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Madarosis: Symptoms, Causes, Diagnosis & Treatment

Madarosis is a medical condition which causes the loss of eyelashes and eyebrows. Initially, the clinical term was only used for eyelashes but is now used for eyebrows as well. The condition can affect one side or both sides of the face and may lead to partial or complete loss of hair from your eyelashes or eyebrows. Madarosis can possibly result in you losing all of your hair (eyelash and eyebrows) or some of them [1] .

Madarosis is a sign of various diseases, both dermatological and complex body diseases. The loss of hair from eyelashes and eyebrows are critical for eye health as the eyelashes protect the eyeball from small foreign bodies (because of inherent reflex closure of the eyes) and the eyebrows protect the bony ridges above the eyes. Both have a significant cosmetic function as well. The condition is common to both sexes and is increasingly found in older individuals [2] , [3] .

Types Of Madarosis

The condition can be unilateral or bilateral, incomplete or complete, and non-scarring or scarring. However, it can be generally recognised as being non-scarring or scarring [4] , [5] .

Non-scarring madarosis is when the internal hair structures remain, where there is a chance of reversing the hair loss.

In scarring madarosis, there is more damage and the hair loss on your eyebrows and eyelashes are permanent.

Symptoms Of Madarosis

The first and foremost indication of the condition is falling eyelashes [6] . Your eyelashes will become brittle and thin and will pull away even in the smallest of contact (such as while applying mascara).

The symptoms of the conditions are as follows [7] :

  • Thinning and loss of hair from other parts of the body, especially the scalp.
  • Sudden weight gain or palpitation, especially if the individual has an underlying condition of the thyroid.
  • Burning eyelids with constant itching and subsequent swelling.

Causes Of Madarosis

The condition has varied causes, that is, various medical conditions and diseases can cause madarosis [8] , [9] , [10] .

1. Trichotillomania

It is a psychiatric disorder. The mental health condition causes individuals to deliberately pull out their hair, especially from the eyelashes, eyebrows, and scalp.

2. Blepharitis

One of the major causes of madarosis is blepharitis. It is the inflammation of the eyelids which can be caused by infections such as parasitic infections like Demodex folliculorum, staphylococcal aureus, leprosy, viral infections like the measles, fungal infections like chlamydia etc. In most of the chronic cases, the recurring irritation can cause the individual to rub the eyes continuously, further leading to loss of eyelashes. Blepharitis causes itchy and red eyelids, dry eyes, and crust around the eyelids.

3. Leprosy

It is one of the other major causes of madarosis. It is commonly found in individuals suffering from leprosy (a bacterial infection that affects the skin, eyes, nose, and nerves).

4. Trauma

Physical injuries to the eyelashes and eyebrows can make them fall out. Trauma includes burns, wounds or accidents.

5. Infections

Fungal, viral and bacterial infections can cause madarosis. Fungal infections include ringworm, bacterial infections include Staphylococcus and syphilis, and viral infections include herpes simplex and HIV.

6. Autoimmune diseases

Some diseases such as alopecia totalis can cause the loss of hair in your body. Other autoimmune diseases that cause hair fall from eyebrows and eyelashes are scleroderma and discoid lupus [11] .

7. Thyroid issues

Hypothyroidism and hyperthyroidism are known to cause madarosis, resulting in your eyelashes falling out.

8. Medications and treatments

Medical treatments such as chemotherapy, radiotherapy, and laser treatments can cause your eyelashes or eyebrows to fall out. The treatments affect hair growth and strength by attacking the growing cells. Likewise, certain medications such as anticlotting medications, thyroid-balancing drugs, anticholesterol drugs and blood pressure medications are also possible causes of madarosis [12] .

9. Nutritional deficiencies

Deficiency in zinc, iron, or biotin also act as a cause of madarosis. As nutritional deficiencies affect your hair, it can cause your hair to thin down and fall [13] .

10. Genetic conditions

Ehlers-Danlos syndrome, ichthyosiform erythroderma, cryptophthalmos and ectodermal dysplasia can cause madarosis.

Apart from all these, skin cancer is also attributed as a cause of madarosis.

Diagnosis Of Madarosis (H2)

In order to understand the symptoms, the doctor will examine your medical history and carry out a physical examination. Apart from these, the doctor will ask you to undergo the following steps too so as to understand and determine the cause [14] .

  • Skin swabs to test for bacterial infections
  • Dermoscopy or dermatoscopy to examine the skin with a magnifier
  • Skin scraping to test for fungal infections
  • Blood tests

Treatments For Madarosis

1. Surgery

In severe cases, follicular transplantation of the eyebrow hair can be opted. It is done by transplanting hair onto the thinning area, by making small incisions. The procedure does not require any stitches or cuts and the hair will grow in a period of a few months, after the surgery [15] .

2. Topical medications

Latanoprost and bimatoprost are the most commonly used ones, which will help in increasing the length or thickening the eyelash hair. The topical medications also help in treating loss of hair from eyebrows.

3. Biotin supplements

These help in repairing hair texture and promotes new hair growth. The vitamin H aids in improving the building block of hair (keratin structure) and helps in regrowing the lost hair [16] .

4. Borax

This can help in treating the infections and toxins, thereby promoting new hair growth. Borax is diluted for application in eyelashes and eyebrows. It has been asserted to promote hair growth and even fill up bald spots.

5. Psychiatric help

This is in the case of individuals suffering from trichotillomania. Psychiatric help will aid the individual by providing them with behavioural and psychological help.

6. Cosmetic treatments

Various measures such as artificial eyelashes, tattooing eyebrows or eyelashes etc., can be used to cover the loss of hair from your eyebrows and eyelashes [17] .

Home Remedies For Madarosis

Apart from the treatment methods, the condition can be treated by adopting some changes into your daily lifestyle [18] , [19] , [20] .

1. Castor oil

Applying the oil will help you against eyelash loss. It encourages regrowth of eyelashes and helps soothe the area in case of any inflammation. Castor oil is also beneficial in getting rid of infections.

2. Protein and fatty acids

By adopting a protein-rich diet, you will be able to regrow your lost hair on eyebrows and eyelashes. Protein promotes and strengthens hair growth.

3. Make-up care

Be extremely careful while using make-up. Do not use old or crusty make-up, and take off all your make-up, especially your eye make-up before going to bed.

View Article References
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  2. [2] Kumar, A., & Karthikeyan, K. (2012). Madarosis: a marker of many maladies.International journal of trichology,4(1), 3.
  3. [3] Sachdeva, S., & Prasher, P. (2008). Madarosis: A dermatological marker.Indian Journal of Dermatology, Venereology, and Leprology,74(1), 74.
  4. [4] CHUANG, S. D., JEE, S. H., CHIU, H. C., CHEN, J. S., & LIN, J. T. (1995). Familial acanthosis nigricans with madarosis.British Journal of Dermatology,133(1), 104-108.
  5. [5] Vij, A., & Bergfeld, W. F. (2015). Madarosis, milphosis, eyelash trichomegaly, and dermatochalasis.Clinics in dermatology,33(2), 217-226.
  6. [6] Smith, K., Winstanley, J., Boyle, F., O’Reilly, A., White, M., & Antill, Y. C. (2018). Madarosis: a qualitative study to assess perceptions and experience of Australian patients with early breast cancer treated with taxane-based chemotherapy.Supportive Care in Cancer,26(2), 483-489.
  7. [7] Prensky, C. J., Brissette, A. R., Sippel, K. C., & Teitelbaum, A. (2018). Eye Symptoms and Toxicities of Systemic Chemotherapy. InThe MASCC Textbook of Cancer Supportive Care and Survivorship(pp. 563-583). Springer, Cham.
  8. [8] Kanski, J. J. (2010).Signs in Ophthalmology: Causes and Differential Diagnosis E-Book. Elsevier Health Sciences.
  9. [9] Kowing, D. (2005). Madarosis and facial alopecia presumed secondary to botulinum a toxin injections.Optometry and vision science,82(7), 579-582.
  10. [10] Nguyen, H. V., Jakobiec, F. A., Zakka, F. R., & Yoon, M. K. (2018). Bilateral upper and lower eyelid margin swelling and madarosis due to lymphoma.Survey of ophthalmology,63(4), 589-594.
  11. [11] Modjtahedi, B. S., Alikhan, A., Maibach, H. I., & Schwab, I. R. (2011). Diseases of periocular hair.Survey of ophthalmology,56(5), 416-432.
  12. [12] Song, J., Song, A., Palmares, T., Song, M., & Song, H. (2017). Ruxolitinib found to cause eyelash growth: a case report.Journal of medical case reports,11(1), 189.
  13. [13] Arunachalam, C., Hegde, V., & Jain, R. (2008). An unusual ocular presentation of acquired immune deficiency syndrome.Indian journal of ophthalmology,56(5), 434.
  14. [14] Selva, D., Chen, C. S., James, C. L., & Huilgol, S. C. (2003). Discoid lupus erythematosus presenting as madarosis.American journal of ophthalmology,136(3), 545-546.
  15. [15] Kataev, M. G., & Filatova, I. A. (1997). Surgical treatment of traumatic madarosis.Vestnik oftalmologii,113(1), 16-19.
  16. [16] Lacouture, M. E. (2015). Management of dermatologic toxicities.Journal of the National Comprehensive Cancer Network,13(5S), 686-689.
  17. [17] Ugurlu, S., Bartley, G. B., Otley, C. C., & Baratz, K. H. (1999). Factitious disease of periocular and facial skin.American journal of ophthalmology,127(2), 196-201.
  18. [18] Job, P. A. C55411: Lifting the lid on dry eye practice–part 4: case studies.
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  20. [20] Bermejo, E. E., De Egea, G. G., Llanos, R. A., Meza, D. L. M., Carreño, M. L., Jaraba, L. E., & Sales, L. C. E. (2018).U.S. Patent Application No. 15/647,201.

Read more about: hair hair loss leprosy
Story first published: Monday, March 11, 2019, 17:30 [IST]
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