Understanding Restasis and Its Purpose
Restasis (cyclosporine ophthalmic emulsion 0.05%) is a prescription medication primarily used to treat keratoconjunctivitis sicca, more commonly known as chronic dry eye disease [1.7.1]. It's designed for patients whose tear production is suppressed due to ocular inflammation [1.7.5]. Unlike over-the-counter artificial tears that provide temporary lubrication, Restasis is a calcineurin inhibitor that acts as a partial immunomodulator [1.6.3, 1.7.5]. By reducing the underlying inflammation that impairs tear gland function, it helps your body increase its natural tear production over time [1.6.6]. The typical dosage is one drop in each eye, administered twice daily, approximately 12 hours apart [1.6.1].
The Active Ingredient: Cyclosporine
The active ingredient in Restasis is cyclosporine [1.6.1]. Originally used as an immunosuppressant to prevent organ rejection in transplant patients, cyclosporine works by inhibiting the activity of T-cells, a type of white blood cell involved in inflammatory responses [1.6.3, 1.6.5]. In the context of dry eye, it calms the immune response on the ocular surface, allowing the tear glands to function more normally [1.7.1]. It is this active ingredient that is the source of the questions surrounding hair growth.
Does Restasis Cause Hair Growth or Eyelash Growth?
The direct answer based on clinical trials and official prescribing information is that Restasis is not expected to cause hair growth or loss [1.2.1, 1.2.4]. Hair growth, or more specifically hypertrichosis (excessive hair growth), is a well-documented side effect of oral or systemic cyclosporine—the form taken by mouth for conditions like organ transplants or severe autoimmune diseases [1.4.1, 1.4.3]. In these cases, the drug circulates throughout the body at a much higher concentration.
When Restasis is administered as an eye drop, very little of the drug is absorbed into the bloodstream [1.2.4]. This minimal systemic absorption means that side effects common with oral cyclosporine, such as high blood pressure, kidney problems, or generalized hair growth, are not expected with the ophthalmic emulsion [1.2.4].
That said, there has been at least one case report in medical literature of a patient experiencing eyelash growth after using cyclosporine 0.05% ophthalmic emulsion [1.2.6]. However, this is considered a rare occurrence and is not listed as a common or expected side effect [1.5.2]. For context, unwanted hair growth (hypertrichosis) has been observed in up to 94.6% of patients on long-term oral cyclosporine therapy in one study [1.4.2]. The distinction in administration route (topical eye drop vs. oral pill) is critical.
Systemic Cyclosporine and Hair
Oral cyclosporine can induce and prolong the anagen (growth) phase of the hair follicle cycle [1.4.5]. This effect is dose-dependent and is more commonly observed in children and adolescents [1.4.2, 1.4.4]. The mechanism is thought to involve the stimulation of hair follicle stem cells and blocking the signals that tell hair to enter the catagen (transitional) phase [1.4.5]. In some rare cases, oral cyclosporine has even been reported to cause hair repigmentation, turning white or gray hair back to its original color [1.3.2]. It is important to reiterate that these effects are associated with the high systemic concentrations achieved with oral therapy, not the low, localized dose used in Restasis eye drops.
Comparison of Ocular Treatments
To understand the side effect profile of Restasis, it's helpful to compare it with other treatments for eye conditions.
| Feature | Restasis (Cyclosporine) | Xiidra (Lifitegrast) | Latisse (Bimatoprost) |
|---|---|---|---|
| Primary Use | Increases tear production in chronic dry eye [1.7.3] | Treats the signs and symptoms of dry eye [1.7.2] | Treats hypotrichosis (inadequate eyelashes), making them longer, thicker, and darker [1.9.1] |
| Mechanism | Calcineurin inhibitor; reduces inflammation [1.6.3] | LFA-1 antagonist; blocks T-cell interaction [1.8.3] | Prostaglandin analog; extends hair growth phase [1.9.2] |
| Hair/Eyelash Growth | Not an expected side effect; very rare reports of eyelash growth [1.2.6, 1.5.2] | Not a known side effect [1.8.1] | Its primary, intended effect [1.9.1] |
| Common Side Effects | Ocular burning (most common), eye redness, watery eyes, eye pain [1.5.6] | Eye irritation, unusual taste sensation (dysgeusia), blurred vision [1.8.3] | Eye itching, eye redness, skin hyperpigmentation around the eye [1.9.3] |
Managing Side Effects and Expectations
The most common side effect reported by Restasis users is a temporary burning or stinging sensation upon instillation, which occurred in about 17% of patients in clinical trials [1.5.6]. This sensation usually subsides with continued use [1.5.4]. Other less common side effects (reported in 1-5% of patients) include eye redness, discharge, watery eyes, eye pain, and blurred vision [1.5.6].
If you are using Restasis and are concerned about any changes, including to your eyelashes, it is important to speak with your ophthalmologist. Do not touch the vial tip to your eye or other surfaces to avoid contamination and potential eye injury [1.7.4]. If you wear contact lenses, they should be removed before using Restasis and can be reinserted 15 minutes after administration [1.7.3].
Conclusion
While the active ingredient in Restasis, cyclosporine, is strongly linked to hair growth when taken orally, the same is not true for the ophthalmic formulation used to treat dry eye. Because Restasis is an eye drop with very low systemic absorption, hair growth is not a recognized or expected side effect [1.2.4]. The overwhelming body of evidence shows that the primary side effects are localized to the eye, such as a temporary burning sensation [1.5.6]. While an isolated case of eyelash growth has been reported, it is not a common occurrence and should not be a primary concern for patients considering or using this medication for chronic dry eye.
For more information on the proper use and full side effect profile, you can review the official prescribing information on the U.S. Food and Drug Administration's website: FDA - Restasis Prescribing Information
