Your eyelashes can be a very visible indicator of your overall eye health. Sleek, sturdy lashes show that the hair follicles in your eyelids are doing well, and are not being negatively impacted by any health conditions in the area of the eyes. Maintaining healthy eyelashes is important for keeping bacteria and other foreign particles out of your eyes.
On the other hand, eyelashes that are loose, brittle, or flaky suggest that something problematic is going on. In more severe cases, eyelashes may begin falling out, a condition known as madarosis. So, what does it mean when that happens?
One strong possibility is infestation by demodex mites, also known as “eyelash mites.” These are microscopic bugs that live on the skin around your eyes, spend most of their time living in hair follicles or sebaceous (oil) glands, and eat oils and dead skin cells. As these critters crawl around with their tiny claws and eat the skin, they can damage the inside of your hair follicles, causing eyelashes to become loose, misaligned, and even fall out if the condition gets bad enough.
Demodex infestations are very common, though most people who maintain proper ocular hygiene do not present any symptoms. Around 69% of adults between the ages of 31-50 have been found to have demodex mites, and the percentage of affected individuals increases with age to 80% in people over 60 and virtually 100% in people over the age of 80.1 Therefore, demodex mites should be the first suspects in a new case of madarosis. An optometrist can easily help you find out if you are suffering from a demodex infestation. If you are, facial wipes or cleansers, like Cliradex, which contain mite-killing compounds, can help.2
Infections from other pathogens, including bacteria and viruses, may be the cause of madarosis, particularly infections of the eyelid. Furthermore, bacterial infections in the eyelid and eyelash follicles can cause inflammation of the eyelid, known as blepharitis. In cases like this, the eyelid will be swollen, reddish, warm feeling, and sore. Keeping your eyelids and lashes clean is a good way to prevent a bacterial or viral infection from occurring.3
Dermatological conditions affecting the area of the eyes can also be a cause of madarosis, as can any condition that causes irritation at the eyelids. Examples of these types of skin disorders include dermatitis, psoriasis and rosacea.4 Certain autoimmune disorders which affect the skin, such as lupus, can also lead to eyelash loss.5 Keeping your face and eyes clean and moisturized can help with dermatological-related eyelash loss.
Finally, madarosis may indicate an imbalance in your body’s nutrient or hormone levels. Certain dietary insufficiencies, such as inadequate intake of protein, biotin, zinc, or iron can all cause hair loss, as well as severe overall malnutrition. Thyroid problems, including hyperthyroidism, hypothyroidism, and hypoparathyroidism, as well as low levels of pituitary hormones, can also cause hair loss in extreme cases. Make sure you are eating a balanced diet, and talk to your doctor if you want to look into nutritional supplementation.6
1. Czepita D, Kuzna-Grygiel W, Kosik-Bogacka D. Investigations on the occurrence as well as the role of Demodex folliculorum and Demodex brevis in the pathogenesis of blepharitis. Klinika oczna. 2005;107(1-3):80-82.
2. Liu J, Sheha H, Tseng SC. The pathogenic role of Demodex mites in blepharitis. Current opinion in allergy and clinical immunology. 2010;10(5):505-510.
3. Vij A, Bergfeld WF. Madarosis, milphosis, eyelash trichomegaly, and dermatochalasis. Clinics in dermatology. 2015;33(2):217-226.
4. Sachdeva S, Prasher P. Madarosis: a dermatological marker. Indian journal of dermatology, venereology, and leprology. 2008;74(1):74-76.
5. Selva D, Chen CS, James CL, Huilgol SC. Discoid lupus erythematosus presenting as madarosis. American journal of ophthalmology. 2003;136(3):545-546.
6. Kumar A, Karthikeyan K. Madarosis: a marker of many maladies. International journal of trichology. 2012;4(1):3-18.