eyelashes

Want fuller lashes? Until recently, your only option was faking it with mascara or extensions. But a few new procedures and products are promising the real thing or close to it. How successful are they?

Eyelash transplants

Think hair transplants, but on the eyelid. It's a minimally invasive procedure that transplants hair follicles from the back of your neck.

The main downside is somewhat comical -- the transplanted lashes continue to grow like normal head hair, and need to be regularly trimmed. In some before/after pictures I've seen, the untrimmed lashes have a disturbing, spider-legs look. They also tend to come in at an odd angle and must be curled.

Finally, the texture of the lashes also seems off, in that head hair doesn't taper at the ends like eyelashes do.

Here's a surgeon who has achieved a much higher level of realism.

Eyelash growth topical treatments

Still, if you're creeped out like I am by the idea of head hair growing out of your eyelids, there's a more natural alternative -- but not without its own drawbacks. In 2005 beauty manufacturer Jan Marini released Age Intervention Eye Lash, a little tube of fluid with an applicator brush, it flew off the shelves because it did something remarkable compared to most over the counter beauty products: it worked.

It's rare to see an OTC product get such unanimously rave reviews. Within months of its release, the internet buzz was palpable. Seemingly every single person who used the product reported sprouting lashes by the baleful within weeks. Many said their lashes were so long they touched their brows and even had to regularly trim them.

Here are some impressive before and after pictures I stumbled across on the web. They depict the changes after 3 months on Jan Marini's original formula. Here's the full thread with more pictures.

You might chalk this up to empty hype, but there's actually some science to back up Jan Marini's claims. Their secret was an ingredient similar to a drug found in eyedrops for Glaucoma patients. These chemicals belong to a class of drugs called prostaglandin analogs, which apparently have the side effect of stimulating eyelash growth.

After the media picked up on the buzz, the company ran into trouble. It isn't exactly clear what went down, but there is speculation the FDA caught on that the company was selling a drug over the counter (which is illegal) and forced it to pull the product. Another possibility is that Jan Marini may have revised the product because a larger company already had a patent on the "special ingredient" for the same use (hair growth). Jan Marini quickly replaced its product with a new version, and mailed it, along with an apology, to the long line of women who had backordered the original.

But the new JM lacked the very ingredient that made the original effective, and any JM users converted to another product, supposedly containing the same Glaucoma drug: (the now discontinued) Revitalash.

Susan Zavell, who runs a skin spa in South Carolina with her physician husband, was kind enough to give me permission to post these before/after Revitalash shots of her right eye. Susan is a frequent contributor on this board, and a trustworthy source as far as I know. The photos are great because they are so high res. She claims to be wearing no mascara in them, and they depict a difference of 16 weeks.

Manufacturer Athena pulled Revitalash off the market in November because of health concerns and patent conflicts with another manufacturer, Allergan. For many eyelash-obsessed women it was still worth the risk. Some have sought out leftover tubes online, or convinced their doctors to write them prescriptions for a similar Glaucoma drug called Lumigan. Allergan is unveiling their own product based on Lumigan called Lumilash.

I did a little research into the original Glaucoma drugs that launched this craze, to verify that they really do promote eyelash growth. They belong to a class of drugs called prostaglandin-type agents. One study on Latanoprost, a prostoglandin drug, found that among 43 patients, there was a mean increase in lash length of the lower eyelid of 19.5 percent in the latanoprost-treated eye (range, 0%-36%). The two patients who had no measurable eyelash-length change exhibited an increase in the number of eyelashes.

Differences in hair appearance between the latanoprost-treated eye and the nontreated control eye included increased number, length, thickness, curvature, and pigmentation.

The brand description of Lumigan, a very similar prostaglandin type agent, also reports eyelash growth as a common side effect.

Pretty persuasive. But my online research also unearthed a few disturbing side effects. In some patients, the prostaglandins actually darken the pigment of the iris and skin surrounding the eyes. After discontinuation of the drug, the skin returns to its normal shade, but changes to the iris are permanent. Eek. Here's what the study on Lumigan had to say:

may gradually change eye color, increasing the amount of brown pigment in the iris by increasing the number of melanosomes (pigment granules) in melanocytes....The change in iris color occurs slowly and may not be noticeable for several months to years.

How common is this side effect? I found an article that compiled the findings from various studies on two different prostaglandin-type agent drugs, called Bimatoprost (brandname Lumigan) and Travoprost (brand name Travatan) about the prevalence of sideeffects.

With Bimatoprost, the very ingredient contained in Revitalash, pigmentation of the iris was reported in 2% of the patients:

Typically the brown pigmentation around the pupil is expected to spread concentrically towards the periphery in affected eyes, but the entire iris or parts of it may also become more brownish. Until more information about increased brown pigmentation is available, patients should be examined regularly and, depending on the clinical situation, treatment may be stopped if increased pigmentation ensues. The increase in brown iris pigment is not expected to progress further upon discontinuation of treatment, but the resultant color change is permanent.

For Travoprost, changes in pigmentation of the iris occurred in 1% to 4% of patients.

There are health risks as well. Here's a brief overview of the Bimatoprost side effects:

Conjunctival hyperemia was the most frequently experienced adverse event in the clinical studies of bimatoprost, occurring in 45% of patients and resulting in discontinuation of treatment in 3%. Adverse events occurring in 15% to 45% of patients include growth of eyelashes and ocular pruritus, and between 3% and 10% of patients experienced ocular dryness, visual disturbance, ocular burning, foreign body sensation, eye pain, pigmentation of the periocular skin, blepharitis, cataract, superficial punctate keratitis, eyelid erythema, ocular irritation, and eyelash darkening.

Bear in mind that the eyelash products apparently contain synthesases of the Glaucoma chemicals, not the active drugs that were studied in the literature cited above. As synethesases are generally weaker than active drugs, the side effects may be less pronounced including eyelash growth itself. Then again it is telling that Athena voluntarily pulled its own product. I also found quite a few anecdotes online of people who reported skin discoloration after using the products.

The bottom line, as always, is caveat emptor. If you decide to use this product, treat it with the same caution that you would any prescription drug. This means paying special attention to any changes in the health or appearance of your eyes and the surrounding skin. It might also help to periodically take pictures with a high resolution digital camera. Personally, I wouldn't mess with my eyes.