Longer lashes! “Should I use Latisse?”

This was a question put to me by a patient recently. She confided that she had bought an eyelash-enhancing product while in the United States. The product was called Latisse and she wanted to know if I felt it was safe to use. I admitted had never heard of it and said I would investigate. At this point she told me she had been using it for about two months, and to be fair she did have amazingly long beautiful eyelashes so it was clearly ‘doing what it said on the tin.’

I realise that this topic doesn’t fall precisely under the heading visual psychology but for most women (and a good many men) body image, beauty, and the disparity between reality and media ideals can have a huge effect on their mental well-being.

Also in the interests of full disclosure I have spent most of my adult life looking for the Holy Grail of mascara; the one which will transform my stubby little lashes into those fit for a Disney Princess.


Yes I am *that* shallow…so sue me.

Latisse, which is manufactured by Allergan, promises all this. The website says that:

LATISSE® is an FDA-approved treatment to grow eyelashes for people with inadequate or not enough lashes.

But Google Latisse and you’ll find all manner of celebrities and beauty-bloggers raving about its lash-lengthening effects. It certainly looks tempting.

But Latisse is not licensed for use in the UK. Even in the US it is a prescription-only drug, albeit licensed for cosmetic purposes.

But what is it and how does it work?

Latisse is actually bimatoprost. For those who don’t know, this is actually the glaucoma medication known as Lumigan, and is formulated to lower the pressure inside the eyes (intra-ocular pressure). One of the unusual side effects of using Lumigan eye drops is that patients start producing darker, thicker lashes.

Allergan presumably decided this was a side-effect with marketing potential and repackaged the drug as Latisse.

But the drug is not without other side effects. The skin around the eyes may become slightly red, and the pigmentation of the lids may increase.

If Latisse is transferred accidentally to the ocular surface the eye pressure can be lowered because after all that is what bimatoprost is prescribed for in glaucoma sufferers. In most non-glaucoma sufferers this effect is harmless. Latisse can also increase the pigmentation of the iris over time if it gets into the eye. Eyes can actually darken in colour. This effect may not be desirable if someone is fond of their naturally blue or green eyes.

More importantly patients who have ocular surface disease such as keratoconus, or corneal ulcers, or who are contemplating ocular surgery such as cataract surgery or LASIK may actually increase their risk of complications if Latisse enters the eye. These risks include the pressure in the eye dropping too low, and a condition called macular oedema, where the retina at the back of the eye becomes compromised.

Bimatoprost (even when it’s used in eye drop form) has also been linked with exacerbating Crohn’s disease.

One of the most striking side effects of Bimatoprost though which I see in practice is something called periorbitopathy. Bimatoprost is something called a prostaglandin analogue. Prostaglandin analogues mimic the prostaglandins made by our own bodies. These are inflammatory molecules formed from a type of fatty acid chain. Prostaglandins have an affinity for the fat cells surrounding the eyes and they change them. This alteration of the fat cells around the eyes can lead to the eyelids drooping, or conversely tightening, the blood vessels becoming more prominent and the upper lid sulcus (the groove between the eye and the brow) deepening. Most of these would be cosmetically unappealing and possibly even negate the positive lash-enhancing effects.

I think this one is a case of proceed with caution. It’s not actually available in the UK yet anyway but we all know that where there’s a will there’s a way! As a cosmetic agent Latisse is powerful and definitely produces longer, thicker lashes, but it is not without risk and I don’t think, having researched it, I would be tempted to try it. My search for mascara Nirvana will have to continue!