What is the most recommended medication for growing eyelashes?

Bimatoprost is the Most Recommended Medication for Growing Eyelashes

Bimatoprost 0.03% solution (Latisse®) is the most effective and FDA-approved medication for growing eyelashes in patients with hypotrichosis. 1 This prostaglandin analog has demonstrated significant efficacy in increasing eyelash length, thickness, and darkness with a favorable safety profile when applied to the eyelid margin.

Evidence for Bimatoprost Efficacy

Clinical Trial Results

• In a 5-month randomized controlled trial, 78.1% of subjects treated with bimatoprost 0.03% demonstrated at least a 1-grade increase in global eyelash assessment score compared to only 18.4% in the vehicle group (p<0.0001) 2
• Bimatoprost produced statistically significant increases in:
  • Eyelash length
  • Eyelash thickness
  • Eyelash darkness
• All subjects in another prospective study noticed favorable changes in their eyelashes after 12 weeks of treatment 3
• A separate study showed mean eyelash length increase of 0.77mm after 6 months of bimatoprost gel use 4

Mechanism of Action

Bimatoprost works by:

1. Stimulating resting hair follicles (telogen phase) to enter the growth phase (anagen phase)
2. Prolonging the anagen phase of eyelashes
3. This dual action leads to increased length, thickness, and darkness of eyelashes 1

Application Method

• Apply once daily to the upper eyelid margin at the base of the eyelashes
• Contact lenses should be removed prior to application and may be reinserted 15 minutes after 5
• Results typically become noticeable after 8-12 weeks of consistent use

Safety Considerations

Common Side Effects

• Conjunctival hyperemia (redness) - most common side effect 2
• Eyelid skin darkening (may be reversible upon discontinuation) 5
• Increased iris pigmentation (may be permanent) 5

Important Precautions

• Use with caution in patients with history of intraocular inflammation
• Avoid allowing the applicator tip to contact the eye or surrounding structures to prevent contamination 5
• Monitor for changes in iris pigmentation, which may be permanent even after discontinuation

Limitations and Special Populations

• Effectiveness is limited in patients with complete eyelash loss due to alopecia totalis or universalis - bimatoprost affects existing eyelashes but may not induce new growth in these conditions 6
• Not well studied in patients with eyelash loss due to chemotherapy or radiation
• Safety profile is generally good, but patients should be monitored for potential ocular side effects

Alternative Options

While bimatoprost is the most effective option, other treatments include:

• Minoxidil 5% - may aid in hair regrowth but less evidence specifically for eyelashes 7
• Latanoprost - another prostaglandin analog with similar effects but less robust evidence 7

Clinical Pearl

For optimal results and safety, patients should be instructed to:

• Apply only to the upper eyelid margin
• Use a clean applicator for each eye to prevent cross-contamination
• Be patient as results develop gradually over several weeks
• Continue regular use to maintain results, as effects may diminish after discontinuation

Bimatoprost represents the most evidence-based approach to eyelash enhancement with a favorable risk-benefit profile when used as directed.