Fashion & Beauty

Longer Eyelashes by Prescription!

The Issue
As we get older, lashes often become sparser, break off and appear shorter. Lashes can be lost during and after chemotherapy or because of alopecia, or other medical conditions. As an ophthalmologist who has always had short, stubby lashes, I’m no exception.

However, I’ve treated many glaucoma patients with topical drugs in the protaglandin family. Patients marvel at or (a few) complain about the eyelash growth that often accompanies the use of these drugs.

New Treatment
Latisse, manufactured by Allergan, introduced in 2009 is the sole FDA approved formulation for eyelash growth. It is only available by prescription. When applied directly to the base area of the upper lid lashes, it’s been clinically proven to stimulate eyelash growth by lengthening the growth phase of the eyelash cycle. In the original Allergan clinical study of 280 volunteers, lashes grew 25% longer, 18% darker and 106% thicker than those in the control group. Latisse is a 0.3% solution of a prostaglandin called bimatoprost which was originally used to treat patients with glaucoma. After a few weeks, some patients experienced an unusual side effect – their lashes were growing, sometimes to an amazingly long length! Allergan, the maker of the glaucoma drug Lumigan, took notice and developed a formulation to enhance eyelash growth. Now they’re doing a huge advertising push.

Side Effects
Although side effects of redness, itching and inflammation have been reported, they’ve generally been mild and reversible when use is stopped. Other, more serious, side effects include eyelid discoloration that may not be entirely reversible. A small number of patients with lighter colored eyes have reported a change in eye color which is irreversible (although this side effect was reported for use of the drug for glaucoma, not eyelash growth). Lashes can also grow unevenly and so long that they begin to turn inward, irritating the cornea and causing inflammation and scarring. Chronic irritation may also reactivate old problems, or predispose those with occasional corneal erosions to experience more frequent flare-ups.

Be aware that Latisse is intended for use only on the upper lids. If applied to the lower lids, unintended hair may grow below the lash line or on the cheeks. Most important, however, Latisse should not be used in patients with glaucoma who are also using a prostaglandin drug to treat their glaucoma without consulting their ophthalmologist. Latisse may decrease the effectiveness of their treatment. In fact, everyone should have a comprehensive eye exam before starting Latisse; it may mask the early signs of glaucoma and delay the diagnosis.

Sales of Latisse have been spectacularly successful. It costs approximately $90-120 per month, $3-4/day, plus a prescribing doctor’s visit. Any doctor can prescribe it, but given the risks, an ophthalmologist would be the best choice. Latisse is applied once a day, at night with an FDA approved applicator. Results are usually noted after eight to sixteen weeks of use. Eyelash growth returns to the pretreatment state when use is stopped.

Although Allergan has tried to prohibit online selling, it is widely available. Online buyers, however, are often not warned about the potential side effects and may be buying a generic knockoff that is not FDA approved or an adulterated version.

Other options are RevitaLash and LiLash, but it is not clear whether these formulations still contain prostaglandin. If they do, they could be removed from the market at any time. Allergen has vigorously defended its patent.

If you want to try a prostaglandin free, non-prescription eyelash conditioner or mascara, you can consider ones that use peptides and plant extracts as their active ingredients. Some highly recommended ones are Marinilash, Peter Thomas Roth Lashes to Die For and Dermalash. Although these products cannot grow lashes, they do lubricate the lashes so they do not fall out as quickly, and increase apparent fullness. At a cost slightly lower than Latisse, they may provide enough enhancements to satisfy many people.

There are of course many mascaras intended strictly for cosmetic use. Some contain filaments or other new formulas that temporarily enhance lashes.

What do you think about this?

Note: Dr. Peck has no financial interest in Allergan or in Latisse.

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