Mirror, mirror, on the wall, what happened to my eyebrows?

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Like shapely lips, an attractive nose and beautiful eyes, eyebrows can add or detract from the beauty of a face. When looking at photos of beautiful faces, almost uniformly the arch of the brow is between the middle third and the outer third of the brow. The position of the brow can project emotions of happiness, sadness, surprise, annoyance, and even relief.

Regardless of the importance of the brow, for various reasons many women tweeze their brows often to the point of having no brow left. Then commonly they will have them tattooed or just penciled on, which is far from a natural-appearing option.

By far the most common cause of eyebrow loss is over-tweezing. Unfortunately, fads come and go, but eyebrow loss from tweezing is often permanent. I can remember well the time when pencil-thin eyebrows were the "in thing."

Plucking eyebrows can and often does damage the follicle that produces the hair. It's understandable to remove the stragglers or misplaced hairs, but people who want a beautiful brow must resist the temptation to refashion the shape of the brows.

Other causes of eyebrow loss are:

  • Hypothyroidism, which is low thyroid hormone production. Your physician can have this checked with lab tests. Generally, cold weather intolerance and fatigue are problems with this hormone deficiency. Estrogen, testosterone and DHT (dihydrotestosterone) hormone levels should also be assessed.
  • Nutritional or vitamin deficiency, such as too little protein intake or low vitamin levels, particularly biotin, vitamin B7.
  • Aging. Most people have thinning of hair with advancing age, including eyebrows.
  • Alopecia areata, a form of alopecia that causes loss of various areas of hair, usually in the scalp.

What is the treatment for eyebrow loss?

The first thing one can do is rule out thyroid or other hormonal issues and-or have these corrected by your physician or an experienced health care professional.

Be sure your diet is balanced, which typically means limited simple carbohydrates, adequate protein and the "good" fats found in nuts, some vegetables such as olives and avocados, and in fish.

To correct the eyebrow hair loss, the most effective, natural-appearing treatment is a hair transplant using single hair follicle grafts. It is paramount that these grafts be placed so that they grow in the proper direction, which requires considerable skill and experience.

The result is well-shaped, full, natural brows using your own hair from the side or back of the scalp.

The procedure is done under local anesthesia and mild sedation. The recovery is a few days, but one must not touch the grafts for a period of one week.

Like any hair transplant, the hairs will need trimming from time to time. The best part is that the hair growth is permanent.

E. Ronald Finger, MD, FACS is a board certified plastic surgeon with offices in Savannah and Bluffton. www.fingerand associates.com

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