Long, thick eyelashes are often associated with beauty and can enhance the appearance of the eyes. While some individuals are naturally blessed with lush lashes, others seek ways to achieve this look. This article explores the various causes of thick eyelashes, including natural factors, medical conditions, and the use of certain medications, as well as potential treatments and important considerations.
Eyelashes, like other hair on the body, have a growth cycle consisting of an anagen (growth) phase, a catagen (transitional) phase, and a telogen (resting) phase. The length of the anagen phase, which lasts approximately 30 days, determines the potential length of the eyelashes. The entire cycle is completed in about 5 to 6 months. Typically, the eyelashes of the upper eyelids range from 8 to 12 mm in length.
An increase in length, curling, pigmentation, or thickness of eyelashes is termed eyelash trichomegaly. Eyelash trichomegaly is defined as increase in length (12 mm or more), curling, pigmentation or thickness of eyelashes. The term “trichomegaly” was first used by Gray in 1944. Growth of eyelashes to a length >12 mm or thickening, increased pigmentation, or curling of hair is termed trichomegaly.
Eyelash trichomegaly may be inherited as an isolated trait or as a feature of a congenital syndrome such as Oliver-McFarlane syndrome or oculocutaneous albinism. Various causes of trichomegaly include congenital, familial, acquired and drugs. It can manifest at birth or present later in life. It can form a part of spectrum of manifestations of some congenital syndromes.
Acquired conditions associated with eyelash trichomegaly include HIV infection, connective tissue disorders, and the administration of drugs such as cyclosporine and topical latanoprost. In HIV trichomegaly has been observed to occur in association with late-stage disease. Eyelash length has been shown to normalize as patients respond to anti-retroviral therapy. However, no association has been seen between the length of eyelashes and either the severity or prognosis of HIV infection.
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Several medications can induce eyelash trichomegaly as a side effect. These include:
Topical Latanoprost: Acquired eyelash trichomegaly has been reported with topical use of latanoprost. The effects of prostaglandin F2-alpha and latanoprost have been found to stimulate not only murine hair follicles and follicular melanocytes but also the conversion from telogen to anagen phase. This side effect has also been tried for cosmetic effects.
Epidermal Growth Factor Receptor (EGFR) Inhibitors: Epidermal growth factor receptor inhibitors are used to treat a variety of solid tumors like bladder, breast, colorectal, head and neck, lung, and ovarian cancers.
Cyclosporine
Although it tends to have a benign course, it can lead to psychological disturbances and can result in corneal abrasions and visual disturbances, if trichiasis occurs. The onset of eyelash trichomegaly is an important point for delineating a specific etiology.
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Latisse is an FDA-approved topical solution of 0.03% bimatoprost ophthalmic solution used to grow and thicken eyelashes. While you sleep, Latisse accelerates the growth rate of your eyelashes so they become longer and sometimes darker. Because Latisse works with the natural growth rate of your eyelashes, you don’t see a change overnight. You should notice thicker, longer, and possibly darker lashes by week 16. You must continue to use Latisse daily to maintain your new lash growth.
Latisse contains bimatoprost, a prostaglandin analogue. On its own, bimatoprost is a prostaglandin - a fatty acid that has hormone-like effects on the body. Bimatoprost is believed to prolong the anagen phase of the eyelash growth cycle, allowing the lashes to grow longer, thicker, and darker.
Before application, wash your hands and face, removing any makeup. The solution is used once nightly and is placed at the roots of the upper eyelashes with a single-use applicator. Food and Drug Administration (FDA) for use on the upper eyelashes only. It may spread to the lower lashes as you blink, but the primary effect will be on the upper eyelashes only. Results usually appear within two months. If you stop using eyelash grower, your eyelashes will gradually return to their original state.
The FDA approved Latisse for eyelash growth in 2008, and it’s deemed safe for adults. However, like any medication, Latisse can have potential side effects.
Common Side Effects: Patients can experience eyelid itching, dry eye, eyelid darkening and bloodshot eyes. Perry says.
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Less Common but Serious Side Effects: It should be noted however that this fatty acid can cause light irises to become darker over the years. For example, it can cause permanent brown discoloration of the iris over months or years of use. Another side effect is known as periorbital fat atrophy - a hollowing-out appearance of the eyelids. This fat atrophy is permanent and can be severe, so you should stop using it immediately if you notice symptoms.
Because bimatoprost is the main ingredient, if you have glaucoma and are already treating it with medication, consult your ophthalmologist before using Latisse, Dr. Perry says. In particular, mention if you’re already using latanoprost or travoprost. Using these drugs in combination with Latisse can increase treatment side effects. If you wear contacts and want to use Latisse, you should know that the FDA warns that your contacts can absorb the product, which can discolor your contacts.
Distichiasis (you might hear it called double eyelashes) is a rare condition where you have two rows of eyelashes. The second row might be a full set of eyelashes, or it might be one or a few. They also might be thinner or shorter than your first row of eyelashes.
There are two main ways you can get double eyelashes. If you're born with it, that's called congenital distichiasis. You can also get it later in your life. That's acquired distichiasis.
Congenital Distichiasis: Congenital distichiasis happens when a cell that's supposed to be part of the system that protects your organs -- called the epithelium -- morphs into something called a pilosebaceous unit. That includes, among other things, a hair follicle. In some cases, the cause of this form of double eyelashes is a mutation of the FOXC2 gene. It plays a role in the development of many organs and tissues before you're born. Congenital distichiasis can be a sign of a rare genetic condition called lymphedema-distichiasis syndrome (LDS). In addition to double eyelashes, LDS causes a buildup of fluid called lymphedema.
Acquired Distichiasis: Acquired distichiasis can happen if your eyelids get injured or inflamed. You might get this type of double eyelashes if you have: Damage to your eye from chemicals, Inflammation of your eyelids called blepharitis, A group of eyelid disorders called meibomian gland dysfunction (MGD) that’s also a cause of dry eye, Ocular cicatricial pemphigoid (OCP), a rare, chronic autoimmune disorder that causes scarring in your eyes, mouth, and throat, Stevens-Johnson syndrome (SJS), a rare, serious disorder that causes layers of your skin to die and shed.
If you have distichiasis, you might not have any other symptoms besides the extra lashes. But you could have: Eye pain, Swelling, Redness, Irritation, Vision loss, Sensitivity to light, Styes (small, painful bumps on your eyelid), A feeling that something is rubbing against your eye when you blink (foreign body sensation), Scarring of your cornea, the clear outer layer of your eye, An open sore on your cornea called a corneal ulcer, Droopy eyelids.
A family history of double eyelashes makes you more likely to get congenital distichiasis. There’s a higher change you’ll get acquired distichiasis if you: Are older, since some conditions that lead to this form of double eyelashes happen with age, Are a woman, since OCP is twice as likely in women, Have eyelid inflammation, Wear contacts, since they're tied to MGD.
The goal of treatment for double eyelashes is to get rid of the extra lashes or to ease any symptoms you have. Your doctor could recommend:
Argon laser thermoblation: In this treatment, lasers destroy the hair follicles that create the extra eyelashes.
Cryotherapy: Extreme cold gets rid of the extra eyelashes, as well as any tissue that causes them.
Electrolysis: This treatment uses electricity and short-wave radio frequency to remove the extra lashes.
Epilation: The extra eyelashes are plucked. This is a temporary treatment because the lashes will grow back.
Lid splitting: In this surgical procedure, your doctor will split your eyelid open so the follicles of your eyelashes are exposed. Then, they'll remove the extra eyelashes.
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