Eyebrow Madarosis: An Updated Review of the Etiology and Management, Part I – Nonscarring Disorders

March 2026 | Volume 25 | Issue 3 | 246 | Copyright © March 2026


Published online March 2, 2026

Janaya Nelson MSa,b, Adam Friedman MD FAADa

aDepartment of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC
bMeharry Medical College, Nashville, TN

Abstract
Background: Eyebrow madarosis, or eyebrow alopecia, has significant cosmetic and psychosocial implications. Nonscarring causes are diverse, including autoimmune, infectious, endocrine, genetic, nutritional, traumatic, and iatrogenic etiologies. Despite its frequency in dermatologic practice, guidance for evaluation and management remains limited.
Methods: A comprehensive PubMed search (1960–2025) was performed using terms related to “eyebrow alopecia,” “eyebrow madarosis,” and specific disease processes. English-language studies were included if they evaluated eyebrow involvement and provided data on etiology, diagnosis, or treatment. Review articles without new patient data and studies limited to scalp alopecia were excluded.
Results: Nonscarring eyebrow alopecia can be caused by autoimmune disorders such as alopecia areata, infections including syphilis and tinea faciei, endocrinologic conditions like hypothyroidism, and inflammatory dermatoses such as atopic or seborrheic dermatitis. Additional causes include nutritional deficiencies, trauma, and drug-induced alopecia. Reported treatments include corticosteroids, calcineurin inhibitors, JAK inhibitors, immunomodulators, antifungals, zinc supplementation, and behavioral therapy. Novel agents such as dupilumab and roflumilast have shown promise for inflammatory-related eyebrow loss.
Conclusion: Nonscarring eyebrow madarosis encompasses a wide range of reversible causes. Early recognition and targeted therapy can lead to eyebrow regrowth and improve psychosocial outcomes. Further studies are needed to establish evidence-based treatment algorithms and validated tools to assess eyebrow regrowth.

INTRODUCTION

The eyebrows are central to facial expression and identity, serving both cosmetic and functional purposes.1,2 Their short anagen phase of approximately two to three months and slow growth rate of 0.12-0.15 mm per day distinguish them from scalp hair.3,4 While eyebrow density is typically stable, aging contributes to thinning and whitening, though some men may develop increased fullness.5 Beyond age-related changes, a variety of underlying conditions can contribute to eyebrow loss. Eyebrow loss, or madarosis, may be complete or partial and is classified as scarring or nonscarring.6 Because eyebrows are so closely tied to appearance and self-identity, eyebrow loss often results in disproportionate psychosocial distress.7 This review summarizes nonscarring causes of eyebrow alopecia and current treatment approaches.

MATERIALS AND METHODS

A comprehensive literature review was conducted to evaluate the clinical evidence related to the causes, diagnostic features, and management of eyebrow madarosis. Studies were identified using PubMed searches performed in August 2025 (1960–2025) with keywords including "eyebrow alopecia," "eyebrow madarosis," "eyebrow loss," "alopecia areata eyebrow," "frontal fibrosing alopecia eyebrow," "eyebrow hypothyroidism," "eyebrow chemotherapy alopecia," and other etiology-specific terms. Articles were included if they met the following criteria: English-language or English translation available; original studies (including case reports, case series, retrospective or prospective reviews, or clinical trials); and explicit evaluation of eyebrow involvement in alopecia or systemic disease. Studies were excluded if they were review articles without new patient data, expert opinions or commentaries, non-English without translation, or focused exclusively on scalp alopecia without eyebrow-specific outcomes. Each study was assessed for details regarding etiology of eyebrow alopecia, diagnostic methods, interventions, and treatment outcomes. For Part I, analysis was limited to nonscarring causes of eyebrow alopecia, and etiologies were further subcategorized by underlying disease process.
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