Understanding the Active Ingredient: Bimatoprost
Latisse's active ingredient is bimatoprost, a synthetic prostaglandin analog. The mechanism of action involves extending the anagen (growth) phase of the eyelash hair cycle. While this leads to longer, thicker, and darker eyelashes, it also carries medical implications, especially regarding its original purpose: lowering intraocular pressure (IOP) in glaucoma patients. This dual function is why a thorough medical evaluation is critical before beginning treatment.
Key Groups Who Should Not Use Latisse
Certain individuals are contraindicated from using Latisse due to safety concerns. A healthcare provider must carefully review a patient's medical history to ensure the treatment is safe.
Patients with Glaucoma or Ocular Hypertension
Because Latisse contains a prostaglandin analog that lowers IOP, it can interfere with other glaucoma medications. Concurrent use with drugs like Lumigan can affect the overall pressure-lowering effect. Patients with a history of elevated IOP or who are using other prostaglandin analogs must only use Latisse under the close supervision of an eye care specialist. For those without pre-existing conditions, Latisse can still cause a minor, clinically insignificant drop in IOP, but monitoring is advised for those with risk factors or a family history of glaucoma.
Pregnant and Nursing Women
The safety of Latisse during pregnancy and breastfeeding has not been established in humans. Animal studies at high doses have shown adverse effects on fetal development. Therefore, it is generally recommended that women discontinue use while pregnant or nursing as a precautionary measure. The manufacturer states it should only be used during pregnancy if the potential benefit outweighs the potential risk to the fetus.
Individuals with Active Eye Infections or Inflammation
Latisse should not be used if you have an active eye infection or inflammation, such as uveitis or conjunctivitis. Using the solution under these conditions can potentially exacerbate the inflammation and worsen the problem. The presence of benzalkonium chloride, a preservative in Latisse, can also irritate or inflame compromised eyes.
Patients with Hypersensitivity to Bimatoprost
Anyone with a known allergy or hypersensitivity to bimatoprost or other ingredients in the Latisse solution must not use the product. Allergic reactions can be severe and may include swelling of the face, lips, tongue, or throat, as well as hives.
Individuals at Risk for Macular Edema
Patients who are aphakic (lacking a lens) or pseudophakic (implanted with a lens) with a torn posterior lens capsule, as well as those with known risk factors for macular edema, should use Latisse with caution. Macular edema, a condition causing swelling in the macula of the eye, has been reported in patients using bimatoprost drops for glaucoma.
Pediatric Patients Under 18
The safety and effectiveness of Latisse for pediatric patients have not been established. Its use is not recommended for anyone under the age of 18.
After Recent Eye Surgery
If you have had recent eye surgery or experience a sudden decrease in vision, you should consult your ophthalmologist immediately before continuing Latisse. The doctor will assess your ocular health to determine if it is safe to resume use.
Potential Side Effects and Other Precautions
Beyond absolute contraindications, there are other side effects and precautions to consider:
- Permanent Iris Pigmentation: The most significant potential side effect is the development of increased brown pigmentation in the iris, which is likely permanent and can occur over months to years.
- Reversible Eyelid Skin Darkening: Darkening of the skin around the eyelids can also occur, but this typically reverses after discontinuing treatment.
- Eyelid Irritation and Redness: Common side effects include itchy eyes, eye redness, and eyelid irritation, especially upon initiation of treatment.
- Contamination: Proper application is crucial to prevent contamination. Reusing applicators or touching the bottle tip to surfaces can lead to serious eye infections.
- Unwanted Hair Growth: Excess solution that repeatedly contacts the skin can cause unwanted hair growth outside the treatment area.
Latisse vs. Over-the-Counter Eyelash Serums: A Comparison
It is important to differentiate between prescription Latisse and cosmetic serums available over-the-counter.
| Feature | Latisse (Prescription Bimatoprost) | OTC Eyelash Serums |
|---|---|---|
| Active Ingredient | Bimatoprost (a prostaglandin analog) | Peptides, vitamins, or botanical extracts |
| Mechanism | Extends the anagen (growth) phase of the eyelash hair cycle | Conditions and strengthens existing lashes, but does not stimulate growth in the same way |
| FDA Approval | Yes, specifically for eyelash growth (hypotrichosis) | No FDA approval for efficacy or safety in lash growth |
| Efficacy | Proven to grow eyelashes longer, thicker, and darker | Less clinical data backing growth; focuses on conditioning |
| Need for Medical Oversight | Required due to potential risks and side effects | Not required; sold as a cosmetic product |
| Potential Side Effects | Iris darkening, eyelid pigmentation, inflammation risks | Typically fewer side effects, but irritation is possible |
What to Do Before Starting Latisse
- Schedule an Eye Exam: Consult an ophthalmologist or healthcare provider for a comprehensive eye exam to rule out any underlying conditions.
- Review Medications: Disclose all medications you are taking, especially any eye drops or glaucoma treatments, to prevent drug interactions.
- Discuss Health History: Be open about your medical history, including any previous eye surgeries, inflammation, allergies, or plans for pregnancy or breastfeeding.
- Practice Proper Hygiene: Familiarize yourself with the application instructions to minimize risks of contamination and unwanted hair growth.
- Remove Contact Lenses: Remove contact lenses before application and wait at least 15 minutes before reinserting them.
Conclusion
Latisse is a powerful prescription medication that can effectively treat eyelash hypotrichosis, but it is not suitable for everyone. Patients with pre-existing eye conditions like glaucoma, uveitis, or macular edema risk factors face significant health risks, and pregnant or nursing women should avoid it entirely. The risk of permanent iris darkening also warrants careful consideration. By understanding these key contraindications and working closely with a healthcare professional, individuals can make an informed and safe decision about whether Latisse is the right choice for them.
Important Safety Information: Before using Latisse, consult an ophthalmologist if you have a history of elevated intraocular pressure, glaucoma, or any inflammatory eye conditions like uveitis.
Pregnancy and Nursing Warning: Use is not recommended for pregnant or nursing women due to potential risks, and it is assigned an FDA Pregnancy Category C rating. Permanent Iris Darkening: Be aware of the possibility of permanent brown pigmentation of the iris, which can occur with prolonged use. Allergy to Bimatoprost: The product is contraindicated for anyone with a known hypersensitivity to the active ingredient, bimatoprost. Risk of Infection: Always use the sterile, single-use applicators provided to avoid contamination and serious eye infections. Proper Application is Key: Only apply Latisse to the base of the upper lashes and blot any excess to avoid unwanted hair growth on other skin areas.
