INTRODUCTION
Hair loss is a detrimental side effect of cancer treatment, affecting up to 65% of patients.1 In addition to targeting hair follicles on the scalp, cancer treatments can also affect growth of eyebrows and eyelashes. However, cancer-associated eyebrow and eyelash loss, or madarosis, is understudied. Presently, there is only one study that quantified madarosis prevalence, citing that 67% of breast cancer patients reported loss of eyebrows and eyelashes, with 25% reporting new anxiety associated with this loss.2
There are currently no standardized regimens for both the prevention of eyebrow and eyelash hair loss and the regrowth of eyebrows and eyelashes following cancer treatment. Furthermore, efforts to camouflage eyebrow and eyelash alopecia can be challenging to execute. In a focus group study including patients with breast cancer, participants reported trying various cosmetics products and procedures like eyebrow pencils and eyeshadow, fake eyelashes, eyebrow tattooing for their madarosis, but overall reported dissatisfaction with the outcomes.3 There is an increased need for a more holistic understanding of who is at risk and what tools we have to mitigate it.
Though madarosis may be more subtle than hair loss on the scalp, the loss of eyebrows and eyelashes can be devastating to patients who are affected. Patients who experience madarosis report avoiding social activities due to fears of how they will be perceived and treated by others due to their appearance.1,3 In addition to psychological distress, patients have reported experiencing bothersome physical symptoms, specifically dry and watery eyes, and many chose to wear sunglasses or other protective eyewear to help with the irritation.3
There are currently no standardized regimens for both the prevention of eyebrow and eyelash hair loss and the regrowth of eyebrows and eyelashes following cancer treatment. Furthermore, efforts to camouflage eyebrow and eyelash alopecia can be challenging to execute. In a focus group study including patients with breast cancer, participants reported trying various cosmetics products and procedures like eyebrow pencils and eyeshadow, fake eyelashes, eyebrow tattooing for their madarosis, but overall reported dissatisfaction with the outcomes.3 There is an increased need for a more holistic understanding of who is at risk and what tools we have to mitigate it.
MATERIALS AND METHODS
The Hair Growth Cycle
Eyebrows and eyelashes are unique not only in their function but also in their life cycles as compared to other hairs on the body. The hair growth cycle consists of three stages: anagen (growth), catagen (transition), telogen (rest), followed by exogen (shedding). The length of hair depends on how long the follicle stays in the anagen phase. Eyebrows and eyelashes remain short as they only stay in the anagen phase for 4 to 12 weeks, while scalp hair can remain in the anagen phase for years.4 The telogen phase of eyebrows lasts 2 to 3 months and 4 to 9 months in eyelashes.4 Eyebrows and eyelashes grow more slowly than scalp hair, growing at 0.12 to 0.15 mm a day compared to 0.30 to 0.40 mm for scalp hair.5
