Ross' Blog

My eyelashes are falling out. Help!

Have you been noticing a thinning appearance to your eyelashes or eyebrow area over the past few months? If so, you may be suffering from an eye condition known as madarosis.

One of the most common causes of madarosis is inflammation around the eyelid margins. Inflammation constricts the normal blood flow to the follicle or root of the eyelash, causing it to weaken and fall out. Inflammations may be secondary to normal bacterial infections such as blepharitis or more rare things like parasites and mites. Allergic reactions secondary to seasonal allergies or to cosmetic products can also cause eyelashes to fall out. Makeup use is often one of main causes behind madarosis as some waterproof mascaras or eyeliners can require a lot of scrubbing in order to remove them. This can loosen eyelashes and cause them to fall out.

Trauma to your eyelash or eyebrow area is another primary culprit. Trauma can be secondary to an injury, or can be self-induced by waxing or plucking. Eyelash or eyebrow hairs may not grow back or they may not grow back in the right direction. Trichotillomania is a psychological impulse disorder were by patients pull out scalp, body, eyelash and eyebrow hairs. This condition may require behavioral therapy versus medical therapy. Madarosis can also be induced from some cancer treatments, as these treatments target fast growing cells like hair follicles.

Madarosis can on occasion be secondary to more severe medical or ocular conditions such as benign or malignant tumors, endocrine disorders, or autoimmune conditions such as discoid lupus erythematosus. In some causes patients who have alopecia areata already may develop madarosis over time.

The initial treatment for madarosis is of course trying to determine the underlying cause of the condition and then treating that. If an underlying cause is not easily determined, then there are a few things patients can do. The first thing is to realize that it can take up to 2 months for eyelashes to regenerate, so you will not notice a difference overnight. Patients should also consider taking a close up photograph of their eyelids, so that they can monitor the progress and quantify the loss or gain of hair follicles.

I always suggest that patients stop wearing any makeup, mascara, eyeliners or fake eyelashes for about 2 months. The goal of this is to remove any chemicals that may be irritating the eyelid. I also suggest that contact lens wearers either consider wearing eyeglasses for this time or at the very least switch to a non-preservative contact lens solution such as ClearCare.  Patients should also perform warm compresses over their closed eyes every morning and every night for about 2-3 minutes, which helps to improve blood flow to the eyelashes. Gentle cleaning of the eyelash and eyebrow area can also be done every morning in the shower with a diluted baby shampoo mixer (1 part baby shampoo, 3 parts water) to remove any bacteria buildup that may be present at the base of the eyelash.

If you still are not noticing any improvement in the appearance of your eyelashes, then you should book an eye exam with your optometrist. In some cases, your eye doctor may need to refer you to an oculoplastic specialist or family doctor for further testing.