ArticlePDF Available

Madarosis: A Marker of Many Maladies

  • Sri Venkateshwaraa Medical College Hospital and Research Centre

Abstract and Figures

Madarosis is a terminology that refers to loss of eyebrows or eyelashes. This clinical sign occurs in various diseases ranging from local dermatological disorders to complex systemic diseases. Madarosis can be scarring or non-scarring depending upon the etiology. Appropriate diagnosis is essential for management. Follicular unit transplantation has been found to be a useful method of treating scarring madarosis and the procedure relevant to eyebrow and eyelash reconstruction has been discussed. A useful clinical approach to madarosis has also been included for bedside diagnosis. The literature search was conducted with Pubmed, Medline, and Google scholar using the keywords madarosis, eyebrow loss, and eyelash loss for articles from 1960 to September 2011. Relevant material was also searched in textbooks and used wherever appropriate.
Content may be subject to copyright.
A preview of the PDF is not available
... Ciliary madarosis or milphosis is a form of alopecia wherein there is loss of eyelashes. 1 The common causes of ciliary madarosis include blepharitis, seborrheic dermatitis, atopic dermatitis, xeroderma pigmentosa, hyperthyroidism and AA. [2][3][4][5] Among blepharitis, anterior blepharitis is associated with milphosis most commonly. ...
... 6 Trichotemnomania is a psychiatric disorder where the affected individual has a tendency or shaving and trimming of hair. 1 Our patient had both trichotillomania and trichotemnomania. However, the absence of clinical signs hinted more towards a psychiatric disorder. ...
... 3 Madarosis (loss of eyebrows and eyelashes) is one of the hallmarks of lepromatous leprosy. 4 The incidence of madarosis in multibacillary disease varies between 45% and 76% in various studies. 5 The bilateral symmetric cicatricial madarosis occurs due to histiocytic infiltration of hair follicles. ...
... Absence of madarosis in long-standing cases is a good prognostic sign. 4 The hair growth usually does not occur after treatment, thereby warranting cosmetic camouflage or hair transplant. 5 ...
... Madarosis (i.e., loss of eyebrows or eyelashes) is an innocuous manifestation of a variety of systemic illnesses (for example, endocrinopathies, infections, genetic disorders) including autoimmune diseases like lupus and localized scleroderma [1]. Alopecia in acute KD, which is a rare manifestation and mostly limited to loss of scalp hair, may reflect the underlying autoimmune/inflammatory mechanisms involved in the disease pathogenesis [2][3][4]. ...
... The most common type caused by medication is telogen effluvium, which characterized by the thinning or shedding of hair resulting from the early entry of hair in the telogen phase. [6][7][8][9] Methylphenidate is a stimulant drug used for the treatment of ADHD. A case of eyebrow loss caused by methylphenidate had been reported. ...
... Such lengthening of eyelashes is suggested to be due to mast cells release of histamine, prostaglandins, and leukotrienes in response to allergies (Church & McGill, 2002;Singh & Pawar, 2018), remodelling hair follicle tissue . On the other hand, the loss of eyelashes, or when they are very short, may signal disorders of a dermatological or nutritional 4 nature, or alternatively, endocrine or systemic diseases (Khong, Casson, Huilgol & Selva, 2006;Kumar & Karthikeyan, 2012). ...
Full-text available
Human eyelashes are one of the facial features that contributes to facial attractiveness. While enhancing the appearance of eyelashes has been practiced since antiquity, research investigations that consider the effect of their length on perceived attractiveness are scarce. Length of eyelashes can be an indicator of health, and it has recently been proposed that there is an optimum length for eye protection. In the current article, we investigated if the attractiveness of eyelash length dovetails with these evolutionary and functional proposals. Our results support this proposition, with the preference for eyelash length following an inverted-U function, with the highest ratings peaking at approximately one third of the eyes’ width. Interestingly, there is a difference between male and female faces, suggesting that while in general, eyelashes of an optimum ratio are considered more attractive, this preference is not solely a biologically adaptive phenomenon and is influenced by cultural norms.
Background: The frontal-temporal triangle area (FTTA) hair has a slow growth rate and thin caliber, which are similar to those of eyebrow hair. However, a comparison of cosmetic outcomes between FTTA and other scalp hair grafts in eyebrow transplantation has not been performed. Objective: To compare the cosmetic outcomes of FTTA hair and periauricular and occipital area (POA) hair in eyebrow restoration. Methods: A retrospective analysis of 155 patients with FTTA or POA hair transplants was performed. Comparative variables included patient characteristics, hair density, diameter, percentage of one-hair follicular units (FUs), number of transplanted FUs, harvesting time, transection rate, hair survival rate, frequency of eyebrow trimming, and patient satisfaction. Results: There was a significant difference in hair density, diameter, percentage of one-hair FUs, and harvesting time between the FTTA and POA hair transplants. The FTTA hair grew significantly slower than the POA hair did. The patients in the FTTA group trimmed their postoperative eyebrows at a significantly longer interval than those in the POA group. The percentage of patients who were very satisfied with the surgery results was higher in the FTTA group. Conclusion: The FTTA hair grafts can provide aesthetically pleasing cosmetic results in eyebrow restoration.
Background Eyelashes play an important role in perception of beauty and protection of eyeballs. The outcome of eyelash restoration varies and mainly depends on the surgeon’s technique and no standard procedure exists. Aims To evaluate the effect of modified single‐hair follicular unit grafting to aesthetically restore eyelashes and provide a potential alternative of standard procedure. Patients and Methods A total of 34 patients with sparse or partially absent eyelashes who underwent modified procedure were included. Single‐hair grafts were harvested from the donor site (post‐auricular, nape, frontal hairline area). Grafts were transplanted with 23 gauge needle and fine forceps in the modified procedure. The patients were followed for a mean of 12 months after surgery. Results All patients were satisfied with the result 12 months after the surgery. An average of 46.5 grafts (34‐68) were transplanted in each upper eyelid. The mean graft survival rate after 1 year was 87.2% (84%‐92%). Of the 34 patients, 3 patients received a second session to achieve a denser appearance. No significant complication as trichiasis, infection, scarring or eyeball injury occurred. Conclusion This modified single‐hair follicular unit grafting is a good alternative for aesthetic eyelash restoration with good cosmetic results, relative easy maintenance, lack of complications, and long‐term patient satisfaction.
Thyroid eye disease (TED) is the most common extra-thyroidal manifestation of Graves’ disease. TED manifests as photophobia, proptosis, erythema, or conjunctival injection. Other signs suggestive of TED include lid lag, globe lag, lid retraction, and even, in some cases, evidence of optic neuropathy. TED up until recently had very few effective medical therapies. Teprotumumab, a monoclonal antibody that targets the IGF-1 receptor, was recently approved for the treatment of TED.
Dermatological disorders can be reflected in the eye and the periorbital area. Various skin diseases can affect the skin of the periorbital area e.g. dermatitis, vitiligo, xanthelasma, hidrocystomas, syringomas, milia, etc. Other cutaneous disorders may have associated ocular involvement e.g. rosacea, port-wine stain and nevus of Ota. Some infectious diseases can affect both the skin and eyes e.g. herpes simplex and herpes zoster. Systemic diseases can have ocular, as well as, dermatological involvement e.g. amyloidosis, dermatomyositis, sarcoidosis and Bechet’s disease. Periorbital dermatological procedures e.g. periorbital chemical peeling and laser procedures, and their expected complications, can be of interest to ophthalmologists.
Background Alopecia areata of the eyebrows can be difficult to treat. Intralesional triamcinolone or potent topical steroids are considered the mainstay of medical therapy. This case illustrates the results of an experimental hair transplant to the eyebrows following years of modest response to intralesional triamcinolone. Objective The aim of this study was to ascertain the benefits of a hair transplant for chronic eyebrow alopecia areata not responding to appropriate medical therapy. Methods A hair transplant was performed with tumescent anesthesia and a total of 85 mini and micrografts placed in the right eyebrow. Followup after the hair transplant occurs every 8 weeks. Results The patient was free of eyebrow alopecia areata for 8 months following the initial hair transplant. Although the disease relapsed, hair growth is now manageable with intralesional cortisone injection performed six times per year. Conclusions For the first time in years, this patient was given 8 months of reprieve from his eyebrow alopecia areata and is currently well-maintained on monthly intralesional cortisone which originally was of only modest benefit. The patient is pleased with the outcome.
Hair transplantation is in demand worldwide, but because Asian hair tends to be more sparse and coarse than Caucasian hair, transplantation procedures need to be adapted to Asian patients. This book, exclusively devoted to Asian hair, is a complete and comprehensive text written by a group of authors sharing their experience in their specialized fields of hair restoration. Included are many practical tips as well as chapters on regional transplantation such as eyebrows, eyelashes, sideburns, beards, and mustaches, in addition to the usual scalp hair restoration. With its many illustrations, the book gives readers a complete knowledge of hair restoration surgery and provides a quick, easy-to-use reference on Asian hair and the differences in patients' demands. With an influx of new physicians in this challenging field of medicine, further education and training are imperative and must be available to provide a high standard of medical practice. This compilation meets that objective and ultimately makes the valuable contribution of restoring patients' self-confidence.
Lid margin inflammation (Table 2.1) is a common ophthalmic problem and in the USA it is said to account for 500 000 patient visits per year.
Body piercings, tattoos, and permanent make-up have become very popular as a fashion statement in recent decades. This book guides the reader through the world of body art. An overview is first provided of the history and epidemiology of tattoos and piercings. Subsequent chapters go on to examine in detail the materials and devices used in various forms of body art, and the techniques employed. All relevant risks and potential complications are clearly described with the aid of color illustrations. Special attention is paid to allergic reactions and the management of complications. The closing chapter examines the techniques and devices used for tattoo removal, with a particular focus on the use of different lasers. © Springer-Verlag Berlin Heidelberg 2010. All rights are reserved.
Eyelash transplantation is classified into two categories: 1. Reconstructive eyelash transplantation for correction of loss caused by injury, diseases, iatrogenic alopecia, congenital atrichia, or trichotillomania. 2. Aesthetic eyelash transplantation