Eyelash and Eyebrow Loss After Chemo

One widely known problem with many chemotherapies is hair loss (alopecia). But some people are surprised and upset when their eyelashes and eyebrows thin and fall out, especially because this can happen weeks or months after you lose other hair. So far, there is no known prevention for “chemo eyelashes.” But there are ways of dealing with the problem.

First, it’s important to understand that this is a completely normal side effect. “Chemotherapy disrupts the normal hair cycle,” says Dr. Jonathan Leventhal, director of the onco-dermatology program at the Smilow Cancer Hospital at Yale. “Particularly those used to treat breast and gynecologic cancers.”

Lash and brow loss may not bother everyone, but for others, it can be especially hard. Lisa, 50, struggled with how she looked without eyebrows: “No definition, so suddenly it’s one very big forehead. I looked tired all the time. I didn’t recognize myself.”

The good news is that for most people, the effect is temporary. Dr. Leventhal says that eyelash regrowth after chemo usually kicks in “several months after” the end of treatment, but, he adds, “a smaller percentage, around one in four people, may have persistent hair loss or sparse or thin regrowth.”

Still, there’s plenty you can do in the short term, while you wait for your chemo eyebrows and eyelashes to grow back. And if months go by, and you still have not-so-lush hair around your eyes, there are a few permanent fixes, too. 

Makeup is usually what people try first. Eyebrow pencils, eyebrow powders, tinted eyebrow gel, and eyebrow stencil kits can all help recreate a natural eyebrow shape and fill in sparse areas. 

“I started using an eyebrow pencil to lightly fill in the gaps of my brows right away,” says Erin, 55 at diagnosis. “By the time they were pretty much gone, I was very practiced at matching my own brows.”

Another easy product is temporary brow tattoos, which are very finely drawn brows in a range of colors and shapes. Like any temporary tattoo, simply wet and stick. These work well if you have some brow hair left, too, to add texture. But avoid any that use an adhesive, as this can pull your own hair out.

False eyebrows are another choice for chemo patients. Think of them like wigs for your brows: sheer pieces with real hairs (the best use human hair). They come in many shades and shapes, and after you stick them on (with a special adhesive), they stay for days. If you’re careful, one set will last for months. These are best if you have no hair left at all, because taking them off can pull out patchy hairs. And be sure to test the adhesive on a small patch of skin first, to make sure it doesn’t give you a rash.

A semi-permanent fix is microblading, an eyebrow tattoo that can last 12 to 18 months. It’s done at the salon by a licensed technician. When Lisa got tired of drawing on her brows every day, and wearing her glasses to frame her eyes, she turned to microblading. “They are amazing and perfect,” she says. “They look 100 percent real and are actually better than my ‘real’ ones ever were!” Check with your oncologist first, though; it may be safer to wait until you’re done with chemotherapy, to avoid any risk of infection.

As with eyebrows, the right makeup can help what you still have. Eyeliner applied carefully along the lash line, plus a good mascara, can almost completely camouflage lash thinning and loss.

False eyelashes are another easy option, and there’s no single style of false eyelashes for chemo patients. Because they’re a general beauty trend, they’re available in tons of different lengths, colors, and thicknesses, from subtly natural to more pronounced. But test the lash glue on a small patch of skin before applying all over. And be careful when taking them off, so they don’t pull out the lashes you have. 

But note: Another big beauty trend, lash extensions, are not good for people who have gone through chemo. They’re tempting because one session in a salon can last more than a month. But the adhesive used to stick on the single lashes can irritate your skin. And the extensions can block your natural lashes when they start to grow in.

If months have passed after chemo and your eyelashes and eyebrows aren’t growing back, you might be ready for a longer-term fix. (But check first with your oncologist to see how long you should wait to give your natural hair a chance.)

The medication minoxidil, usually prescribed for pattern hair loss (baldness), can also help your brow hair grow back. Minoxidil comes in two formulations — topical (applied to the skin) and oral (taken as a pill). Topical minoxidil is FDA-approved for hair loss affecting the scalp. However, dermatologists may recommend this as off-label treatment for topical application to the eyebrows. Oral minoxidil can also be used off-label for different forms of hair loss, and may be another option for eyebrow hair loss. Ask your oncologist and dermatologist if this is right for you.

Another prescription drug that can make eyelashes and eyebrows grow is Latisse (chemical name: bimatoprost). It’s FDA-approved for use on the skin at the base of the upper lashes once a day for at least two months. It can also be used off-label for the eyebrows. But you’ll want to talk to your dermatologist about possible side effects. It can make your eyelid skin darker temporarily, give you an itchy rash, or permanently make your iris, the colored part of your eye, dark brown. This last effect is rare, but possibly a big deal to you if you have light-colored eyes.

Finally, permanent makeup — a tattoo with a fancier name — is an option, for eyeliner and for drawn-on brows. As with any permanent tattoo, think long and hard about shape and style. (And maybe try microblading first.) You’ll want to pick something that looks natural, so you’ll still love it decades from now!

However you deal with losing eyelashes or eyebrows with chemo, it may help to look at this process like you would with losing your hair on your head. With a blank slate, it can be a chance to experiment — and you might discover totally new looks that you never would have before.

Learn more about minimizing chemo side effects.

 

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