Thinning eyebrows a challenging problem for mature women

Key Points

A. Acne induced by hairstyling products was popularized by the concept of pomade acne.

Pomades are products used by persons with kinky hair to add shine, confer water resistant properties following hair straightening and moisturize the hair shafts. The ingredient in pomades responsible for acne was olive oil. The newer pomade formulations have replaced olive oil with dimethicone and cyclomethicone, which are noncomedogenic and nonacnegenic.

Q. Can hair change in both appearance and shape at menopause?

A. Hair can definitely change in appearance and shape at menopause. Hair growth is under hormonal control, and hormone status changes at menopause.

With the reduction in endogenous estrogen secretion, androgenetic alopecia is a frequent concern at menopause. While hormone replacement can possibly minimize further hair loss, I do not believe that it can reliably stimulate regrowth.

Some women on oral hormone replacement who are continuing to experience rapid hair loss may achieve better results when switched to an estrogen patch. Topical minoxidil is another option.

In addition to change in growth rate, hair appearance can also change. Straight hair can become curly, and curly hair can become straight. It is more common for straight hair to become curly. This is due to a change in the shape of the hair shaft. With menopause, the hair cross-sectional shape may become more irregular, resulting in curly hair.

Q. How can thinning eye-brows be cosmetically addressed?

A. Thinning eyebrows are a common concern among mature women with challenging treatment options. The most effective way to prevent thin or absent eyebrows with age is to prevent the problem earlier in life.

The most common cause of eyebrow loss in maturity is overplucking of the eyebrows during youth. It might be worthwhile for the dermatologist to counsel young women who are plucking their eyebrows to a thin line that this might not be a good practice. Each time a hair is plucked, there is a chance of permanent follicular damage and no regrowth. Over years of plucking, the incidence of hair loss from traumatic plucking increases. Since eyebrows thin with age, as does all body hair growth, it is important not to hasten the process by overplucking during youth.

Another common cause of eyebrow loss is scratching of the eyebrows from seborrheic dermatitis. This problem can be diagnosed by examining the eyebrow hairs for irregular breakage and the obvious presence of erythema and yellowish skin scale characteristic of seborrheic dermatitis. Treating the seborrheic dermatitis with a combination of desonide cream and ketoconazole cream twice daily for one week should control the problem, which can be better maintained by the use of over-the-counter ketoconazole shampoo.

Finally, severe eyebrow loss can be managed cosmetically. Eyebrow pencil, which is a wax crayon, can be artistically applied in between existing eyebrow hairs and the hairs can be held in place to camouflage areas of thinning with an eyebrow gel.

Eyebrow gels are available as a clear or pigmented fixative to keep the hairs in place for a pleasing line above the eye. Hair spray can also be used, if a commercial fixative is too expensive.

Eyebrows can also be tattooed on the skin, a common practice in the Middle East. Some persons might find this attractive, while others prefer a more natural appearance. Unfortunately, eyebrow transplantation is not a reliably successful procedure.

Zoe Diana Draelos, M.D., is a Dermatology Times editorial adviser and consulting professor of dermatology, Duke University School of Medicine, Durham, N.C. Questions may be submitted via e-mail to zdraelos@northstate.net
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