no deficiency, and Biotin can distort some blood tests, including thyroid tests, so mention it before any test. More on this in my Biotin article.
Age-related thinning
Slow, symmetrical thinning without other symptoms is usually age-related. Loss that starts quickly, affects one side, or comes with a receding hairline should not be put down to age.
Eyelash serums: be careful with prostaglandin analogues
Some lash serums contain prostaglandin analogues, the same group of active ingredients used for glaucoma (for example bimatoprost). They can make lashes longer and fuller, but the effect fades within months of stopping. Known side effects:
Redness and itching of the eyelids and surrounding skin
Darkening of the eyelid skin
Darkening of the iris in light-coloured eyes, which may be permanent
Loss of fat around the eye: a deeper upper-lid sulcus and a sunken look
Changes in eye pressure (important for people treated for glaucoma)
Some products sold as "cosmetic" may not clearly list this ingredient. If you have an eye condition, are pregnant or breastfeeding, ask a doctor first. A serum does not treat the cause, so alopecia areata or blepharitis can be missed.
How is the cause found? Examination, trichoscopy and blood tests
Assessment starts with the history: how fast the loss began, whether it is one-sided, itching, cosmetic procedures, medicines and supplements. Brows, lashes, scalp and nails are examined together. Trichoscopy is the key tool: exclamation-mark hairs in alopecia areata, broken hairs of varying length in hair pulling, and loss of follicular openings in scarring alopecia. A small biopsy is taken if needed. Blood tests are chosen according to the history; the usual ones are thyroid tests, a full blood count and ferritin.
Treatment: how much can we rely on each option?
Alopecia areata: local treatment for limited patches; systemic treatment for extensive disease is supported by randomised trials.
Frontal fibrosing alopecia: the aim is to stop progression; evidence is mainly observational.
Blepharitis and seborrhoeic dermatitis: lid hygiene and targeted treatment, with regular maintenance.
Hair pulling: behavioural therapy first.
Deficiencies: corrected only when a blood test shows them.
Permanent loss: once the condition has been stable for a long time, eyebrow transplantation or permanent make-up can be used as camouflage.
When should you see a dermatologist promptly?
Brows or lashes are falling out quickly over a few weeks
Eyebrow loss comes with a receding hairline at the forehead or temples
There are also bald patches on the scalp or in the beard
Lash loss is limited to one spot with a firm lump, sore or bleeding on the eyelid
There is marked eyelid swelling, pain or blurred vision (see an eye doctor the same day)
You notice eyebrow or eyelash loss in a child
My practice is in central Kırklareli, Türkiye, about one hour from Edirne: İstasyon Mahallesi, Edirne Caddesi No:102, Kırklareli, Türkiye.
Frequently asked questions
What illness can cause eyebrow loss?
The most common causes are alopecia areata, seborrhoeic dermatitis, blepharitis, hair pulling, over-plucking and frontal fibrosing alopecia. Thyroid disease, iron deficiency and medicines are less frequent causes. The cause is identified by examination and trichoscopy.
Is losing the outer part of the eyebrow a sign of thyroid disease?
It can be, but it does not prove it. The same pattern appears with age, frequent plucking and frontal fibrosing alopecia. A blood test confirms thyroid disease.
Why are my eyelashes falling out?
Usually because of blepharitis, eyelash extensions and glue, rubbing or pulling, alopecia areata or chemotherapy. Lash loss in one spot together with a lump on the eyelid should always be examined.
Do eyebrows and eyelashes grow back?
If the follicle is alive, usually yes. In scarring conditions such as frontal fibrosing alopecia, and after years of pulling, the loss can be permanent, which is why early diagnosis matters.
Are eyelash growth serums safe?
Serums with prostaglandin analogues can lengthen lashes but may cause eyelid redness and darkening, loss of fat around the eye and iris colour change in light eyes. People with eye disease, and pregnant or breastfeeding women, should not use them without medical advice.
Which doctor treats eyebrow and eyelash loss?
Follicle problems are a dermatology matter. Eyelid inflammation, vision symptoms or a lump on the eyelid are assessed together with an ophthalmologist.
References
Kumar A, Karthikeyan K. Madarosis: a marker of many maladies. Int J Trichology. 2012;4(1):3-18. PMC
Vañó-Galván S, Molina-Ruiz AM, Serrano-Falcón C, et al. Frontal fibrosing alopecia: a multicenter review of 355 patients. J Am Acad Dermatol. 2014;70(4):670-678. DOI
Kucukevcilioglu M, Bayer A, Uysal Y, Altinsoy HI. Prostaglandin associated periorbitopathy in patients using bimatoprost, latanoprost and travoprost. Clin Exp Ophthalmol. 2014;42(2):126-131. DOI
Harries MJ, Ahmed A, Ascott A, et al. British Association of Dermatologists living guideline for managing people with alopecia areata 2025. Br J Dermatol. 2026;194(2):e56-e73. DOI
This article is for general information; diagnosis and treatment are decided after examination.
Last updated: 24 October 2026 · Dr. Kağan Cingöz, MD, dermatologist
Contact
WhatsApp: +90 555 209 09 39 · info@drkagancingoz.com · İstasyon Mahallesi, Edirne Caddesi No:102, Kırklareli, Türkiye
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