Understanding Latisse and its Mechanism
Latisse is a prescription topical treatment used to grow eyelashes, making them longer, thicker, and darker. Its active ingredient is bimatoprost, a synthetic prostaglandin analog. The medication works by extending the anagen (growth) phase of the eyelash hair cycle. This causes more hairs to grow and for a longer duration, resulting in more prominent lashes. While highly effective for many users, its mechanism can also lead to unintended and sometimes serious side effects. Knowing the risks and how to apply the medication correctly can help minimize adverse reactions.
Common and Reversible Side Effects
Clinical trials have shown that certain side effects occur in a small percentage of patients, typically less than 4%. Most of these are considered mild and will likely resolve after discontinuing the treatment.
- Itching and Redness: Some of the most frequently reported side effects are an itching sensation (pruritus) and redness (hyperemia) in and around the eyes. This can be due to the product's active ingredient or the preservative, benzalkonium chloride.
- Dry Eye Symptoms: Latisse can sometimes lead to eye dryness and irritation. The preservative in the solution can contribute to this, and if it becomes bothersome, an eye lubricant may be recommended by a doctor.
- Eyelid Skin Darkening: The skin on and around the eyelid can become darker in color. This is caused by an increase in melanin production in the pigment cells. This pigmentation is typically reversible within several weeks or months of stopping the medication.
- Increased Tearing: Some users have reported excessive tearing as a side effect.
Less Common but Potentially Serious Side Effects
While less frequent, some side effects associated with Latisse are more significant and should be taken seriously. Some of these risks come from the fact that bimatoprost was originally a glaucoma medication (branded as Lumigan), and its effects on the eye's internal workings can persist even with topical application to the lashes.
- Permanent Iris Pigmentation: The most feared and concerning side effect is a change in the color of the iris, the colored part of the eye. This permanent increase in brown pigmentation is more common in people with hazel or green eyes and is very infrequent in Latisse users, although it is well-documented in patients using the glaucoma formulation. Because Latisse is applied externally to the lashes rather than directly into the eye, the risk is much lower, but it is not zero. The color change will likely not reverse even after treatment stops.
- Abnormal Hair Growth: If the solution repeatedly comes into contact with skin outside the intended treatment area, such as the cheeks or forehead, it can cause unwanted hair growth. This highlights the importance of precise application and blotting any excess liquid.
- Deepening of the Eyelid Sulcus: A rare side effect sometimes referred to as “sunken eyes,” this involves periorbital fat loss, which can lead to a hollowed-out appearance around the eyes.
- Decreased Intraocular Pressure (IOP): The active ingredient in Latisse can lower the pressure inside the eye. For patients already being treated for glaucoma with other prostaglandin-related medications, using Latisse must be done under strict doctor supervision to avoid potential complications.
- Eye Inflammation and Infection: Misuse, such as reusing the sterile applicators or allowing the bottle tip to become contaminated, can lead to serious eye infections like conjunctivitis. Pre-existing inflammatory conditions like uveitis or conjunctivitis also warrant caution.
Comparison of Latisse Side Effects
| Feature | Common and Reversible Side Effects | Less Common and Permanent/Serious Side Effects |
|---|---|---|
| Effect | Eye itching, redness, dryness, eyelid skin darkening, increased tearing | Permanent iris pigmentation, abnormal hair growth, lowered intraocular pressure, eye infection, deepening of eyelid sulcus |
| Incidence | Approximately 4% in clinical trials | Infrequent, but some are irreversible |
| Reversibility | Effects typically resolve weeks to months after stopping Latisse | Permanent eye color change; other effects like unwanted hair growth and eyelid darkening can reverse if caused by improper application |
| Risk Factor | Can be linked to sensitive eyes or the product's preservative | Higher risk with lighter eye colors for iris pigmentation; improper application increases other risks |
How to Minimize the Risks of Latisse
Minimizing the risk of experiencing Latisse side effects largely comes down to correct and consistent application. Following these steps, also endorsed by the American Academy of Ophthalmology, is crucial:
- Read and Follow Instructions: Always read the product information leaflet and adhere to the instructions from your prescribing doctor. Do not apply more than directed.
- Apply to Upper Eyelashes Only: Latisse is only intended for the upper eyelid margin where the lashes meet the skin. The blinking process distributes a small amount to the lower lashes naturally. Never apply it directly to the lower lid.
- Use a Single Applicator Per Eye: To prevent cross-contamination and the risk of a serious eye infection, use a new sterile applicator for each eye and discard it immediately after use.
- Blot Excess Solution: After applying, use a clean tissue to blot any excess solution that may have run onto the cheek or other facial areas to prevent unwanted hair growth.
- Remove Contacts: If you wear contact lenses, remove them before applying Latisse and wait at least 15 minutes before reinserting them.
- Avoid Contamination: Do not let the bottle tip or applicator come into contact with your fingers or any other surface.
- Consult Your Doctor: Inform your physician if you experience any persistent or severe side effects. Immediately report any new ocular conditions, changes in vision, or signs of infection.
Who Should Not Use Latisse?
Latisse is not for everyone. Certain individuals should avoid it or use it with extreme caution after consulting a medical professional.
- Pregnant or Nursing Individuals: The safety of bimatoprost during pregnancy and lactation has not been adequately evaluated.
- Individuals with Eye Pressure Problems: Those with a history of abnormal intraocular pressure or those using glaucoma medications should use Latisse only under the close supervision of a physician.
- People with Active Eye Conditions: If you have an active eye infection, inflammation (like uveitis or conjunctivitis), or are at risk for macular edema, Latisse may not be appropriate.
- Allergic Individuals: Do not use Latisse if you are allergic to any of its ingredients.
Conclusion
Latisse offers a clinically proven way to achieve longer, thicker, and darker eyelashes. However, prospective users must be fully aware of what are the bad side effects of Latisse, ranging from common, reversible irritations like redness and itching to rare, potentially permanent changes like increased iris pigmentation. Many risks can be mitigated by adhering strictly to the proper application technique and only using the product under a doctor's care. Before starting treatment, discuss all potential benefits and risks with your doctor to make an informed decision based on your individual eye health.
