Introduction
History itself stands in admiration of the eyelashes of Audrey Hepburn and, at least for a while, Nicki Minaj.
Eyelashes are a key aesthetic feature of the face, drawing attention to and framing the emotive dominance of the eyes. Furthermore, they serve as a potent and singular signal of femininity, youth and beauty.
Most commonly, women will use eyelash extensions or fake eyelashes to enhance their flutter. However, there are some new treatments that are growing in popularity to enhance the eyelashes.
In 2008 the FDA approved the drug bimatoprost for hypotrichosis (a lack of hair) of the eyelashes (NDA 022369). Like many medications used for hair loss, bimatoprost was originally intended for other medical purposes and was used to manage an eye condition called glaucoma. It was discovered that patients using this medication grew longer eyelashes and so interest in this topic grew.
History itself stands in admiration of the eyelashes of Audrey Hepburn and, at least for a while, Nicki Minaj.
Eyelashes are a key aesthetic feature of the face, drawing attention to and framing the emotive dominance of the eyes. Furthermore, they serve as a potent and singular signal of femininity, youth and beauty.
Most commonly, women will use eyelash extensions or fake eyelashes to enhance their flutter. However, there are some new treatments that are growing in popularity to enhance the eyelashes.
In 2008 the FDA approved the drug bimatoprost for hypotrichosis (a lack of hair) of the eyelashes (NDA 022369). Like many medications used for hair loss, bimatoprost was originally intended for other medical purposes and was used to manage an eye condition called glaucoma. It was discovered that patients using this medication grew longer eyelashes and so interest in this topic grew.
How are eyelashes different to scalp hair?
Eyelashes are designed to protect the eyes. They grow in cycles like the rest of our hair but are not impacted by testosterone. They are the widest mature hairs in the body and vary in length. Typically we have 90-160 in the upper lid and about 80 in the lower lid.
How do they grow?
Studies indicate that eyelashes grow for 30 days, enter a phase of transition for 15 days where they shorten and enter a dormant phase called telogen for 100 days before falling out. Thus, they have a life span of between 3-6 months.
How long do eyelashes grow?
The length of our eyelashes varies from 10-12mm in the upper lid and 6-8mm in the lower lid. These lengths are different between ethnicities. Asian eyelashes have fewer curls and lift up angles, thicker but fewer hairs, but similar lengths to caucasians. This is in keeping with scalp hair variations amongst the two groups.
How does bimatoprost work?
Bimatoprost is a prostamide F2α analog; it works similar to the body’s own prostamides however the exact mechanism of action is not totally known. The way inwhich it increases the eyelash length is to prolong the growth phase of the hair, called anagen phase. It probably does this via cell receptors and genes; it has been used on hair follicles in petri dishes outside the body so may not work by changing blood flow. Interestingly, minoxidil increases prostaglandin synthesis and prolongs anagen also.
How can we use bimatoprost?
Bimatoprost, Lattisse® or Lumigan®, eye drops 0.03% can be applied once each night along the upper eyelid margin at the root of the eyelashes using a special applicator. The applicator should be single use. Studies have shown that it can increase the length, darkness and thickness of eyelashes.
How safe is this medication?
Bimatoprost needs to be applied to the eyelash margin and not on the surface of the eye. If it gets onto the eye, there may be some side effects. Bimatoprost can darken the iris which is the coloured part of your eye. It can also give you headaches, itchy eyes and a pink eye; although these are not considered serious.
Less commonly, if applied to the eye frequently and not the lid margin, it is possible to have deepening of the eyelid sulcus and loss of the fat near the eye. If you have eye problems, you should not use this medication. You should always use this medication as directed. There is no good reason to use bimatoprost during pregnancy; wait until after delivery and breastfeeding.
How effective is bimatoprost?
Studies have shown a range of different outcomes with some studies showing 77% of patients having a response to bimatoprost and some studies showing lower; they differed in dose and indications of use.
How else can bimatoprost be used?
Research has trialled bimatoprost on scalp hairs and there may be a possibility of using bimatoprost on other hair loss settings such as the autoimmune balding condition alopecia areata. It may potentially be used for scalp hair loss in the future. Furthermore, it has a role in treating eyebrow hair loss (please see the eyebrow article).
REFERENCES
Khidhir KG, Woodward DF, Farjo NP, et al. The prostamide-related glaucoma therapy, bimatoprost, offers a novel approach for treating scalp alopecias. FASEB J. 2013;27(2):557-567. doi:10.1096/fj.12-218156
Law SK. Bimatoprost in the treatment of eyelash hypotrichosis. Clin Ophthalmol. 2010;4:349-358. Published 2010 Apr 26. doi:10.2147/opth.s6480
Na JI, Kwon OS, Kim BJ, et al. Ethnic characteristics of eyelashes: a comparative analysis in Asian and Caucasian females. Br J Dermatol. 2006;155(6):1170-1176. doi:10.1111/j.1365-2133.2006.07495.x
