QIs Latisse the answer for darker, thicker, longer lashes? If so, at what cost?

A
Jamie Restivo, MPAS, PA-C

Jamie Restivo, MPAS, PA-C

Crumay Parnes Associates, Inc.
Dermatology and Dermatologic Surgery
Enola, PA

Medically reviewed on 12.1.2023 by Gabriela Maloney, DO

Latisse (bimatoprost ophthalmic solution) 0.03% was FDA approved in 2008 and is indicated to treat hypotrichosis of the eyelashes. The main ingredient is the same as in Lumigan (bimatoprost ophthalmic solution) 0.01%, which is FDA approved to treat elevated intraocular pressure/glaucoma. Patients treated with this drug were noted to have longer, thicker, and darker lashes.1 From these clinical findings, its cosmetic indication was born.

 So let’s review the potential side effects

  • Eye irritation, which can include pruritus of the eye, conjunctival hyperemia, and dry eye2
  • Disparity between eyes in regards to length, thickness, pigmentation, number of lashes or vellus hairs, and/or direction of eyelash growth2
  • Periocular skin and lash line discoloration2
  • Increased brown iris pigmentation2
    • This is likely permanent
  • Orbital fat loss
    • Deepening of the upper eyelid sulcus, enophthalmos, and involution of dermatochalasis3

These side effects are easily noted when Latisse is used unilaterally and intraocularly. The differences between both eyes are more readily appreciated on physical examination. With symmetric use of Latisse topically, the above may be more difficult to assess.3

With discontinuation of Latisse, most of the above side effects can be reversed.3

Best practices

  • If you plan to prescribe Latisse, counsel your patients about risks and benefits and make an informed decision together
  • Recommend patients avoid application to the lower lash line. This can cause unwanted hair growth in that area.
  • Recommend use as the instructions specify to the upper lash line with single-use sterile applicator
  • Recommend patients practice good lid hygiene. OCuSOFT Lid Scrub is a viable option. This is a gentle cleanser for the eyelids. This can help to relieve dry eye symptoms and can soothe irritated eyelids. This can also help if there is any existing meibomian gland dysfunction, styes, and/or chalazia.
  • If your patient wears contacts, advise them to remove them before applying Latisse

Alternatives

There are a plethora of alternatives available OTC; exercise caution, however, as these are not regulated by the FDA, and their safety and potential side effects are not well known

Not every brand discloses that its products contain a prostaglandin analog

So how do you know?

Look at before and after photos. Do the after photos show erythema or hyperpigmentation of the upper lash line? If so, the product could contain a prostaglandin analog.

Isopropyl cloprostenate is a prostaglandin analog found in some OTC lash serums. Hint: look for “PROST” in the ingredient list.

References:

  1. Hazanchuk, V. (2019, December 5). What You Should Know About Eyelash Growth Serums. American Academy of Ophthalmology. Retrieved November 18, 2023, from https://www.aao.org/eye-health/tips-prevention/latisse
  2. Latisse product insert and Latisse.com 
  3. Berke, S. J., MD, FACS (2012). PAP: New Concerns for Prostaglandin Use. Review of Ophthalmology. https://www.reviewofophthalmology.com/article/pap-new-concerns-for-prostaglandin-use