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

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.

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.

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.

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.