Eyelashes Keep Falling Out: How to Prevent Loss of Eyelashes & What to Do to Have Thick, Healthy Eyelashes

Eyelash loss can be distressing. Understanding why this happens can help one find ways to prevent future eyelash loss and bring back lusher ones.

First Some Definitions:

1.) What are the Stages & Life Cycle of Eyelashes?

1. Anagen Stage: eyelashes grow

2. Catagen Stage: a transition stage

3. Telogen Stage: eyelashes just stay there all grown up. 

4.  Falling out Stage: Eyelashes continuously cycle through these stages and take about 90 days or 3 months to grow back. 

2.) Other Definitions:

Milphosis refers to the falling out of eyelashes.

Madarosis describe eyelash or eyebrow loss resulting from a destructive process. 

Alopecia is a more general term used to describe the absence or loss of hair from any skin area where it is normally present (ie, Alopecia areata: loss of hair in several areas including the scalp, brows, eyelashes, and bearded portion of the face; Alopecia adnata has been used to describe eyelash loss but more appropriately refers to an underdevelopment of the eyelashes)

Trichotillomania:  hair/eyelash loss from the patient pulling hair out (ie., may be part of a compulsive disorder causing an irresistible urge to pull out hair leading to pleasure or relief.

CAUSES OF EYELASH LOSS: 

1. The Number 1 Reason for Eyelash Loss is Aging and Hormonal Changes:

Hormonal changes 

2. Blepharitis and Meibomian Gland Dysfunction:

Blepharitis is an inflammation of the eyelid margin which can cause damaged eyelash follicles. If the inflammation is left untreated, it can lead to damaged meibomian glands as well. This sets up a chronic inflammatory pattern that can lead to eyelash loss and trichiasis (ie, when the eyelash grows in the wrong direction and begins to scratch the cornea). 

Treatment:

a. Lid hygiene, warm compresses,  Hypochlorous acid Spray (ie, Avenova), and/or diluted tea tree oil scrubs (if your skin & lashes can tolerate it) to kill any Demodex mites which are often at the root of the problem. 

 “A lot of patients have the misconception that if you scrub your eyelashes with a mild soap that it’ll make your lashes fall out, but that’s actually incorrect,” says Michelle Andreoli, MD, a clinical spokeswoman for the American Academy of Ophthalmology. “If you massage your eyelashes every night with a mild soap to get the surfaces as clean as you can and maintain the health of the eyelash follicle, your eyelashes will actually grow thicker and longer and they won’t fall out as fast.”

b. diet is important: I recommend a gluten-free, sugar-free diet.

2. Medications:

There are some medications that can lead to hair loss: check the side effect profile of all medications you are using. Recently a patient noted that she lost all her hair and eyelashes after taxing 1 dose of topiramate  Topomax. 

Here are more drug reported to cause hair & eyelash loss (ie, alopecia).

• Antibiotics
• Anticonvulsants (example: Topamax)- Topamax / Patient/Info-Forums)
• Antidepressants and mood stabilizers (including Prozac and Zoloft); gabapentin
• Birth control pills
• Blood pressure medications
• Chemotherapy drugs: very common to lose eyelashes & hair
• Cholesterol-lowering drugs
• Hormone replacement therapy
• Immunosuppressants
• Prescription anti-inflammatories
• Retinoids (acne medications with vitamin A)
• Some OTC and prescription antacids 

3. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/blepharitis

3. Autoimmune Diseases:

Treatment Options To Have Lush, Full Eyelashes: