Enhanced eyelashes: prescription and over-the-counter options

Abstract

Women have long strived to possess long, thick, and dark eyelashes. Prominent eyes and eyelashes are often considered a sign of beauty and can be associated with increased levels of attractiveness, confidence, and well-being. Numerous options may improve the appearance of eyelashes. Mascara aims to temporarily darken, lengthen, and thicken eyelashes using a combination of waxes, pigments, and resins. Artificial eyelashes can be adhered either to the dermal margin or to individual eyelashes. Individuals may even use eyelash transplantations to improve the appearance of their eyelashes. The unique properties of eyelashes (e.g., relatively long telogen and short anagen phases compared with scalp hairs, slow rate of growth, and a lack of influence by androgens) may allow for specific aesthetic interventions to improve the appearance of natural eyelashes. Some over-the-counter (OTC) products may contain prostaglandin analogs that can affect eyelash growth, but neither the safety nor efficacy of these OTC cosmetics has been fully studied. Originally indicated for the reduction of intraocular pressure, the synthetic prostaglandin analog bimatoprost was recently approved for the treatment of hypotrichosis of the eyelashes. In a double-blinded, randomized, vehicle-controlled trial, bimatoprost safely and effectively grew natural eyelashes, making them longer, thicker, and darker. Bimatoprost was generally safe and well tolerated and appears to provide an additional option for individuals looking to improve the appearance of their eyelashes.

Fig. 1

a Hair cycle of normal eyelashes. b Potential mechanisms of action of bimatoprost ophthalmic solution 0.03% on the eyelash cycle [13, 16, 17] (Latisse package insert and unpublished data, Allergan, Inc.)

Fig. 2

Sample images of patient eyelashes before and after 16 weeks of once-daily bimatoprost treatment. The patient entered the study with a baseline overall eyelash prominence assessed as moderate (grade 2) on the Global Eyelash Assessment (GEA) scale. After 16 weeks of double-blind treatment with bimatoprost ophthalmic solution 0.03%, the patient’s eyelashes were markedly prominent (i.e., GEA score of 3). In determining GEA scores, raters utilized a photonumeric guide and evaluated overall eyelash prominence, including length, fullness, and color of both upper eyelashes, with length considered the most important feature

Fig. 3

Changes in eyelash length, thickness, and darkness associated with bimatoprost in a double-blind, vehicle-controlled trial [22]. Eyelash qualities were assessed by digital image analysis based on superior-view digital eyelash photographs taken with standardized equipment and subject preparation. Last observation carried forward was performed on weeks 1–16. * P < 0.0001 vs. placebo based on the Wilcoxon rank-sum test