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Anatomically we can define the eyebrows as a part of the face formed by short hairs located at the level of the supraciliary arches of the facial mass about 2 centimeters above the eyes. Its function is complementary to that of the eyelashes, protecting the eyes from sweat, dust, solar radiation and other environmental aggressions. However, there is another function of the eyebrows that is of utmost importance for the social interaction of people with each other: gestures. With a simple eyebrow movement we can convey different thoughts or emotions such as: concentration, pride, awe, fear, surprise… In general, hair follicles in the body are “living” structures that continuously go through different phases: growth, maturation and shedding (anagen, catagen and telogen, respectively). Depending on the length of the growth or anagen phase, the resulting hair will be longer or shorter. In the case of eyebrows, this phase lasts approximately one month and their length does not usually exceed two centimeters. For comparison, in the scalp, the growth phase lasts several years and the hair can reach a length of several tens of centimeters. On the other hand, the percentage of follicles in this growth phase differs from area to area. In the scalp it is 85% while in the eyebrows it is 15%. This is of some importance since follicles in the growth phase are the most sensitive to any disease or toxicity. In an adverse situation such as anemia, stress or drug toxicity, the first hair to fall out is the scalp hair. The eyebrows, however, are usually maintained until a more severe stage of the disease. MAIN PATHOLOGIES THAT CAUSE EYEBROW AND EYEHEAD LOSSCicatricials(definitive)

1. Lichen planus pilaris: it has a previous inflammatory phase that can be treated to avoid the definitive destruction of the hair follicle.
2. Cutaneous lupus: similarly, the inflammatory phase can be treated to reduce scar lesions.
3. Scars: due to the direct destruction of hair follicles and secondary fibrosis produced to create the scar.
4. Cutaneous tumors: due to the destruction of follicles by tumor growth

Non-scarring

1. Alopecia areata: is an autoimmune inflammatory disease that temporarily inflames the hair follicles causing hair loss, generally temporary.
2. Trichotillomania: is a disease associated with stress whereby people continually pull out the hairs on their heads, eyebrows or eyelashes.

There are different medical treatments that can be used for alopecia of the eyebrows and eyelashes. In the case of non-scarring alopecia, there are possibilities of regrowth either naturally or with the help of treatments that stimulate hair follicle growth. There are different pharmacological treatments to stop or reverse alopecia of the eyebrows and eyelashes as well as to stimulate their growth. These treatments are not free of side effects and must be supervised by a dermatologist. In scarring alopecia it is essential to start treatment early (in the inflammatory phase) to reduce as much as possible the definitive loss of hair from the eyebrows and eyelashes. There are some basic care and cosmetic treatments that can complement pharmacological treatments in some cases. It is advisable to use high quality cosmetic products to avoid damaging the eyebrows and eyelashes. It is very important to gently remove make-up with a cotton pad soaked in micellar water or make-up remover cream. In addition, it is essential to avoid any aggressive treatment or manipulation of its structure. The eyelid is a very delicate region and the eyebrows and eyelashes are very weak. They are easily damaged and fall off and then take more than two months to come back. The indication for eyebrow transplantation is for any type of alopecia in this area as long as the main cause that produced it is absent or stabilized. Eyebrow transplantation is performed similarly to scalp hair transplantation but with some nuances. Follicular units are first removed from the donor region and then grafted to the recipient region. The duration of a transplantation of both eyebrows is 2 to 3 hours and the price ranges from 2000 to 3000 euros. In the case of eyebrow transplantation there are certain differences with respect to scalp transplantation:

• The hair of origin should be of similar thickness: generally from the nape of the neck, retroauricular region, pubis or axilla.
• It is very important to design the “new eyebrow” taking into account the needs of each face.
• Single hair follicular units should be grafted.
• The direction of the grafted hair follicle should be aligned with the direction of the eyebrow.