Madarosis - Know It All

Introduction

Madarosis is a medical condition characterized by hair loss or the absence of hair in areas where hair is normally present. While madarosis can affect any part of the body that has hair, it is most commonly observed in the eyebrows and eyelashes. The loss of eyebrows and eyelashes can have a significant impact on a person's appearance, causing self-consciousness and lowering self-esteem.

What Is Madarosis?

Madarosis is a condition in which individuals lose their hair which leads to partial or complete loss of eyelashes or eyebrows. It can either affect both sides or one side, depending on the condition. It begins with thinning of the hair in these areas to eventually complete loss. There are two types of madarosis

• Non-scarring Madarosis - In this type, the structures of the internal hair remain within the hair follicle. Hence, this non-scarring madarosis is reversible.

• Scarring Madarosis - Unlike non-scarring madarosis, there is more damage to the hair follicle, deeper inflammation, and fibrosis (thickening of the skin tissues) in this type of madarosis. Hence, there is permanent loss of eyelashes and eyebrows.

Which Conditions or Disorders Cause Madarosis?

It can be a result of a variety of underlying conditions, such as autoimmune disorders, genetics, infections, hormonal imbalances, genetics, or trauma. The severity of madarosis can range from mild to severe, depending on the underlying cause and the extent of hair loss. The following are the conditions that cause loss of eyelashes and eyebrows–

• Hansen’s Disease (leprosy) - Hansen’s disease is a bacterial skin infection affecting the eyes, nerves, and nose causing loss of eyelashes and eyebrows.

• Blepharitis - Blepharitis is characterized by inflammation of the eyelids. This inflammation causes the eyelashes to fall out. It also causes the areas of the skin around the eyes to become dry and itchy.

• Trichotillomania - This condition is caused by a mental condition that causes the person to pull out the hair from the scalp, eyebrows, or eyelashes.

• Autoimmune Disorders - Autoimmune disorders, such as alopecia areata (hair loss), can cause madarosis. Other conditions include hypothyroidism, hyperthyroidism, discoid lupus erythematosus, atopic dermatitis, scaling skin disorders (psoriasis), scleroderma, and rosacea.

• Skin Cancers - Skin cancers, especially cancerous ones, are more prone to cause madarosis than benign ones.

• Genetic Conditions - Studies show madarosis is seen in genetic conditions like Ehlers-Danlos syndrome (a disorder of the connective tissue), ichthyosiform erythroderma (autoimmune skin disorder), cryptophthalmos (a disorder characterized by the absence of eyelids and presence of eyelashes), ectodermal dysplasia (skin disorder affecting the sweat glands, hair, teeth, and nails).

What Are the Other Conditions That Can Cause Madarosis?

Other conditions that can cause madarosis are

• Infections - Bacterial, viral, or fungal infections of the skin affecting the areas around the eyes can also cause madarosis. These infections include HIV (human immunodeficiency virus), staphylococcus infections, herpes simplex virus infections, and ringworm infections. These infections are often associated with other symptoms like redness, puffiness of the skin, itching, burning, and pain sensations.

• Nutritional Deficiencies - Nutritional deficiencies can affect hair growth to a greater extent. A deficiency of zinc, iron, vitamin C, and biotin can cause reduced hair growth on the scalp but also affect the hair on the eyelashes and eyebrows.

• Hormonal Imbalances - Hormonal imbalances, for example, low thyroid hormones in the body, can lead to madarosis.

What Are the Medical Causes of Madarosis?

Some medical treatments and medications can cause hair loss in the areas around the eyes.

• Medications - Medications like anticonvulsants, anticoagulants, medicines containing retinoids (topical creams and gels containing retinoids used for treating certain skin conditions), androgens, botulinum toxin injections, and so on can cause permanent loss of eyelashes and eyebrows.

• Medical Treatments - Chemotherapy, radiation therapy, and traditional laser therapies can cause shedding of the hair from the eyelashes and eyebrows.

• Trauma And Injuries - Injuries to the eye, eyelids, and areas around the eyes can cause permanent loss of eyelashes and eyebrows. Physical injuries include accidental falls, burns, deep cuts, and wounds. Medical surgeries, eye surgeries, or injuries from sharp medical instruments can cause wounds and permanent loss of hair in that area.

How Is Madarosis Diagnosed?

Dermatologists often begin diagnosing skin conditions by noting the family history, medical history, and trauma history to find the cause of the condition. Physical examination includes inspecting the area around the eyes and relating the hair growth to overall body hair. Any signs of hair loss, whether partial or complete, around the eyes and eyebrows help to investigate further. Doctors often recommend additional tests like–

• Blood tests to check for vitamin and thyroid levels.

• Skin swab tests for bacterial infections.

• Skin scraping for fungal infections.

• Additionally, doctors perform deeper skin examinations via dermatoscopy.

How Is Madarosis Treated?

Madarosis can be treated with a variety of options, depending on the underlying cause. For example, if madarosis is caused due to any infections, antibiotic medications are prescribed to get rid of the cause.

In some cases, treating the underlying condition can help to reverse the hair loss, while in other cases, cosmetic treatments such as eyebrow or eyelash transplants may be necessary. It is essential to consult a medical professional to determine the underlying cause of madarosis and to develop a personalized treatment plan. The following are the ways madarosis can be managed–

• Artificial false eyelashes.

• Using makeup products to create eyelashes and eyebrows.

• One can go for eyebrow tattooing for a permanent eyebrow look.

• Eyelash and eyebrow transplants.

• Eyelash grafts (professional cosmetic camouflaging methods).

• Using topical solutions (minoxidil solution) that promote hair growth in those areas.

What Is the Prognosis of Madarosis?

Depending on the severity of the condition, some people may or may not be able to completely reverse madarosis. The non-scarring type of madarosis is more likely to get reversed in comparison to the scarring type. The eyelashes and eyebrows are more likely to grow back.

Conclusion

In conclusion, madarosis is a medical condition that can significantly impact a person's appearance and self-esteem. While it can be caused by a number of underlying conditions, there are treatment options available to help manage and potentially reverse hair loss. Seeking the advice of a medical professional is important to determine the best course of action.