Outer eyebrow thinning is specific enough that it actually has its own name: the Hertoghe sign. If you have eczema and you’ve noticed the outer third of your eyebrows getting sparser while the part near your nose stays full, there’s a real explanation for that, even if it’s a little more complicated than you’d expect.
What the Hertoghe Sign Actually Looks Like
The Hertoghe sign is thinning or loss specifically at the outer, tapered end of the eyebrow, the part farthest from your nose. The inner section usually stays put. It tends to happen gradually rather than all at once, and it doesn’t hurt or itch on its own. It’s really just a visible change you might notice one day.
How Eczema Can Cause This
When eczema shows up around the eyes, which happens a lot since that skin is thin and sensitive, the itching can lead to a lot of rubbing and scratching in that exact spot. Over time, all that repeated rubbing can physically damage the hair follicles at the eyebrow, and the outer edge usually takes the brunt of it since it’s such an easy place to reach. This is a mechanical cause, different from some of the other explanations for this same pattern, which is worth keeping in mind before assuming eczema is definitely behind it.
Here’s the Honest Part
The Hertoghe sign was actually first described over a hundred years ago as a marker of hypothyroidism, an underactive thyroid, and that’s still its classic association in medicine. Eczema is a recognized cause too, but some research has actually questioned how strong that specific link really is. So it’s not something to treat as a definite diagnosis on its own.
A few other things can cause this same pattern, including aging, alopecia areata, nutritional deficiencies, and just plain over-plucking over the years. Eczema is a real, plausible explanation if you already have it, but this sign by itself doesn’t confirm anything for sure.
Should You Get Your Thyroid Checked?
Since thyroid disease is actually the more classic explanation for this pattern, it’s worth mentioning to your doctor, especially if you’ve also noticed things like fatigue, weight changes, or feeling unusually cold. This isn’t meant to alarm you. It’s just a genuinely useful detail to bring up so your doctor has the full picture.
What Helps If Eczema Is the Cause
If eczema-related scratching really is behind it, the fix isn’t about the eyebrow itself. It’s about calming down the underlying flare that’s causing the itch in the first place:
- Use a gentle, fragrance-free moisturizer made for the delicate eye area itself, since regular face or body creams are often too rich or too active for such thin skin.
- Support the skin around the area too, using something like Dermasolve’s Eczema Cream on the surrounding face and brow area (not directly on the eyelid), which can help the skin barrier there stay resilient between flares.
- Treat the active eczema with whatever your dermatologist has prescribed for that spot.
- Try to interrupt the scratch cycle, since ongoing rubbing keeps re-damaging the follicles even as they try to bounce back.
Here’s the good news: this kind of hair loss usually isn’t scarring, meaning once the underlying inflammation and scratching are under control, the hair often grows right back.
When to See a Doctor
- You’ve noticed this pattern and aren’t sure whether eczema, thyroid, or something else is behind it
- You have other symptoms that might point to a thyroid issue
- The hair loss doesn’t improve even once your eczema is well controlled
- You want to rule out other causes, like alopecia areata
A quick conversation with your doctor can sort out which explanation actually fits your situation, rather than assuming based on the pattern alone.
Mike Marenick is the founder of HealFast Skincare and holds the patent for his invention, Ovasome Technology, used in skincare formulations. He began developing skincare products after watching his mother manage psoriasis for decades, and has spent over twenty years formulating treatments for chronic skin conditions. His work has been featured on Home Shopping Network, in two national infomercials, and in more than 300 publications including Vogue, Newsweek, and Allure. He is not a medical doctor — always consult a dermatologist for diagnosis and treatment of skin conditions.
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