Eyelash loss

Abstract

Loss of eyelashes may occur with several conditions, including a variety of skin diseases, drug side effects, endocrine disorders, metabolic abnormalities, traumatic insults, inflammations, toxins, psychiatric disorders, and systemic disease. If the history and results of clinical, laboratory, and consultative assessments are negative, one must consider the possibility the patient is pulling them out (trichotillomania). Three case reports of spontaneous lash loss are described-one secondary to trichotillomania, one a result of hypothyroidism, and another with features of both hypothyroid and trichotillomania-to illustrate the presentation and appropriate workup to obtain a diagnosis.

Keywords: Lash loss; allopecia; madarosis; milphosis; trichotillomania.

Figure 1

Multiple broken lashes are seen in the central portion of the upper eyelid adjacent to normal lashes.

Figure 2

Several areas of broken lashes adjacent to normal lashes on the upper and lower eyelid.

Figure 3

(A) Loss of eyelashes involving entire right upper lid and the lateral two thirds of the lower lid. (B) Nineteen months after treatment of hyperthyroidism, eyelashes have returned on upper lid and are starting to return on lower lid, although they remain sparse.