As women become more familiar and comfortable with the idea of a medication that can help give them the kind of lush, long eyelashes they've always wanted, physicians have increasingly found themselves prescribing Latisse (bimatoprost ophthalmic solution 0.03 percent, Allergan) and addressing eyelash issues previously dealt with primarily at the cosmetics counter.
Dermatologist Dee Anna Glaser, M.D., who was involved in the initial clinical trials for Latisse, says that in the roughly two years of prescribing the drug, her patients have, by and large, been highly satisfied with the product.
"Most patients have tolerated Latisse very well, and overall, our experience has been that we have seen good, consistent results," says Dr. Glaser, professor of dermatology, Saint Louis University, St. Louis.
"I would say patients almost like the darkening and thickening as much, if not more, than the lengthening," she said. "It just gives a very nice, natural look without having to put on mascara or fake eyelashes. You can cry at the movies or jump in the pool and not have to worry about smudging."
The results appear consistent across patient age and skin-type groups, but patients with the greatest need for thickening or darkening may be the ones who express the highest satisfaction, she says.
"Sometimes the patients who are the most satisfied are the ones with very light, blond or gray lashes, in whom you or I may not think have achieved what might be considered thick or long eyelashes, but who really notice the difference, compared to those who already had moderately thick, long lashes," Dr. Glaser says.
Bimatoprost was originally developed for and continues to be used in the treatment of glaucoma, in which it is directly applied to the eyeball. Its evolution into a cosmetic treatment for hypotrichosis, or inadequate eyelashes, came almost accidentally, when investigators looking at its efficacy for the treatment of glaucoma noticed that patients happened to develop thicker, darker and longer eyelashes.
"In addition to observing that the medication was indeed effective in reducing eyeball pressure, the investigators noticed that patients grew very long eyelashes, so their challenge was to determine how to get the lash growth without the drop in eyeball pressure or the redness and other side effects that can occur with a direct application," Dr. Glaser says.
The solution was an applicator that provided a much smaller, pre-measured dose, applied to the eyelid rather than the eyeball. Results are typically seen in about eight to 12 weeks, and remain until the daily applications are discontinued.
In a phase 3 double-blind, placebo-controlled trial involving 278 patients, Latisse use over 16 weeks was shown to offer significantly greater improvement than a vehicle group (p < 0.0001) for measurements of eyelash prominence, darkness, thickness and length.