People living with alopecia areata can have hair loss anywhere hair grows on the body, including the face. Eyebrows and eyelashes help protect the eyes, and they can also be an important part of a person’s appearance and identity.

For some people, losing hair in their eyebrows or eyelashes might feel alarming. Read on to learn about treatments that may help and ways to care for yourself while managing eyebrow and eyelash hair loss caused by alopecia areata.

Why Can Alopecia Areata Cause Eyelash and Eyebrow Loss?

Alopecia areata is an autoimmune disease. In autoimmune diseases, the immune system mistakenly attacks healthy parts of the body instead of protecting them from threats like viruses or bacteria.

With alopecia areata, the immune system attacks the hair follicles. Although it most often affects the hair on your scalp, it can also affect hair in other areas, including the eyebrows and eyelashes.

When alopecia areata affects the eyebrows or eyelashes, it happens because the immune system mistakenly targets the hair follicles around the eyes. In most cases, the follicles are not permanently damaged, so the hair may grow back.

Studies show that brow and lash hair loss may be linked to more severe scalp hair loss. Some evidence suggests that people with eyebrow loss are more likely to have eyelash loss, and vice versa.

Eyelash or eyebrow hair loss can happen even when you don’t have much scalp loss. In rare cases, it may even be the first or only sign of alopecia areata.

What Does Eyelash and Eyebrow Loss From Alopecia Areata Look Like?

Eyebrow and eyelash loss caused by alopecia areata is called madarosis, and it’s relatively common in people with alopecia areata. About 75 percent of people with severe alopecia areata have patchy hair loss in the eyebrows, eyelashes, or both. Usually, eyebrow and eyelash loss with alopecia happens alongside hair loss on other parts of the body.

Common patterns of eyebrow and eyelash loss with this type of alopecia include:

• Patchy or complete loss of eyebrow hairs on both sides
• Patchy loss of eyelashes on both sides, including upper and lower eyelids
• Black or yellow dots on the scalp that can be seen during a close-up scalp exam called trichoscopy
• Exclamation point hairs (hairs that are thicker at the tip than at the root), seen by trichoscopy

Emotional Symptoms of Eyebrow and Eyelash Hair Loss

Loss of eyebrow and eyelash hair can be stressful and upsetting. In one study of women who experienced loss of eyebrows or eyelashes, more than half said they feared what other people thought of them, and 25 percent said they had new anxiety.

If you are struggling with eyebrow or eyelash hair loss, you’re not alone. Many people with alopecia areata report that eyebrow hair loss is just as important to them as scalp hair loss. Studies show that our eyebrows play a big role in how we see and recognize ourselves and others.

If eyebrow or eyelash hair loss is causing stress or anxiety, talk to a healthcare provider. They can provide support or refer you to mental health resources.

Does Eyebrow and Eyelash Hair Loss Regrow?

Brows and lashes can grow back with alopecia areata. Like other hair lost to alopecia areata, it may grow back white or blond at first and may be thinner than before. Over time, and/or with treatment, your original hair color and texture often return. Often, successful treatment for your scalp hair loss will also help your eyelashes and eyebrows grow back.

Sometimes, your hair will grow back on its own (including hair on your face). With alopecia areata, hair can grow back in some spots and fall out in others. In some cases, symptoms can go away altogether.

What Treatments Help With Eyelash and Eyebrow Loss?

Many of the treatments used for scalp hair loss in alopecia areata can also be used for eyebrow and eyelash loss. Because the skin around the eyes is delicate, some alopecia areata treatments need to be used differently or more carefully in these areas.

These treatments haven’t all been studied specifically for the eyebrows and eyelashes, but some people have reported good results. Talk to your doctor to find the right treatment for you.

Corticosteroids

These anti-inflammatory medicines are commonly prescribed treatments for alopecia areata. They can be taken as pills or applied to your skin using medicated lotion, cream, or foam (for eyebrow loss). Corticosteroids can also be given as injections in each eyebrow every four to six weeks for up to six months. As far as we know, topical or injected steroid treatment has not been shown to work well for eyelash loss.

Minoxidil

Minoxidil can be applied directly to the skin and is used to help with hair growth. It usually takes about 12 weeks of treatment before hair will start growing back.

Bimatoprost

Bimatoprost is a topical drug that can be used to help grow back lashes and brows. For eyelashes, it’s applied to the skin on the base of your upper eyelid. For eyebrows, it’s applied to the eyebrow area.

Janus Kinase Inhibitors

This is a newer type of medication used to treat the inflammation linked to alopecia areata. Several types of Janus kinase (JAK) inhibitor drugs have shown good results in helping with hair regrowth for alopecia areata, and with eyelashes and eyebrows in particular. Eyebrow and eyelash studies on this type of drug include the following:

• Baricitinib (FDA-approved for severe alopecia areata in 2022) — More than 35 percent of people saw full eyebrow regrowth, and more than 36 percent of people saw full eyelash regrowth.
• Tofacitinib pill — After six months or more of treatment, 34.5 percent had full eyebrow regrowth and 38.7 percent had full eyelash regrowth.
• Tofacitinib topical solution — When applied to the eyebrow area skin and into the eyes as an eye drop, this medication helped the majority of participants regrow eyebrows and eyelashes.
• Ruxolitinib — This medication has not been studied extensively for brow and lash use, but it has shown promise as a topical medication.

How To Cope With the Day-to-Day Impact

If you’re experiencing eyebrow or eyelash loss, there are steps you can take in addition to treatment that can help.

• Eye protection — Because your brows and lashes help protect your eyes from dust and debris, it’s a good idea to use sunglasses or hats to help protect your eyes if you have hair loss in these areas.
• Cosmetic support — To help you feel more confident, you may choose to use makeup, such as brow pencil, eyeliner, or other cosmetics, to fill in these areas.
• Emotional support — Many people with alopecia areata report feeling lonely or anxious. If you are feeling this way, you’re not alone, and help is available. Practice self-care, consider talk therapy, and seek out support from friends, loved ones, and others with alopecia.

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Have you had good results preventing or stopping eyelash and eyebrow loss? Let others know in the comments below.