Why Are Your Eyebrows Thinning? 10 Causes You Need to Know

Dr Dray

AI-assisted summary of Why Are Your Eyebrows Thinning? 10 Causes You Need to Know — original source. Check the original for full context.

Source published: 2026-09-28

Key ideas

Eyebrow thinning is a symptom that requires clinical evaluation rather than immediate cosmetic self-treatment, as over-the-counter brow serums cannot treat underlying pathology and delay proper medical therapy. (0:00)
Differentiating scarring from nonscarring hair loss is the most vital clinical priority; scarring alopecias such as frontal fibrosing alopecia permanently destroy follicles and require rapid intervention to halt irreversible spread. (1:14)
Eyebrow loss patterns offer crucial systemic clues, such as Hertoghe's sign (lateral third thinning) pointing to hypothyroidism and smooth, round patches signaling alopecia areata. (3:35)
Indiscriminate nutritional supplementation can worsen brow loss, as excessive zinc induces copper deficiency hair shedding, and high-dose vitamin A toxicity directly triggers follicular loss. (5:56)

Detailed notes

## Background Published on YouTube by dermatologist Dr Dray on September 28, 2026, this educational video explores the various underlying causes of eyebrow hair loss (madarosis). The channel description explains that finding the root condition—ranging from autoimmune diseases and thyroid disorders to scarring alopecias like frontal fibrosing alopecia—is far more critical than reflexively reaching for cosmetic growth serums.

## TL;DR Dr. Dray explains that eyebrow thinning is a clinical symptom requiring an accurate diagnosis rather than a quick fix with over-the-counter serums. She divides eyebrow loss into nonscarring conditions—such as alopecia areata, thyroid dysfunction, eczema, infections, nutritional imbalances, and medication side effects—and irreversible scarring alopecias like frontal fibrosing alopecia and discoid lupus. While nonscarring forms retain dormant follicles that can regrow once systemic or dermatologic triggers are treated, scarring conditions permanently destroy follicles, demanding rapid medical intervention to halt disease progression. Ultimately, growth stimulants like minoxidil or bimatoprost are only useful as supportive therapies after the root cause has been properly identified and controlled.

## Atmosphere & style The presentation is clinical, direct, and pragmatic, marked by Dr. Dray's signature no-nonsense delivery and grounded medical authority. Her delivery blends educational seriousness with candid, wry humor, warning viewers against falling for wellness trends, self-prescribed supplements, or health coaches. The video feels like an illuminating, thorough consultation in an exam room, pivoting from practical reassurances about treatable shedding to sharp clinical urgency when detailing scarring conditions.

## Bulletin - [00:00](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=0s) Eyebrow thinning is a symptom that requires clinical evaluation rather than immediate cosmetic self-treatment, as over-the-counter brow serums cannot treat underlying pathology and delay proper medical therapy. - [01:14](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=74s) Differentiating scarring from nonscarring hair loss is the most vital clinical priority; scarring alopecias such as frontal fibrosing alopecia permanently destroy follicles and require rapid intervention to halt irreversible spread. - [03:35](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=215s) Eyebrow loss patterns offer crucial systemic clues, such as Hertoghe's sign (lateral third thinning) pointing to hypothyroidism and smooth, round patches signaling alopecia areata. - [05:56](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=356s) Indiscriminate nutritional supplementation can worsen brow loss, as excessive zinc induces copper deficiency hair shedding, and high-dose vitamin A toxicity directly triggers follicular loss.

## Key takeaways - [00:00](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=0s) Eyebrows serve vital functional roles in facial recognition and eye protection, and their thinning should not be casually written off as an unavoidable result of aging or menopause. - [00:00](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=0s) Over-the-counter growth serums and minoxidil are ineffective when used as standalone solutions if the underlying metabolic, autoimmune, or inflammatory driver remains unaddressed. - [01:14](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=74s) Scarring alopecias permanently obliterate hair follicles into fibrotic tissue, making hair transplantation the only restorative option once tissue has scarred down. - [02:28](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=148s) Alopecia areata can cause sudden, nonscarring loss of part or all of the eyebrow, necessitating targeted immunosuppressive therapies such as corticosteroids or JAK inhibitors. - [03:35](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=215s) Thinning of the outer third of the eyebrows (Hertoghe's sign) is a classic indicator of low thyroid hormone levels that requires systemic medical correction. - [04:01](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=241s) Common inflammatory skin conditions like atopic dermatitis and seborrheic dermatitis cause localized eyebrow shedding that requires barrier repair, anti-inflammatories, or antifungals. - [04:44](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=284s) Infectious pathogens—including secondary syphilis, facial ringworm from domestic pets, and leprosy—can manifest directly as eyebrow hair loss. - [05:56](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=356s) Hair production is metabolically demanding, but self-supplementing with high-dose zinc can backfire by precipitating secondary copper deficiency and worsening shedding. - [07:00](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=420s) Trichotillomania is a nonscarring mechanical cause of eyebrow thinning that requires behavioral management strategies rather than reliance on topical hair stimulants. - [07:53](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=473s) Medications such as cytotoxic chemotherapies, selective estrogen receptor modulators, and aromatase inhibitors frequently trigger eyebrow loss. - [08:53](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=533s) Excessive intake of fat-soluble vitamin A through over-the-counter supplements can trigger follicular toxicity and diffuse eyebrow shedding due to its long tissue half-life. - [09:22](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=562s) Frontal fibrosing alopecia (FFA) is a lichenoid scarring alopecia that affects both women and men, often attacking eyebrows before or alongside frontotemporal hairline recession. - [10:48](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=648s) Autoimmune conditions such as morphea en coup de sabre and discoid lupus erythematosus cause destructive, permanent eyebrow scarring if not rapidly controlled with immunosuppressants. - [13:37](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=817s) Red flag symptoms—including sudden patchy loss, skin redness, scaling, burning, or shiny scar tissue—warrant an in-person dermatology evaluation utilizing dermoscopy.

## Detailed walkthrough ### [00:00](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=0s) Why Eyebrows Matter and the Pitfall of Brow Serums

Dr. Dray welcomes viewers and immediately redirects the common impulse people have when they notice their eyebrows thinning, losing their tail ends, or developing completely bald gaps. Rather than typing "what's a good brow growth serum for sparse brows" into a search bar, people need to be asking a much more fundamental question: "why do I have sparse brows?" Jumping straight to an over-the-counter growth serum without understanding the root cause can actively backfire. Not only is a serum often entirely useless for the underlying pathology, but relying on it wastes critical time that could have been spent initiating proper medical therapy.

Brows are far more than aesthetic decorations. They are functional facial structures that play a vital role in facial recognition and physically shield the eyes from sweat running down the forehead and aeroallergens drifting through the air. Dr. Dray cautions against casually writing off eyebrow changes as an inevitable consequence of aging or menopause, noting that "people will just put everything on the shoulders of menopause." When brow loss begins, it demands a clinical explanation rather than casual dismissal.

[01:14](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=74s) Scarring vs. Nonscarring Eyebrow Loss

The absolute first question a dermatologist asks when evaluating eyebrow thinning is whether the process is scarring or nonscarring. In scarring alopecias, the inflammatory disease process directly targets and destroys the hair follicle. Once a follicle "scars down," it is gone forever—"there's no turning back. You will not grow a hair from that follicle ever again." Under those circumstances, the only way to restore hair to the scarred patch is through hair transplantation, which Dr. Dray emphasizes is a challenging and intricate procedure into the delicate brow region that most patients would prefer to avoid.

```mermaid flowchart TD accTitle: Scarring vs Nonscarring Eyebrow Loss Evaluation accDescr: A decision flowchart distinguishing between scarring and nonscarring eyebrow loss and their respective management goals.

A["Eyebrow Thinning or Hair Loss"] --> B{"Clinical Evaluation:<br/>Scarring vs. Nonscarring?"}

subgraph Scarring["Scarring Alopecia"] B -->|"Follicles destroyed & replaced by scar"| C["Permanent Follicle Obliteration"] C --> D["Goal: Rapid Medical Intervention to Halt Spread"] D --> E["Regrowth Impossible<br/>(Transplant only option)"] end

subgraph Nonscarring["Nonscarring Alopecia"] B -->|"Follicles preserved but dormant/inhibited"| F["Follicular Potential Intact"] F --> G["Goal: Diagnose & Treat Root Cause"] G --> H["Potential for Regrowth<br/>(Adjunctive Serums/Minoxidil)"] end ```

Because an unaddressed scarring condition progressively obliterates remaining follicles, time is of the essence. Letting any hair loss process linger makes it substantially harder to halt or reverse, but in scarring conditions, early intervention is the only window available to save surviving follicles before irreversible tissue destruction takes place.

[02:28](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=148s) Autoimmune Eyebrow Loss: Alopecia Areata

One major nonscarring etiology is alopecia areata, an autoimmune disease where the body's own immune system abruptly mounts an attack against the hair follicles. While well known for creating round bald patches on the scalp, it can strike any hair-bearing site, including the eyebrows. The hallmark of alopecia areata is a sudden, "out of the blue frank loss of a patch of hair" within the brow, or even the loss of the entire eyebrow or both brows altogether.

The skin left behind in alopecia areata is smooth and devoid of tiny broken hairs or emerging stubble. Because the follicles remain intact beneath the skin, this is a nonscarring form of loss, but regaining hair requires turning off the targeted autoimmune assault:

- **Targeted Anti-inflammatories:** Dermatologist-prescribed anti-inflammatory agents are essential to suppress the local immune attack. - **JAK Inhibitors:** Janus kinase (JAK) inhibitors represent advanced immune modulators proving highly effective at interrupting the specific signaling pathways driving alopecia areata. - **Supportive Regrowth Agents:** Minoxidil or cosmetic brow serums can serve as adjunctive therapies to stimulate dormant follicles, but only alongside proper immune suppression.

[03:35](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=215s) Systemic and Dermatologic Causes: Thyroid Disease and Eczema

Eyebrow patterns often act as subtle clinical clues for systemic endocrine disorders. A classic sign is Hertoghe's sign—the selective thinning or complete absence of the outer (lateral) third of the eyebrows—which is a well-established warning sign of low thyroid hormone (hypothyroidism). Because thyroid dysfunction carries wide-ranging, serious metabolic consequences for overall health, noticing that the tails of the brows have vanished should prompt a visit to a primary care provider to test thyroid levels, as correcting thyroid hormone balance helps address the hair loss.

Thinning of the outer brows is not exclusive to thyroid disease; common dermatologic conditions of the face also trigger eyebrow shedding:

- **Atopic Dermatitis:** Severe eczema affecting the periorbital and brow skin can lead to localized outer-brow thinning due to chronic eczema-related barrier dysfunction and scratching. - **Seborrheic Dermatitis:** This oily inflammatory condition is driven by an abnormal immune response to *Malassezia* yeast thriving in sebum-rich areas. When it establishes itself in the brows, the accompanying inflammation causes hair to shed. - **Treatment Approach:** Seborrheic dermatitis requires targeted topical antifungals, anti-dandruff active ingredients, and short courses of topical anti-inflammatories for active flares. Growth serums cannot counteract brow loss if active seborrheic dermatitis is left smoldering underneath.

[04:44](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=284s) Infectious Causes: Syphilis, Ringworm, and Leprosy

Several infectious pathogens can manifest directly in the eyebrows, and failing to identify them carries severe consequences:

- **Secondary Syphilis:** Syphilis is clinically infamous as "the great imitator." When it causes patchy or outer-third eyebrow loss, the presentation is historically referred to as the omnibus sign (or Omni-bus sign). Dr. Dray warns that leaving syphilis untreated risks devastating neurologic damage from "that little trep" (*Treponema pallidum*). - **Tinea Faciei (Facial Ringworm):** Fungal dermatophyte infections can spread directly across the face and infiltrate the eyebrow hair follicles. Dr. Dray highlights a classic, relatable scenario: adopting and cuddling a new kitten carrying fungal spores on its fur, which can lead to fungal folliculitis and sudden brow shedding. - **Lepromatous Leprosy:** Far from being an eradicated relic confined to biblical history, leprosy continues to occur and causes characteristic eyebrow loss, clinically termed madarosis.

[05:56](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=356s) Metabolic Demand and Nutritional Pitfalls

Hair synthesis is an exceptionally energy-intensive, metabolically demanding biological process. When the body faces severe physiological or emotional stress, it triages its resources and deprioritizes hair production. Similarly, systemic nutritional deficiencies can trigger shedding in both scalp and brow hair.

Zinc deficiency is a recognized trigger for eyebrow loss, frequently seen in individuals with malabsorption disorders such as inflammatory bowel disease (IBD) or rare inherited defects in zinc transport. However, Dr. Dray warns against blindly self-diagnosing and supplementing with zinc for sparse brows. Taking high doses of unnecessary zinc over extended periods induces secondary copper deficiency, which in turn triggers its own severe hair loss across the scalp and brows. Self-prescribing supplements often produces the exact outcome the patient was trying to avoid.

[07:00](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=420s) Trichotillomania and Mechanical Trauma

Eyebrow loss can also stem from mechanical, behavioral trauma known as trichotillomania—a compulsive urge to pull out one's own hair. Often serving as a subconscious or soothing coping mechanism, it commonly affects the scalp, but because eyebrows are prominently and easily accessible, they are frequently targeted. Children may develop temporary hair-pulling behaviors that they eventually outgrow, while in others it persists as an ongoing disorder.

Stimulating agents like minoxidil, bimatoprost (Latisse), or over-the-counter prostaglandin analog serums can technically stimulate regrowth in these nonscarred follicles, but they are entirely futile if the physical pulling behavior remains active. Dr. Dray points to comprehensive behavioral management strategies and evidence-based supplements such as N-acetylcysteine (NAC) as central pillars for managing the urge before relying on growth serums.

[07:53](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=473s) Medication-Induced Brow Loss

A variety of systemic medications interrupt the follicular cycle, with cancer chemotherapies being the most dramatic example. Chemotherapy drugs eradicate rapidly dividing cells, and as a bystander effect, the rapidly dividing matrix cells of the hair follicle abruptly shut down, causing anagen effluvium:

- **Chemotherapy Regimens:** Classes such as taxanes, doxorubicin, and cyclophosphamide regularly induce extensive, dramatic loss of scalp hair, eyelashes, and eyebrows. - **Post-Chemotherapy Regrowth:** Although brows typically regrow once treatment concludes, some patients experience permanently sparse or incomplete regrowth compared to their baseline. In these post-treatment phases, topical bimatoprost (Latisse) or minoxidil can assist in boosting density. - **Hormone Therapies:** Endocrine-targeted treatments, including selective estrogen receptor modulators (SERMs) and aromatase inhibitors, are also clinically recognized triggers of eyebrow alopecia.

[08:53](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=533s) Nutritional Excess and Vitamin A Toxicity

While nutritional deficits are widely discussed, excess nutrient intake can be equally destructive to eyebrow density. Ingesting high doses of vitamin A is a frequently overlooked culprit behind eyebrow thinning, often catching patients completely off guard because they assume over-the-counter supplements are inherently benign. Many wellness products and multivitamins pack a massive payload of vitamin A. Unlike pharmaceutical retinoids modeled after vitamin A derivatives—such as isotretinoin—supplemental fat-soluble vitamin A has an exceptionally long biological half-life and lingers in body tissues for extended periods.

Dr. Dray warns patients to exercise extreme caution with standalone vitamin A supplementation, emphasizing that aggressive intake routinely backfires. Beyond shedding and thinning of the brows, vitamin A toxicity triggers severe skin dryness, peeling, and widespread dermatological issues. While every preceding cause covered in the discussion falls into the nonscarring category—where correcting the underlying trigger offers an excellent chance of restoring the hair—patients must recognize when follicle damage risks becoming permanent.

[09:22](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=562s) Frontal Fibrosing Alopecia (FFA) and Scarring Hair Loss

The conversation pivots to scarring alopecias, where inflammatory destruction of the hair follicle creates irreversible damage if left unchecked. A primary driver of this is frontal fibrosing alopecia (FFA). Although classically recognized in post-menopausal women, FFA can arise at any age and frequently affects men, who are routinely excluded from the conversation or misdiagnosed with standard androgenetic alopecia (male pattern baldness). In men, FFA typically assaults the beard area in addition to the eyebrows and hairline.

FFA begins as an insidious perifollicular inflammatory reaction, manifesting as subtle, scaly, erythematous bumps surrounding individual hair follicles. If this inflammation is permitted to "cook there and brew," it inevitably destroys the stem cell reservoir and replaces the follicle with scar tissue. Loss of the eyebrows commonly goes hand-in-hand with frontotemporal hairline recession and can even precede scalp loss. Halting this process requires prompt clinical diagnosis and targeted anti-inflammatory or immunomodulatory therapy to put out the fire before any stimulatory agents are introduced.

```mermaid flowchart TD accTitle: Clinical Pathway for Frontal Fibrosing Alopecia accDescr: Step-by-step diagnostic and treatment progression from early inflammation to maintenance for FFA.

subgraph EarlyStage["1. Early Presentation"] A["Perifollicular Scaly Bumps & Erythema"] --> B["Eyebrow Thinning & Hairline Recession"] end

subgraph HaltInflammation["2. Anti-Inflammatory Control"] B --> C["Systemic Therapy: Hydroxychloroquine"] B --> D["Topical Agents: Steroids or Calcineurin Inhibitors"] end

subgraph RegrowthPhase["3. Secondary Stimulation"] C --> E["Minoxidil or Bimatoprost for Viable Follicles"] D --> E end ```

- **Pathology:** Lichenoid inflammation attacks the infundibulum and isthmus of the hair follicle, progressing to irreversible scarring (cicatricial alopecia). - **Misdiagnosis risk:** Men with FFA are frequently mislabeled with male pattern baldness, allowing eyebrow, beard, and hairline loss to advance unchecked. - **Medical interventions:** Regrowth stimulants cannot salvage destroyed follicles; the inflammatory assault must first be arrested using systemic agents like hydroxychloroquine or localized prescription topicals such as corticosteroids and calcineurin inhibitors.

[10:48](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=648s) Scleroderma En Coup de Sabre, Discoid Lupus, Trauma, and Radiation

Beyond FFA, a spectrum of autoimmune and physical insults can obliterate eyebrow follicles through scarring. Scleroderma (systemic sclerosis) includes a localized facial variant known as *morphea en coup de sabre*, so named because the lesion resembles the indurated strike of an open saber across the forehead. This linear sclerotic band produces unilateral eyebrow loss alongside tissue atrophy. Failure to arrest this disease with systemic immunosuppressive and anti-inflammatory drugs not only cements permanent madarosis but can result in severe structural facial disfigurement.

Discoid lupus erythematosus (DLE), a scarring subtype of cutaneous lupus, is another aggressive condition where autoimmune inflammation literally "cooks" the hair follicles. DLE plaques induce follicular plugging, erythema, hyper- or hypopigmentation, and permanent scarring that will erode the eyebrows unless suppressed with specialized systemic medications and strict photoprotection, as ultraviolet radiation exacerbates the disease.

Physical trauma and oncology treatments round out the destructive etiologies. Deep thermal burns or lacerations—whether from an accident or "if you got into a knife fight and somebody got you in the brow area"—replace functional follicular units with dense fibrotic scar tissue where hair physically cannot regrow. In those irreversible scenarios, surgical hair transplantation remains the sole restorative route, though it carries distinct aesthetic challenges that patients must weigh carefully. Similarly, external beam radiation therapy targeting head, neck, or facial cancers inevitably causes localized scarring and permanent madarosis whenever the treatment field intersects the brow margin.

[12:41](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=761s) The Reality of Minoxidil and Eyebrow Growth Serums

Turning to the widespread commercial craze for brow growth serums, minoxidil, and prostaglandin analogs (such as bimatoprost), Dr. Dray emphasizes that these products are not universal fixes. While growth stimulants can provide noticeable cosmetic density in the right diagnostic setting, or serve as standalone recovery aids once an acute, self-limiting insult has cleared, they cannot bypass biology. Relying on an over-the-counter peptide serum or topical minoxidil while ignoring the underlying systemic driver is an exercise in futility.

A prime illustration is thyroid disease: when untreated hypothyroidism induces lateral thinning of the eyebrows, no commercial serum will reverse the shedding until systemic thyroid hormone levels are normalized. Dr. Dray humorously points out that masking the issue makes no sense when systemic health is compromised: "Hello, you have low thyroid. You need to fix that... You're going to feel like stink and be wondering why you have all these problems." Stimulating a follicle that is either actively starved of metabolic support or being actively dismantled by immune cells wastes valuable time and money.

[13:37](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=817s) Red Flags, Dermoscopy, and When to See a Dermatologist

Eyebrow thinning is not an independent diagnosis; it is a clinical symptom pointing to an underlying problem. Dr. Dray urges viewers to abandon the urge to self-treat and schedule a formal evaluation with a board-certified dermatologist, especially when hair loss exhibits distinct red flags. Dermatologists approach hair loss fundamentally differently than consumers looking for quick cosmetic fixes: the clinical priority is to isolate and treat the root mechanism so that hair loss halts and recovery can begin.

During an in-office exam, dermatologists use specialized clinical training alongside dermoscopy—high-powered polarized magnifying instruments—to inspect subtle follicular clues that remain completely invisible to the naked eye, such as follicular hyperkeratosis, loss of follicular ostia, or delicate vascular patterns. A full evaluation may require a punch biopsy, systemic lab work, a comprehensive scalp and body check, and a close nail examination. Dr. Dray strictly advises patients: "Don't go to the dermatologist with nail polish on. Can't look at your nails if they're covered up with polish or artificial nails," as nail matrix changes frequently mirror systemic autoimmune disorders, psoriasis, and alopecia areata.

She also warns strongly against ordering direct-to-consumer lab panels or consulting unlicensed "health coaches" for medical hair loss:

- **Direct-to-consumer lab kits:** Blood panels for endocrine or autoimmune markers require precise clinical timing, specialized handling, and medical expertise to interpret correctly; self-ordered labs often mislead patients. - **Provider qualifications:** A health coach lacks the medical licensure and diagnostic tools necessary to manage scarring alopecias or complex endocrine disorders. - **Urgent signs that mandate an evaluation:** - Sudden, rapid, or patchy eyebrow shedding. - Progressive hair loss extending along the scalp hairline, beard, eyelashes, or body sites. - Localized cuticular erythema, scaling, pustules, burning, or intense pruritus. - Shiny, smooth, indurated, or porcelain-white skin where follicular openings have vanished.

## Notable quotes > [00:00](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=0s) people will just put everything on the shoulders of menopause. — Dr. Dray

> [01:14](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=74s) there's no turning back. You will not grow a hair from that follicle ever again. — Dr. Dray

> [02:28](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=148s) out of the blue frank loss of a patch of hair — Dr. Dray

> [04:44](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=284s) the great imitator. — Dr. Dray

> [04:44](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=284s) that little trep — Dr. Dray

> [09:22](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=562s) cook there and brew — Dr. Dray

> [10:48](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=648s) if you got into a knife fight and somebody got you in the brow area — Dr. Dray

> [12:41](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=761s) Hello, you have low thyroid. You need to fix that... You're going to feel like stink and be wondering why you have all these problems. — Dr. Dray

> [13:37](https://www.youtube.com/watch?v=ivkDDeSnLbE&t=817s) Don't go to the dermatologist with nail polish on. Can't look at your nails if they're covered up with polish or artificial nails — Dr. Dray

## Mentioned Dr. Dray, Minoxidil, Bimatoprost, Latisse, N-acetylcysteine (NAC), Hydroxychloroquine, Isotretinoin, Taxanes, Doxorubicin, Cyclophosphamide, Treponema pallidum, Malassezia

## Video description Why are your eyebrows thinning? Eyebrow hair loss, also called madarosis, can have many different causes, and finding the underlying cause is often more important than simply reaching for a brow growth serum.

In this video, dermatologist Dr. Dray explains the most common causes of eyebrow thinning and eyebrow hair loss, including alopecia areata, thyroid disease, atopic dermatitis, seborrheic dermatitis, infections, nutritional deficiencies, medication side effects, trichotillomania, and trauma. She also explains why distinguishing scarring from nonscarring eyebrow hair loss is so important.

One of the key conditions discussed is frontal fibrosing alopecia (FFA), a form of scarring hair loss that can cause eyebrow loss and may sometimes affect the eyebrows before obvious scalp hairline changes develop. Early recognition and treatment can be important for preserving remaining hair follicles.

Dr. Dray also discusses minoxidil for eyebrows, cosmetic brow growth serums, prostaglandin analogs, and why stimulating hair growth is not the same thing as treating the underlying cause of eyebrow loss.

The video covers clues that may help distinguish different causes of eyebrow thinning, including patchy eyebrow loss, loss of the outer third of the eyebrows, redness or scaling, itching, changes in the scalp hairline, and shiny or scarred skin.

TIMESTAMPS

0:00 Introduction 0:51 Why Do Eyebrows Matter? 1:14 Scarring vs. Nonscarring Eyebrow Hair Loss 2:28 Alopecia Areata and Eyebrow Loss 3:35 Thyroid Disease and Thinning Eyebrows 4:01 Atopic Dermatitis and Seborrheic Dermatitis 4:44 Infections That Can Cause Eyebrow Loss 5:56 Nutritional Deficiencies and Eyebrow Thinning 7:00 Trichotillomania and Trauma 7:53 Medications That Can Cause Eyebrow Loss 8:51 Vitamin A and Other Toxic Exposures 9:22 Scarring Causes of Eyebrow Hair Loss 9:30 Frontal Fibrosing Alopecia (FFA) 11:00 Other Scarring Conditions 12:41 Minoxidil and Eyebrow Growth Serums 13:50 When Should You See a Dermatologist? 14:26 Bottom Line

KEY TOPICS COVERED

• Eyebrow hair loss and thinning eyebrows • Madarosis • Frontal fibrosing alopecia and eyebrow loss • Alopecia areata of the eyebrows • Thyroid disease and eyebrow thinning • Hertoghe's sign • Seborrheic dermatitis and eyebrow loss • Atopic dermatitis • Syphilis and eyebrow hair loss • Nutritional deficiencies • Trichotillomania • Medication-induced eyebrow loss • Vitamin A toxicity • Scarring vs. nonscarring alopecia • Minoxidil for eyebrows • Eyebrow growth serums • When to see a dermatologist for eyebrow loss

If eyebrow thinning is sudden, patchy, progressive, associated with inflammation or scaling, or accompanied by changes to the scalp hairline or eyelashes, Dr. Dray explains why a dermatology evaluation may be more appropriate than simply trying another brow growth serum.

#EyebrowHairLoss #EyebrowThinning #Madarosis #FrontalFibrosingAlopecia #AlopeciaAreata #HairLoss #Minoxidil #Dermatologist #ScarringAlopecia #ThyroidDisease #EyebrowGrowth #DrDray

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[Source](https://www.youtube.com/watch?v=ivkDDeSnLbE)

中文简报

眉毛为何变稀疏？你需要了解的10个原因 Dr. Dray指出，眉毛变稀疏是一种需要精准诊断的临床症状，而非靠非处方精华液即可快速解决的问题。她将眉毛脱落分为非瘢痕性病症（如斑秃、甲状腺功能异常、湿疹、感染、营养失衡以及药物副作用）和不可逆的瘢痕性脱发（如额部纤维化脱发和盘状红斑狼疮）。非瘢痕性脱发保留了休眠毛囊，一旦全身或皮肤病诱因得到治疗便可再生；而瘢痕性病症会永久破坏毛囊，需要迅速进行医疗干预以遏制病情恶化。归根结底，米诺地尔或比马前列素等促生长药物只有在根本病因被查明并控制后，作为辅助治疗手段才具有价值。眉毛变稀疏是一种需要专业临床评估的症状，而非立刻自行采取美容手段，因为非处方眉毛精华液无法治疗潜在病因，还可能延误规范的医疗治疗。 (0:00) 区分瘢痕性脱发与非瘢痕性脱发是最关键的临床首要任务；额部纤维化脱发等瘢痕性脱发会永久破坏毛囊，必须迅速干预以阻止不可逆的蔓延。 (1:14) 眉毛脱落的形态分布能提供关键的全身性线索，例如赫托格征（Hertoghe's sign，即眉毛外侧三分之一变稀疏）提示甲状腺功能减退，而光滑的圆形脱发斑则提示斑秃。 (3:35) 盲目摄入营养补充剂可能会加重眉毛脱落，例如过量的锌会诱发缺铜性脱发，而高剂量维生素A中毒则会直接导致毛发脱落。 (5:56)

Reading summary

Dermatologist Dr. Dray explains that thinning eyebrows represent a clinical symptom of underlying systemic, inflammatory, infectious, or behavioral disorders rather than a cosmetic consequence of aging. Successful intervention depends on identifying whether follicular loss is scarring or nonscarring, rather than relying on over-the-counter growth serums. The Scarring Versus Nonscarring Prognostic Divide (1:14) The essential initial step in evaluating eyebrow thinning is distinguishing between nonscarring and scarring alopecias. In nonscarring conditions, hair follicles remain biologically viable, preserving the capacity for regrowth once the root cause is resolved. Conversely, scarring alopecias involve inflammatory destruction of the follicle's stem cell reservoir, permanently replacing functional tissue with fibrotic scar tissue. Dr. Dray emphasizes that once a follicle scars down, natural hair growth cannot resume, making rapid intervention essential to preserve surviving follicles before hair transplantation becomes the only restorative option. A primary cause of permanent loss is frontal fibrosing alopecia (FFA), characterized by perifollicular erythema and scaly papules that coincide with frontotemporal hairline recession. While classically documented in post-menopausal women, Dr. Dray highlights that FFA also affects men, where it frequently involves the beard and is often misdiagnosed as male pattern baldness. Other scarring etiologies include discoid lupus erythematosus, morphea en coup de sabre (a localized scleroderma causing tissue atrophy), radiation therapy, and physical trauma such as burns or lacerations. Halting these conditions requires urgent prescription therapy, including hydroxychloroquine, topical calcineurin inhibitors, or corticosteroids, rather than cosmetic hair stimulants. Systemic, Autoimmune, and Infectious Etiologies (2:28) Eyebrow shedding often provides visible clinical clues for systemic pathology. Hertoghe's sign—the loss or thinning of the outer third of the eyebrows—is a hallmark of hypothyroidism, which requires endocrine management rather than topical remedies. Nonscarring loss also occurs in alopecia areata, an autoimmune disorder that triggers sudden, smooth bald patches across the brow or body. Because follicular structures remain intact beneath the skin, resolving alopecia areata relies on dampening immune activity with prescription anti-inflammatories or Janus kinase (JAK) inhibitors before applying adjunctive regrowth agents. Infectious and dermatologic conditions also disrupt eyebrow density. Secondary syphilis can manifest as patchy or lateral brow loss known as the omnibus sign, carrying severe neurologic risks if left untreated. Fungal dermatophytes causing tinea faciei can spread to brow follicles—often following direct contact with infected animals, such as kittens—while lepromatous leprosy causes profound eyebrow madarosis. In addition, common inflammatory skin disorders such as atopic dermatitis and seborrheic dermatitis provoke brow shedding through barrier damage, rubbing, and immune reactions to sebum-dwelling Malassezia yeast, requiring targeted topical antifungals and anti-inflammatory therapies. Nutritional Pitfalls, Behavioral Triggers, and Medications (5:56) Because hair follicle synthesis is an energy-intensive biological process, physiological stress and pharmacological agents frequently interrupt the growth cycle. Cancer chemotherapies, including taxanes and cyclophosphamide, trigger anagen effluvium by disrupting rapidly dividing matrix cells, while endocrine treatments such as selective estrogen receptor modulators (SERMs) and aromatase inhibitors can also prompt thinning. Similarly, behavioral compulsions like trichotillomania cause physical follicular loss through pulling, which Dr. Dray notes must be managed with behavioral therapy and evidence-based adjuncts like N-acetylcysteine (NAC) rather than topical serums. Nutritional management presents critical therapeutic hazards. While systemic malabsorption or dietary zinc deficiencies can impair brow growth, Dr. Dray cautions against indiscriminate zinc supplementation; excessive zinc intake induces secondary copper deficiency, triggering widespread scalp and eyebrow shedding. Ingesting high doses of fat-soluble vitamin A through over-the-counter supplements represents another overlooked driver of eyebrow loss. Due to its long biological half-life, surplus vitamin A accumulates in tissues, resulting in follicular shedding alongside cutaneous dryness and peeling. Limitations of Growth Serums and Diagnostic Red Flags (12:41) Over-the-counter brow serums, minoxidil, and prostaglandin analogs like bimatoprost cannot compensate for unaddressed systemic or inflammatory disease. Dr. Dray warns that attempting to stimulate hair follicles that are actively starved of metabolic support, undergoing autoimmune attack, or continuously pulled produces negligible results while delaying critical medical care. Stimulatory products serve primarily as secondary aids once the underlying pathology has been identified and brought under control. Accurate diagnosis requires clinical evaluation by a board-certified dermatologist utilizing dermoscopy to inspect follicular openings, scaling, and vascular architecture invisible to the naked eye. Comprehensive evaluations often entail biopsies, blood panels, and nail inspections, which Dr. Dray notes require patients to remove nail polish and artificial nails. Patients are advised to bypass direct-to-consumer lab kits and unlicensed practitioners, especially when presenting with red flags such as rapid shedding, spreading loss to the beard or hairline, localized pustules, burning, or shiny, indurated skin indicating permanent follicular loss. Eyebrow thinning functions as an external signal of complex internal or cutaneous pathology rather than an isolated cosmetic issue. Effective care requires distinguishing between reversible nonscarring shedding and irreversible scarring alopecias, prioritizing prompt medical diagnosis over unguided self-treatment with over-the-counter serums.

Source quotes

[0:00] Dr. Dray: people will just put everything on the shoulders of menopause. [1:14] Dr. Dray: there's no turning back. You will not grow a hair from that follicle ever again. [2:28] Dr. Dray: out of the blue frank loss of a patch of hair [4:44] Dr. Dray: the great imitator. [4:44] Dr. Dray: that little trep [9:22] Dr. Dray: cook there and brew [10:48] Dr. Dray: if you got into a knife fight and somebody got you in the brow area [12:41] Dr. Dray: Hello, you have low thyroid. You need to fix that... You're going to feel like stink and be wondering why you have all these problems. [13:37] Dr. Dray: Don't go to the dermatologist with nail polish on. Can't look at your nails if they're covered up with polish or artificial nails

Original transcript

[0:00] Well, hey guys. Welcome back. If you're [0:01] new here, I'm Dr. Dre. I'm a [0:03] boardcertified dermatologist. If you [0:05] have noticed that your brows are getting [0:07] thinner, outermost aspect of your brow [0:09] seems to be gone. Maybe you're even [0:11] noticing patches within the brow where [0:13] you have complete absence of hair. [0:16] Rather than searching what's a good brow [0:18] growth serum for sparse brows, you need [0:20] to be searching why do I have sparse [0:22] brows? There are many possible reasons [0:24] to have brow thinning, brow loss. [0:28] Determining what the best option for you [0:30] is to get it back on track all depends [0:33] on what type of brow loss you have. So, [0:35] in today's video, we're going to talk [0:36] about many reasons why your brows might [0:39] be thinning. By the end of the video, [0:40] you're going to begin to understand why [0:42] if I had wasted my time on a brow growth [0:44] serum, man, it really could have [0:45] backfired. Because not only was that not [0:47] the right thing, I wasted time I could [0:49] have been using properly treating the [0:51] brow issue. Brows are not just cosmetic [0:53] adorments. They actively function on [0:56] your face for well facial recognition, [0:58] but also they play a role in protecting [1:01] your eyes from like sweat running into [1:04] them and aerero allergens and things of [1:06] that sort. Don't dismiss these things as [1:08] just part of the aging process, [1:10] menopause. I mean, people will just put [1:12] everything on the shoulders of [1:14] menopause. The first question that as [1:16] dermatologists we care about, is this a [1:18] scarring or a non-scarring type of hair [1:21] loss? This is important because scarring [1:24] types of hair loss, diseases that result [1:26] in scarring of the follicle, whether it [1:28] be the follicles on your head, your [1:30] body, your face, your brows. Once that [1:32] bad boy forms a scar, that follicle [1:34] scars down, there's no turning back. You [1:37] will not grow a hair from that follicle [1:40] ever again. The only way to get hair in [1:42] that area where there's scar transplant. [1:44] Hair transplant. That's why the [1:46] distinction is incredibly incredibly [1:48] important and why you guys need to be [1:50] asking what type of brow loss do I have [1:52] because if you have a type of brow loss [1:54] that will go on to form a scar, you need [1:57] to get on top of that not with a brow [1:59] growth serum but rather with the [2:02] appropriate directed therapy because the [2:04] longer you let any type of hair loss [2:06] process go on, the harder those [2:08] processes, whether they be scarring or [2:10] not, are to control or to get the hair [2:12] going back. But in the case of scarring, [2:14] remember, you've got to you got to [2:16] prevent that scarring cuz once you get [2:17] the scar, you're not getting the hair [2:19] back. Brow transplant, hair transplant [2:21] into the brows, it's a it's a thing. I [2:23] have a video on it. Is challenging. [2:24] Okay, it's got its challenges. Wouldn't [2:26] we rather not have to go down that road? [2:28] One of the causes. It's an autoimmune [2:30] disease known as alipcia ariata. This is [2:32] an autoimmune condition where your [2:34] immune system decides, hey, I'm going to [2:36] start attacking hair follicles. You may [2:37] have heard of this because it commonly [2:39] can affect the scalp hair, but it can [2:41] affect any hair on any body surface [2:44] including the brows. And what you will [2:45] experience is a sudden onset out of the [2:48] blue frank loss of a patch of hair like [2:51] in the brow. Okay? You'll just have a [2:52] gap in your eyebrow or maybe the entire [2:54] brow falls out or maybe all the hairs of [2:56] your brows fall off. That can happen [2:58] too. It's smooth. There are no little [3:01] hairs growing throughout there. It is [3:02] complete hair loss. This is a [3:04] non-scarring type of hair loss, but you [3:06] got to control the immune response [3:08] coming in an attack in the follicle. [3:10] That's how to treat it. Minoxidil brow [3:12] growth serums actually can help support [3:14] getting things back on track. But you [3:15] also need uh dermatologist administered [3:18] prescribed anti-inflammatories that [3:20] address the immune response to properly [3:23] control and prevent it. And now we have [3:26] very specific immune modulators, we'll [3:28] call them, known as Jack inhibitors. [3:30] These are proving to be very helpful for [3:32] this condition, much more so than some [3:34] random brow growth serum. Another cause [3:36] that I know a lot of you guys already [3:37] know about cuz you ask me about it all [3:38] the time. Low thyroid hormone, thinning [3:40] of the lateral aspect of the brows, [3:42] okay, is a warning sign of low thyroid [3:44] called hertox sign. You don't want to [3:46] miss that because low thyroid, oh man, [3:48] it's bad for your health. All right, [3:50] there are all sorts of health [3:51] complications. Brows can be an early [3:53] warning sign, a clue. So if you see [3:55] that, you know, you need to check in [3:56] with your health care provider. could be [3:58] related to your thyroid. Correcting the [4:00] thyroid issue can help. There are also [4:02] skin conditions that can cause your [4:04] brows to become sparse or lose your [4:05] brows. Autotopic dermatitis can affect [4:08] the brows. You can get thinning of the [4:09] outer aspect of your brows. Thinning of [4:11] the outer aspect of your brows isn't [4:13] always low thyroid. It can be attopic [4:15] dermatitis, a type of eczema. Also, [4:17] sebriic dermatitis, that oily skin [4:19] condition related to an abnormal immune [4:21] response to malisthesia, which becomes [4:22] too comfortable in the over oily [4:24] environment. Well, that can affect the [4:27] brows and lead to brow loss. You got to [4:29] control the sebriic dermatitis with [4:30] topical antifungals, topical [4:33] anti-dandruff ingredients, and where [4:35] needed for flares, topical [4:36] anti-inflammatories. A brow growth serum [4:39] might help, but not if you don't address [4:41] the sebri dermatitis. The root cause [4:43] needs to be tackled. There are also [4:45] several infections that can cause loss [4:48] of the brows. One of them is known as [4:50] syphilis. Check out my video syphilis is [4:53] back. Syphilis is the great imitator. [4:56] Okay, you don't want to sleep on a [4:58] diagnosis of syphilis because let that [5:00] go on. Not only will you not have brows, [5:02] but your brain will be it'll really jack [5:05] you up. That little trep. The brow loss [5:07] sign in syphilis is called the omnibus [5:10] sign. Not only syphilis, but fungal [5:11] infections. Yeah, ringorm can affect [5:14] your brows, cause brow loss. Uh just [5:16] like you get ringorm on your face, it [5:18] can pop them up to your brows. The [5:21] little fungus trickles down into the [5:22] hair follicle. You get a hair loss [5:24] there. That's actually a clue for a [5:26] facial fungal infection. Tine faciali. [5:28] If you got a new kitten recently, that [5:30] is a common scenario for tineia faci cuz [5:32] you're cuddling the kitten. They got the [5:34] spores of the fungus on their little [5:36] fur. Next thing you know, you're missing [5:37] an eyebrow cuz a little kitty cat. Um [5:40] and then something else that you guys [5:42] are like, "What is this?" The old [5:43] testament lomus leprosy. Yeah. Um [5:47] materis it's called with that. before [5:49] you go saying, "Oh, that doesn't exist [5:51] anymore. That that was wiped." No, no, [5:53] no, no, no. Check out my video, leprosy [5:56] on the rise. Then, just like your scalp, [5:58] growing hair is metabolically demanding. [6:00] Okay? That's why when you are stressed [6:02] out, your body's like, "Eh, we're not [6:04] going to waste energy on this [6:06] energyintensive process of growing [6:08] hair." And you can get all sorts of hair [6:10] loss things. But if you've got an [6:11] underlying nutritional deficiency, [6:13] that's a scenario where brows can fall [6:15] out, just like the hair. Zinc deficiency [6:17] could be playing a role here. It is a [6:20] recognized cause of eyebrow loss. Some [6:22] patients say with inflammatory bowel [6:24] disease, malabsorption problems end up [6:27] with low zinc and this can be a warning [6:29] sign. There are also some rare [6:31] hereditary conditions where you have uh [6:33] problems with the zinc absorption and [6:35] babies present with problems. Check out [6:37] my video on warning signs of zinc [6:38] deficiency. But yeah, it can jack up [6:40] your brows. If you don't correct the [6:42] zinc deficiency, you're never going to [6:43] get your brows back. And if you have [6:45] sparse brows and you're like, hm, maybe [6:46] I'll just take a zinc supplement. Don't [6:48] do that cuz guess what? High doses of [6:50] unnecessary zinc over time can make you [6:52] copper deficient. And guess what that [6:53] leads to? Hair loss, including [6:56] potentially the brow. So don't self [6:58] diagnose. Don't self treat. It [7:00] backfires. Tricketamania. People uh have [7:03] this compulsion to pull out their hair. [7:05] It's kind of like a self soothing thing [7:07] and it becomes, you know, a compulsion [7:10] for some. Sometimes it's just a [7:11] behavior. Children can develop this. [7:13] they outgrow it. What are they doing? [7:15] They're literally pulling their hair [7:16] out. Oftent times it's the scalp, but [7:18] the brows are really accessible. And so [7:20] the brows are are commonly affected. And [7:23] you know, you you can use minoxidil here [7:25] to get things back on track. You could [7:27] use bataprost aka lates or even the you [7:31] know prostaglandon analog serums that [7:33] you come across online could get brow [7:35] growth back, but only if the behavior is [7:37] controlled. If you keep pulling [7:38] everything, you're not going to get [7:39] ahead of it with a serum. In my video on [7:41] triricotillamania, I give a [7:43] comprehensive strategy for controlling [7:45] behavior and we also discuss the [7:46] supplement an acetylcysteine for that [7:49] condition. So check that video out, but [7:51] it's not really going to be a brow serum [7:52] is the go-to per se. Medications can [7:55] cause your brows to fall out. The most [7:56] obvious is going to be chemotherapies. [7:58] All right, chemotherapies that can cause [8:00] of course the hair to fall out because [8:02] they destroy rapidly dividing cells. [8:04] Great for cancer killing, but also [8:06] bystandard effect, the follicle is [8:08] rapidly dividing and it's like not [8:09] making hair now. Boom. You get what's [8:11] called an antigen aluvium. All your hair [8:13] falls out with chemotherapy. Likewise [8:15] can affect the brow area such as [8:18] taxines, doc, rubicon, cyclophosphomide, [8:21] other chemotherapy regimens as well. [8:23] When it comes to the brow loss, it can [8:25] be pretty significant including the [8:27] lashes. Most cases patients will have [8:30] their brows come back once the regimen [8:32] is finished. However, some patients do [8:35] have their brows come back very sparse [8:37] in comparison to what they were when [8:38] they began. In which case at that point [8:40] uh bomatoprost aka latis or minoxidil [8:43] may be maybe something to help you out. [8:45] Estrogen receptor modulators, aromatase [8:48] inhibitors. Um these have also been [8:49] associated with brow alipcia. We talked [8:52] about nutritional deficiencies. What [8:53] about nutritional excess? High doses of [8:56] vitamin A can cause brow loss. And [8:59] that's something people don't realize [9:00] that they're doing. They take [9:02] supplements that have a boatload of [9:03] vitamin A in them. And in contrast to [9:06] prescriptions that are modeled after [9:08] vitamin A or vitamin A derivatives like [9:10] isotininoan, supplemental vitamin A [9:13] stays in your system even longer. It has [9:15] a very long halflife. Be real careful [9:17] with the vitamin A supplementation. I'm [9:19] telling you, it can backfire. Dry skin, [9:21] all kinds of skin problems with that. [9:23] Everything we've talked about up to this [9:24] point has been non-scarring, meaning you [9:26] got a good chance of getting stuff back [9:28] on track, provides you correct the [9:30] underlying ideology. But what about the [9:32] stuff that scars your follicles? This is [9:34] something we need to bring up. I've got [9:35] videos on it, but it involves women, [9:38] mostly post-menopausal women, but any [9:41] age, but it also involves men, okay? And [9:43] they often get left off of the [9:45] conversation. And that is a condition [9:46] known as frontal fibrosis alipcia. You [9:48] lose your frontal hairline. First starts [9:50] out as this kind of inflammatory [9:52] response around the follicle. You get [9:53] these little scaly bumps. It can be red [9:55] cuz that's inflammation. And then if [9:57] that inflammation is allowed to cook [9:59] there and brew, well, guess what? It [10:00] causes a scar. And this classically [10:02] affects of course the frontal hairline, [10:04] hence the name. Over time you get a [10:05] receding frontal hairline. A lot of men [10:07] get misdiagnosed as having androgenetic [10:09] alopecia. Uh but they got frontal [10:11] fibrosin alopecia. If you're a man it [10:13] can affect the beard area commonly going [10:15] to affect the brows commonly. I mean [10:18] almost go hand in hand. That's something [10:20] that needs to be promptly diagnosed and [10:22] the inflammatory process halted with [10:24] imom modulatory therapies [10:26] anti-inflammatories. Then only [10:28] thereafter can minoxidil or bataprost [10:31] get you some regrowth. Okay. But you got [10:34] to address the underlying inflammatory [10:36] issue. Often times this is actually [10:38] treated with hydroxychloricquin. [10:40] Sometimes topical steroids can be [10:41] helpful here locally or calcinurine [10:43] inhibitors. Check out my video on um [10:45] frontal fibrosin alopecia treatments. We [10:47] go into detail there. What about other [10:50] scarring conditions? How many of you [10:51] have heard of the condition scleraderma [10:53] systemic sclerosis? Well, this is a [10:56] condition which I also have a video on [10:58] as a side note in terms of all the ways [10:59] it affects your skin. There's a variant [11:01] of it, a localized form of it that [11:03] affects the face and it's called [11:05] inudisab. And it basically is like a [11:07] line of it on the forehead and it causes [11:10] brow loss on one side. And so you really [11:13] got to treat the underlying inflammatory [11:16] process of this disease. Otherwise, if [11:17] that's allowed to go on, not only can it [11:20] cause scarring of that follicle and [11:22] permanent brow loss, but it can really [11:23] lead to a lot of disfigurement in the [11:25] face as well. And this is treated um or [11:27] the progression is halted with a variety [11:30] of systemic anti-inflammatory [11:32] medications. And there are a whole host [11:33] of other things that you need to be [11:34] evaluated for when you get a diagnosis [11:37] of this. Um then you've got discoid [11:39] lupus, a variant of uh cutaneous lupus. [11:42] Got a video on it if you want to know [11:43] all the cutaneous manifestations. Uh but [11:45] discoid lupus leads to hair loss that [11:47] scars, okay? Because that lupus [11:49] inflammation, it is it's cooking. It's [11:51] cooking follicles and it can affect your [11:53] brows as well. Got to control that bad [11:56] boy with this specific [11:57] anti-inflammatories. And you got to be [11:59] careful in the sun with lupus. Very [12:01] careful. So diagnosis is key. Burns. [12:03] Okay. If you had a burn, a significant [12:05] trauma, you've developed a scar, maybe [12:07] you got into a knife fight and somebody [12:09] got you in the brow area, you're not [12:10] going to get the brow to grow back [12:12] there. If there is a scar, hair ain't [12:14] going to grow. The only chance you have [12:15] of getting hair to grow there is that [12:17] transplant, which check out my video on [12:19] brow transplants. Brow transplants, they [12:21] can be successful. They have their they [12:23] have their issues though that you you'll [12:24] want to know about. But some people are [12:26] super happy with them. Speaking of [12:28] cancer treatment, if you have had a [12:29] radiation therapy to treat a cancer and [12:32] um the brow area happened to be exposed [12:34] to the radiation, that can definitely [12:36] cause um a scarring hair loss in the [12:38] affected area and brow loss that [12:40] persists after the radiation. So again, [12:42] getting back to the question that you [12:44] probably initially entertained the the [12:46] internet about, um, what about [12:48] minoxidil? What about brow growth [12:50] serums? These absolutely can be very [12:52] helpful for the right diagnosis. [12:54] Sometimes they're helpful as standalone [12:56] treatments provided the underlying cause [12:59] is controlled and gone away. You know, [13:01] knowing the root cause, what you [13:03] actually have, your diagnosis, the most [13:05] important thing. If you have [13:06] hypothyroidism causing lateral thinning [13:09] of the brows, you can chase all of the [13:11] brow growth serums that you want. [13:13] They're not going to work provided that [13:14] the thyroid issue is not addressed. And [13:16] hello, you have low thyroid. You need to [13:19] fix that. It's not good for you to have [13:20] a low thyroid. You're going to feel like [13:22] stink and be wondering why you have all [13:24] these problems. Check out my video. I [13:26] know I'm plugging a lot of videos, but I [13:28] have a lot of videos on all these skin [13:30] warning signs of these different [13:31] complicated conditions. low thyroid, you [13:33] know, it it really there are a lot of [13:35] skin clues is what I'm getting at. So, [13:37] don't assume, especially if it's sudden, [13:39] it's progressive, it's patchy, if you [13:41] have symptoms associated with it, itch, [13:42] you got a rash in the area, you're [13:44] noticing hair loss from other body sites [13:46] or your head, your scalp. Um, cuz brows [13:49] are on your head. Duh. See a [13:51] dermatologist. Remember, we got those [13:52] fancy looking tools. All right? You [13:55] know, A, we have our eyes which are [13:56] trained to see stuff that you don't see. [13:58] And B, we have those fancy magnifying [14:00] glasses. And there are specific signs [14:03] around the hair follicle that we can see [14:05] through those magnifying glasses that [14:07] you're never going to see with the naked [14:08] eye or even know about. See a [14:09] dermatologist. That's your best bet. [14:11] They might need to take a biopsy. They [14:13] may be ordering blood work and maybe [14:14] check in other body sites to make sure [14:16] you don't have evidence of, you know, [14:18] supporting other skin diseases or [14:20] infections. They may be looking at your [14:21] nails. Don't go to the dermatologist [14:23] with nail polish on. Okay? Can't look at [14:25] your nails if they're covered up with [14:26] polish or artificial nails. Eyebrow [14:28] thinning is not a diagnosis. is a [14:30] symptom. Understanding the root cause is [14:33] is key. Otherwise, you just spin in your [14:35] wheels and you could potentially miss [14:36] out on the opportunity to get the best [14:39] brow growth back, especially if you have [14:40] a scarring type of hair loss. All right, [14:42] y'all. Comment below. Is this something [14:44] that you have been affected by? I hope [14:46] this video was helpful and just kind of [14:48] clarifying that in dermatology, we think [14:50] about things a lot different than maybe [14:52] you might. When you have a problem, a [14:53] symptom, you you want to you want to get [14:55] rid of the symptom real fast, but we're [14:56] thinking what is a cause? because we [14:58] know that that symptom is only going to [15:00] go away if we address the root cause. [15:02] And if we don't correctly, that's key, [15:04] correctly identify the root cause, [15:06] that's what we want to do, help you out, [15:07] not waste your time. So, see a [15:09] dermatologist. I I know it can be [15:11] challenging. At any rate, check in with [15:13] your healthcare provider. You know, the [15:14] basic labs might be indicated alone can [15:17] provide important clues like this, my [15:19] thyroid, am I nutri something like that. [15:21] Don't go on one of these direct to [15:23] consumer websites and try and order your [15:25] own blood work. There's a lot of the [15:26] blood work you might need. It's tricky [15:28] to interpret if it's not ordered the [15:30] right way. If it's not checked the right [15:31] time of day, see a health care provider, [15:34] a licensed health care provider, not a [15:37] health coach. Health coach is not going [15:38] to correct thinning brows. A health care [15:40] provider. Check out the playlist on hair [15:43] loss. If you also have a hair loss [15:45] disorder going on, whether it be alipcia [15:47] ariata like in plano pyloraris, frontal [15:50] fibrosis alipcia. If you've got sever [15:52] dermatitis, check out my videos on that. [15:54] If you have attopic dermatitis, I got a [15:56] ton of videos on that. A recent one all [15:58] about the new treatments in 2026. If you [16:02] enjoyed today's video, give it a thumbs [16:03] up, share with your friends. And as [16:05] always, don't forget sunscreen and [16:06] subscribe. I'll talk to you guys [16:07] tomorrow. Bye. [16:13] [music] [16:19] [music]