Eyelash Falling Out (Madarosis) – Ayurvedic Treatment And Therapies

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Ayurveda explains falling out of eyelashes as a disorder caused due to dryness of eyelids. Ayurveda reckons this condition is due to imbalanced Vata Dosha

Table of Contents

Introduction, pathogenesis, symptoms

Pakshma Shata is a condition wherein the eyelids and eyelashes are afflicted by vitiated pitta consequentially leading to the loss of falling down of eyelashes from eyelids.

Pakshmashata has not been explained or mentioned by Master Sushruta in the list of eyelid disorders. This condition has been explained only by master Vagbhata in Ashtanga Samgraha. It is also called Pakshma Sadana.
Read – Eye Diseases Causes, Pathogenesis, Symptoms, Treatment, Herbs

Pakshma = eyelashes
Shata = to fall down

Pathogenesis of Pakshma shata eye disorder
Pakshmashata eye disorder is caused when the vitiated pitta contaminates / afflicts the posterior (inner) aspect of the eyelids and eyelashes and subsequently cause detachment of the eyelashes from their attachment with the eyelids. Consequentially the eyelashes fall of from the eyelids. This disease in which there is falling off or loss of eyelashes from the eyelids is called pakshma shata.
Read – Blepharitis: Inflamed Eyelids Ayurvedic Treatment, Remedies

Symptoms of Pakshmashata eye disorder

Pakshmanam shatanam – eyelashes fall off from the eyelids following affliction of the eyelids by the vitiated pitta
Kandu – itching in eyelids
Daha – burning sensation in eyelids
Shotha – swelling of eyelids
Read – Krimigranthi, Jantugranthi Definition, Location, Symptoms, Treatment

Sanskrit verse Paksmhashata

Ayurvedic treatment

Eyelashes fall – Ayurvedic treatment:
Opening of eye lash roots – Romakupa vikuttana –
Using sterile needles, the pores of the eyelashes i.e. the site of attachment of eyelashes with eyelids should be dug deep into and the blood should be let out.
leech therapy – Jalauka avacharana –
Site of eyelashes (from where they have fallen off) are subjected to bloodletting by applying leeches on those sites.
Read – Leech Therapy Procedure, Benefits, Side Effects, Treatment

Panchakarma – Vamana –
Patient should be subjected to emesis treatment by making him / her drink milk or sugarcane juice. Milk or sugarcane juices are used as emetic-helping liquids. They are given full stomach until the person has the urge to puke. Later emetic medicines are given and the person is made to vomit. This expels the morbid kapha and pitta and is also an ideal cleansing measure to treat pakshmashata eye disorder.
Read – Vamana Therapy – Right Method, Side Effects, Management

Nasal drops – Nasya –
nasal medication / errhines using ghee prepared and processed with herbs having coolant properties and predominant in sweet taste, example – Drakshadi ghrita etc should be administered.
Read – Nasya Karma Procedure, Types, Benefits, Contra Indications

Shushka Churnanjana (Dry Collyrium) – (read more here)
Collyrium prepared by triturating purified powder of Pushpa Kasisa (iron sulphate, yellow variety of vitriol) in a copper vessel / mortar for ten times in juice of holy basil, should be used to apply over the regions of fallen eyelashes in dry form or mixed with cow urine.

Modern correlation
Pakshmashata eye disorder can be closely correlated to a condition named Madarosis explained in the modern medicine. (read more)

Madarosis causes, signs

Word derivation of Madarosis
It is derived from Greek term madao which means ‘to fall off’. Here, the term relates to the predominant sign of the disease i.e. falling off of the eyelashes.

Madarosis is a condition which results in the loss of eyelashes. Sometimes the eyebrows are also lost. Originally, the term Madarosis was used to describe the loss of only eyelashes. But now, the definition of madarosis covers fall and loss of both, the eyelashes and eyebrows.

When eyelashes are lost, it is called as ciliary madarosis. When eyebrows are lost, it is called as superciliary madarosis. Both eyelashes and eyebrows can be lost at the same time. Loss of eyelashes is also called as milphosis.

This condition can occur on one side or both sides (both eyes). Similarly, there may be temporary or permanent loss of eyelashes or eyebrows.
(Read more)

Causes of Madarosis

Causes	As in
Opthalmological conditions	Blepharitis i.e. infection of eyelid
Dermatologic conditions	Atopic dermatitis Seborrhoeic dermatitis Psoriasis on eyelids Frontal fibrosing alopecia Acne Rosacea etc
Nutritional defects	Severe malnutrition Hypoproteinemia Zinc deficiency Biotin and iron deficiency
Infections	Leprosy Syphilis / viral infections like herpes or HIV Fungal infections
Trauma	Injury to eyelid margin Trichotillomania
Medications / drugs	Chemotherapy drugs Crack cocaine Anti-thyroid and lipid lowering drugs Anticoagulants Barbiturates Propranolol Epinephrine etc
Autoimmune disorders	Alopecia areata Discoid / chronic cutaneous lupus erythmatosus Graham-Little syndrome etc
Other diseases	Hypothyroidism Hyperthyroidism Hypoparathyroidism Hypopituitarism Amyloidosis etc.

Signs and Symptoms of Madarosis
Loss of hair from the eyelids, eyebrows or eyelashes – is the predominant symptom of madarosis.

The below mentioned symptoms if found in people having madarosis is suggestive of other diseases being causal.

Swelling, itching, redness and burning sensation of eyelids
Loss of hairs from scalp and other parts of the body
Palpitation or weight gain (thyroid involvement)

Madarosis pathology, Diagnosis

Patho-physiology of Madarosis
Madarosis takes two pathways of pathogenesis –

Non-scarring pathway – In this, there is no scarring of eyelid margins, the hair follicles remain intact. This condition could be reversed with proper diagnosis and prompt treatments.

Scarring pathway – In this condition, the hair follicles are permanently lost due to tissue damage and scarring, atrophy or inflammation.

Diagnosis of Madarosis
Diagnosis is done mainly by inspection of the afflicted area. The presenting symptom / sign often clinch the diagnosis.

Blood tests can be done to determine the presence of pre-existing conditions or to diagnose the causative disease if any.
Skin swabs may be taken to test bacterial infections.
Skin scraping may be taken to test for fungal infections.
Dermoscopy or dermatoscopy is done to examine the skin.
Family history need to be looked at. Some of the related causative conditions for madarosis are inherited. (read more)

Classification of Madarosis
Non Scarring Madarosis – There is re-growth of eyelashes after the primary disorder has been treated.

Scarring Madarosis – In this condition the hair loss is permanent. The eyelashes can be grown back after cosmetic treatments.

Prevention of Madarosis
The best and only way of preventing madarosis is to identify the underlying conditions as soon as possible and treat them promptly.

Home remedies, treatment

Home Remedies of Madarosis

Castor Oil – irritation of the affected area is often one of the chief causes for loss of eyelashes in madarosis. One needs to apply castor oil daily to the eyelid margins. This helps soothe the area. Application of castor oil will also help in growth of eyelashes which have been lost once again. The mentioned oil also has anti-inflammatory action.
Biotin – It is also known as Vitamin H. Biotin is fortified with number of additional nutrients. When taken regularly, it causes reversing of eyelash loss.
Borax – when the skin is cleansed with borax, it eliminates any toxins and enhances the chances of growth of eyelashes.
Olive oil – This oil is rich in vitamin E and oleic acid and is abundantly used to make hairs thick, including eyelashes. This oil nourishes the eyelashes and keeps them dark. With the help of cotton swab, the olive oil is applied to the lashes and kept overnight. It is washed off with lukewarm water in the morning.
Eyelid massage – This promotes the growth of eyelashes. It also improves blood flow to the hair follicles and nourishes the hair follicles. It stimulates hair growth and prevents thinning and also breakage of lashes. After putting few drops of oil, petroleum jelly or shea butter on the eyelids, massage your eyelids with the help of your fingertips along the lid margin and lash line for 5-7 minutes at least twice daily.
Aloe Vera – It is one of the best home remedies used for thickening eyelashes. It is an abode of many kinds of vitamins and nutrients and thus promotes growth of eyelashes. It also acts as moisturiser for eyelashes.
Before going to bed, apply fresh aloe vera gel on your lashes using a clean, old mascara wand. Leave it overnight. It needs to be rinsed off with warm water the next morning. 1 tablespoon each of aloe vera and jojoba oil should be mixed with 1 teaspoon of chamomile infusion. This mixture should be applied on your eyelashes using a clean old mascara wand. It should be rinsed off with warm water after 15 minutes.
Lemon Peels – These are rich in vitamins C and B, folic acid and other nutrients. These ingredients promote growth of eyelashes. When infused in olive or castor oil, the cleansing and stimulating properties of the oil get enhanced. Soak 1 tablespoon of dried lemon peels in olive or castor oil and allow it for couple of weeks. This oil should be applied on the eyelashes at bedtime and left overnight. It should be washed off with warm water the following morning.

Treatments of Madarosis
Madarosis can be reverted back if early treatment is done.

The treatment of madarosis is totally dependent upon the pre-existing conditions. These conditions causing madarosis should be promptly treated to treat madarosis.

Below mentioned are cause related treatments for madarosis –

Antibiotics in the presence of blepharitis
Behavioral and psychological help in trichotillomania
Hair transplant surgeries (non-scarring cases)
Restoration surgeries in severe cases like follicular transplantation
Minoxidil topical application in case of loss of eyelashes due to alopecia areata
Cosmetic treatments to cover the hair loss, like applying artificial eyelashes, tattooing eyebrows / eyelashes, penciling in the eyebrows or using mascara etc (read more)

Important points about Madarosis
It was reported that 76% of patients with varying types of leprosy had madarosis. Thus, madarosis is associated with leprosy.