Eyelash loss, medically termed madarosis, can be concerning, though it is often part of a natural biological process. Eyelashes, like all body hair, follow a cyclical growth pattern consisting of three phases: anagen (growth), catagen (transition), and telogen (resting/shedding). The anagen phase for an eyelash is short, lasting about 30 to 45 days. It is normal to lose between one and five lashes each day as they complete the telogen phase and are replaced by new growth. Excessive or rapid shedding that results in noticeable gaps signals that an underlying factor is disrupting this healthy cycle.
Daily Routines and Physical Stress
Many instances of increased eyelash shedding stem from mechanical damage or chemical irritation caused by daily habits. Improper removal of eye makeup, especially waterproof formulas, often requires excessive rubbing, which physically damages the lashes. Leaving mascara on overnight can cause lashes to become brittle and dry, increasing the likelihood of breakage and loss.
The use of an eyelash curler can also cause damage, particularly if pressed too hard or used after applying mascara, which can crimp and break the lashes at the base. Eyelash extensions pose a risk due to the weight of the fibers and chemical stress from adhesives. Applying or removing extensions can cause trauma to the hair follicle, resulting in temporary loss of the natural lashes.
Chronic physical stress, such as habitually rubbing the eyes, directly contributes to premature shedding. This mechanical trauma weakens the hair follicle’s hold on the lash, causing it to enter the resting phase prematurely. This loss is often reversible once the damaging habit or product is identified and eliminated.
Internal Health Conditions and Infections
When eyelash loss is not linked to cosmetic habits, it often points to intrinsic health issues that affect the hair growth cycle. Thyroid dysfunction, including both underactive (hypothyroidism) or overactive (hyperthyroidism) thyroid, is a common systemic cause. The thyroid gland regulates hormones that influence hair follicle activity, and an imbalance can push lashes into the telogen or resting phase.
Autoimmune conditions can also target and damage the hair follicles, leading to eyelash loss. Alopecia Areata is one such condition where the immune system mistakenly attacks the hair follicles, sometimes causing patchy loss only in the eyelashes. This localized form is a non-scarring process, meaning the hair follicle remains capable of regrowth once the underlying inflammation is addressed.
Localized infections and inflammatory skin conditions on the eyelid margin are another frequent cause of lash loss. Blepharitis is an inflammation of the eyelids, often resulting from clogged oil glands or bacterial overgrowth, which causes redness, itching, and crusting around the lash base. An infestation of microscopic Demodex mites can also lead to blepharitis and inflammation-induced lash shedding.
Certain prescription medications can disrupt the hair cycle and cause temporary eyelash loss. Chemotherapy drugs, for instance, cause an abrupt cessation of growth in the anagen phase, known as anagen effluvium. Other drug classes, including some blood thinners, acne medications, and retinoids, may also cause lashes to shed by triggering a premature shift into the resting phase.
Seeking Diagnosis and Medical Treatment Options
Sudden or unexplained eyelash loss, especially if accompanied by other symptoms, signals the need for professional medical advice. Red flags include loss that affects the eyebrows or scalp, is accompanied by pain, swelling, or redness of the eyelids, or occurs alongside systemic symptoms like fatigue or unexplained weight changes. These signs suggest a deeper medical issue that needs investigation beyond simple cosmetic adjustments.
A dermatologist or an ophthalmologist is the appropriate specialist to consult. The diagnostic process begins with a detailed medical history and a physical examination of the eyelids, sometimes using a specialized microscope to look for signs of inflammation or mites. If a systemic disorder is suspected, blood tests may be ordered to check hormone levels or to look for markers of autoimmune activity.
Treatment is highly specific and focuses on resolving the underlying cause. Infections or blepharitis may be managed with improved eyelid hygiene, warm compresses, or prescription topical medications. For conditions without a simple fix, such as Alopecia Areata, prescription growth serums like bimatoprost are available. This topical solution works by prolonging the anagen growth phase, which increases the thickness and length of the lashes, and has shown efficacy in stimulating regrowth.