Madarosis is a condition that results in the loss of eyelashes, and sometimes eyebrows. The term "madarosis" is derived from the ancient Greek "madaros", meaning "bald".[1] It originally was a disease of only losing eyelashes but it currently is the loss of both eyelashes and eyebrows. Eyebrows and eyelashes are both important in the prevention of bacteria and other foreign objects from entering the eye. A majority of patients with madarosis have leprosy, and it was reported that 76% of patients with varying types of leprosy had madarosis.[2]
Madarosis is not a critical or severe condition. The main symptom and sign of madarosis is the loss of hair from the eyelids, eyebrows, or eyelashes. Many symptoms are from other diseases involved.
Swollen, itchy, red, burning eyelids
Loss of hair from other parts of the body, mainly the scalp
Weight gain or palpitation if there is a thyroid problem
Ophthalmological conditions: blepharitis is an infection of the eyelid. Anterior blepharitis is either staphylococcal blepharitis, or seborrhoeic blepharitis and posterior blepharitis is due to the meibomian gland.
Nutritional defects: Severe malnutrition can cause chronic hair loss. Hypoproteinemia causes hair loss by early onset of telogen. Zinc deficiencies like acrodermatitis enteropathica, can lead to the loss of eyebrow/eyelash hair. Other deficiencies like biotin and iron make it possible for loss of hair as well.
There are two major pathways. In the non-scarring pathway, the hair follicles remain intact which could potentially be reversed with the proper diagnosis and treatments.[6] In the scarring pathway, the follicles are permanently lost due to tissue damage, atrophy, or inflammation.[7]
The severity of the pre-existing condition determines which type of madarosis occurs.
Ophthalmologic conditions: there are multiple types of infections and are common. The gray line of the eye is a line that divides the eyelid into parts: anterior part is skin and muscle while posterior is tarsus and conjunctiva. The blepharitis is classified based on the type of eyelid involvement. Anterior blepharitis is either staphylococcal blepharitis, or seborrhoeic blepharitis which have symptoms of the presence of scales that are along the hair shaft. Posterior blepharitis is usually due to meibomian gland dysfunction.
Nutritional Defects: Zinc is important in hair growth and the lack of zinc can cause hair loss, specifically madarosis. The main proteins in hair are biotin and iron so deficiencies would result in a loss of hair.
Trauma: Trichotillomania is a psychological disorder where the hair is pulled out or breakage occurs when anxious. Both trichoteiromania (hair loss from constant rubbing) and trichotemnomania (hair loss from constant shaving of the hair) can result in hair loss.
Drugs/Medications: The heart medication amiodarone has been reported to commonly cause loss of eyelashes and eyebrows. Cocaine abuse has shown hair loss due to the hot vapors traveling up causing burning of the hair of the eyebrows or eyelashes. Radiotherapy and chemotherapy can cause hair loss due to the eradication of the hair cells, especially when used to treat ocular tumors.
Genetics: Some of the diseases listed in the causes can be inherited.
Diagnosisedit
The main diagnosis technique is observing the area. Then blood tests can be done to determine if there is a pre-existing condition. Family history can be considered because some of the related causes/conditions can be inherited.
Classificationsedit
There are two major types of classifications of madarosis. The first is labeled as "non-scarring." Non-scarring the hair has the ability to regrowth after treatment of the primary disorder. Scarring madarosis is when the hair loss is permanent and can only regrow after cosmetic treatments.[8]
Preventionedit
The only prevention method is determining the underlying condition before treatment options are too late.[citation needed]
Treatmentsedit
Madarosis has different possible treatments and can be reversed if treated early enough. The treatments for madarosis are completely dependent upon the pre-existing condition. When treating blepharitis, antibiotics are used to combat the bacterial infection. People with trichotillomania need to seek behavioral and psychological help.[citation needed] Many people look to hair transplant surgeries, especially in non-scarring cases. These surgeries are mainly used as a cosmetic reason rather than a medical one. There are also other treatments that can be used for cosmetic purposes.
Surgical treatmentsedit
There are restoration surgeries for the eyebrows in severe cases. Many surgeons opt for nylon implants, but have been banned in some countries due to infections. Follicular transplantation is now the procedure of choice. In this surgery, hair samples are individually taken for a donor area and transplanted into the thinning area. Small incisions are made and grafts are placed individually according to the amount of hair in each follicle, eyebrows single. In this procedure, there are no scars or stitches and hair begins to grow after a few months post surgery.[9]
Medicationsedit
Minoxidil is a common topical treatment of eyebrow hair loss due to alopecia areata. There are other topical treatments (latanprost or bimatroprost) that are mainly used to treat glaucoma that can also be used to lengthen, thicken, and change the pigments of the lashes.[10]
Cosmetic treatmentsedit
Many people use cosmetic treatments to cover the loss of the hair, such as applying artificial eyelashes, tattooing eyebrows/eyelashes, penciling in the eyebrows or using mascara to make the existing eyelashes look longer. Some people even use eyeliner to make the eye stand out when lacking eyelashes.
Recent researchedit
There is currently researching being done to find more treatments dependent on the different pre-existing conditions.
Studies are being conducted in which madarosis can be related to malignancy. A study by Groehler and Rose found that there was a statistical significance between these two. They concluded that patients malignancy lesions on the eyelid have a higher chance of having madarosis than a patient with a benign lesion. They stated that despite the fact that it is significant, the absence of madarosis does not mean the lesion cannot be malignant.[11]
In many leprosy cases, madarosis is a symptom or a quality after diagnosis. However, in India, leprosy is common and researchers report a case of madarosis before diagnosis of leprosy with no skin lesions, only madarosis. This allowed for quicker treatment.[12]
The main reason many people have madarosis is due to the chemotherapy drugs. There was a clinical trial in 2011 that tested an eyelash gel called bimatoprost. This gel enhanced the eyelashes in quantity and thickness. They tested this on 20 breast cancer patients who were undergoing chemotherapy. Results seemed positive, in that the group of people who used the gel had growth of eyelashes after the chemotherapy drugs.[13]
Referencesedit
^"Bioline International Official Site (site up-dated regularly)". www.bioline.org.br. Retrieved 2015-11-04.
^Krishnan, Ajay; Kar, Sumit (2012-01-01). "Bilateral Madarosis as the Solitary Presenting Feature of Multibacillary Leprosy". International Journal of Trichology. 4 (3): 179–180. doi:10.4103/0974-7753.100092. ISSN 0974-7753. PMC3500062. PMID 23180932.
^Kumar, Annapurna; Karthikeyan, Kaliaperumal (2012-01-01). "Madarosis: A Marker of Many Maladies". International Journal of Trichology. 4 (1): 3–18. doi:10.4103/0974-7753.96079. ISSN 0974-7753. PMC3358936. PMID 22628984.
^Parrino, D.; Di Bella, S. (2016). "Hertoghe sign: a hallmark of lepromatous leprosy". QJM. 109 (7): 497. doi:10.1093/qjmed/hcw046. ISSN 1460-2725.
^Feldman, Mark; Friedman, Lawrence S.; Brandt, Lawrence J. (2015-01-01). Sleisenger and Fordtran's Gastrointestinal and Liver Disease E-Book: Pathophysiology, Diagnosis, Management. Elsevier Health Sciences. ISBN 9781455749898.
^Khong, J. J.; Casson, R. J.; Huilgol, S. C.; Selva, D. (2006-11-01). "Madarosis". Survey of Ophthalmology. 51 (6): 550–560. doi:10.1016/j.survophthal.2006.08.004. PMID 17134645.
^Faheem, Mahmood Syed. "Madarosis - Loss of eyelashes - Loss of eyebrows | the dynamic natural skin care". Madarosis - Loss of eyelashes - Loss of eyebrows | the dynamic natural skin care. Retrieved 2015-12-10.
^Faheem, Mahmood Syed. "Madarosis - Loss of eyelashes - Loss of eyebrows | the dynamic natural skin care". Madarosis - Loss of eyelashes - Loss of eyebrows | the dynamic natural skin care. Retrieved 2015-12-10.
^"Follicular Unit Extraction (FUE) Hair Transplant | Bosley". www.bosley.com. Retrieved 2015-11-04.
"Eyebrow Transplant Through Follicular Unit Transplant (FUT) | Medispa". www.medispaindia.in. Retrieved 2018-02-10.
^Kumar, Annapurna; Karthikeyan, Kaliaperumal (2012-01-01). "Madarosis: A Marker of Many Maladies". International Journal of Trichology. 4 (1): 3–18. doi:10.4103/0974-7753.96079. ISSN 0974-7753. PMC3358936. PMID 22628984.
^Groehler, Jennifer M.; Rose, John G. (2012-03-01). "Madarosis as an indicator for malignancy in eyelid margin lesions". Optometry and Vision Science. 89 (3): 350–352. doi:10.1097/OPX.0b013e31824352b6. ISSN 1538-9235. PMID 22246332. S2CID 52856613.
^Krishnan, Ajay; Kar, Sumit (2012-01-01). "Bilateral Madarosis as the Solitary Presenting Feature of Multibacillary Leprosy". International Journal of Trichology. 4 (3): 179–180. doi:10.4103/0974-7753.100092. ISSN 0974-7753. PMC3500062. PMID 23180932.
^Morris, Carrie L; Stinnett, SS; Woodward, JA (2011-01-01). "The Role of Bimatoprost Eyelash Gel in Chemotherapy-induced Madarosis: An Analysis of Efficacy and Safety". International Journal of Trichology. 3 (2): 84–91. doi:10.4103/0974-7753.90809. ISSN 0974-7753. PMC3250027. PMID 22223967.