Cosmetic Dermatology Expert Opinion: Latisse

A recent Los Angeles Times article, "Latisse lash lengthener has its fans and detractors" looked at patient's satisfaction with Latisse® (bimatropost) for eyelash growth, and recent news regarding possible side effects.

Latisse® (bimatropost) is applied once a day, usually at night, to the eyelashes with a disposable eyelash brush that dispenses the recommended dose. Results are usually reported 4 to 6 weeks later, with full results seen after 12 to 16 weeks.

One satisfied Latisse patient was quoted saying, "It does what it says it's going to do and my lashes look nice and healthy. It gives me a more youthful appearance. Younger gals have gorgeous lashes, and now I don't have to wear false lashes."

Nonetheless, concern about possible side effects continues. Besides stimulating eyelash growth, the drug can cause eye redness, itchiness, irritation, infection, darkening of the skin around the application area. A possible change in eye color is also reported, particularly in people who have any amount of brown pigment in their eyes. The story quoted one patient who reported being unable to continue Latisse® treatment due to eye irritation. More recently, some ophthalmologists are suggesting that patients have an eye exam before starting treatment.

Dr. Steve Yoelin, who is reported to have prescribed Latisse® to more than 1,500 patients, stated that he prescribes Latisse® with confidence and that it makes his patients happy. He dismisses safety concerns, saying that, in his experience, side effects are minimal. Dr. Yoelin also pointed out that the active ingredient of Latisse®, bimatropost, isn't applied directly into the eye as it is when used to treat glaucoma and that cosmetic use requires just 5% of the dose used to treat glaucoma. "In the four years I've been using this drug for eyelash growth, I have not seen any iris color change," he says.

DERMATOLOGIST EXPERT OPINIONS

Dr. Christine Brown, M.D.(December 9, 2009) "Eye exams are not required by the FDA nor dermatologists. The incidence of side effects, such as pigmentation of the eye or surrounding skin is exceptionally rare. The most common side effect is redness which is a transient problem. Latisse works well, especially under the supervision of a dermatologist."

Christine Brown, M.D., dermatologist. Visit Dr. Brown's practice Website, Christine Brown, M.D.

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Amy McMichael, M.D., Dermatologist(December 10, 2009) "The data for the safety of Latisse is well studied since this medication has been around in eyedrop form for more than 8 years. The post-marketing studies of Lumigan and the more recent FDA pivotal studies for Latisse underscore the safety of the drug. Anecdotely, many patients who used Lumigan for glaucoma in one eye only have applied the Lumigan to the other eye to even out the lash growth--under the supervision of their ophthalmologist and without unwanted side effects.

"Another factor is that patients do not apply Latisse into the eye, but to the top eyelid only. This allows for little penetration into the eye itself and significantly less medication exposure overall.

"As with any medication applied to or around the eye, it is important to note if there is irritation with application and to seek the care of an ophthalmologist prior to starting the medication if you have known underlying vision or eye problems. At present, my patients are thrilled with the results of Latisse. So far, none have experienced any side effects. I simply ask a brief history of eye health, and if there is any concerning problem, I ask them to consult their ophthamologist prior to prescribing.

"Reports of eye color change have been noted with Lumigan, not with Latisse, so far in clinical studies. But there is a very small possibility of this happening in those patients who have light eyecolor, but with some flecks of pigment. Those with crystal blue eyes do not seem to be at risk."

Amy McMichael, M.D., Dermatologist. Visit The Department of Dermatology at Wake Forest University School of Medicine.

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Marta Rendon, M.D., Dermatologist(January 19, 2010) "Although few studies have shown that at the current dose of Latisse no significant side effects were reported, I would tend to agree with ophthalmologists that until there is more data, an eye exam would be appropriate, especially if there is any history of eye conditions."

Marta Rendon, M.D., Dermatologist. Visit the Dermatology and Aesthetic Center.

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Jeffrey Ellis, M.D., Dermatologist(January 5, 2010) "We have seen very good success in hair growth from the use of prostaglandin analogues, like Latisse. We do not think that it is necessary to have a routine ophthalmologic examination before applying this medication to the eyelash margin. However, as the prescribing physician, it is important to know and educate patients about potential complications from this medication. One of the most troubling can be a permanent color change to the iris, especially notable in patients with light blue or hazel eye color."

Jeffrey Ellis M.D., Dermatologist. Visit Belaray Dermatology.

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Jeff Dover, M.D., Dermatologist

(January 20, 2010) "We have had excellent results with Latisse thus far. This prostaglandin medication otherwise known as Bimatoprost was first used to treat glaucoma. Latisse was first prescribed as an eye drop medication and a beneficial side effects that was noted was increased eyelash length and thickness.

"Allergen, one of the leading pharmaceutical companies in America, which first developed the product for glaucoma took advantage of this beneficial side effect and studied this agent  to see just how well it worked as a lash enhancer.

"Painted on the upper eyelash in a very large study completed last year in the U.S., it increased the length of eyelashes an average of 30% and doubled their thickness. Most of the individuals in the study were very pleased with the outcome.

"Latisse was approved earlier this year by the FDA and we’ve been using it in our practice now for several months. Patients have been uniformly very pleased. Their lashes get longer and thicker and become much more appealing looking. Only approved for use to help to thicken eyebrows we have treated a few patients who have thin eyebrows and they so far been quite please with the results.

"When treating eyelashes, Latisse is applied to the upper eyelashes only. It should not be applied directly into the eye. It takes about 8 weeks to notice results and it can take up to sixteen weeks to see the full effect of the medication. When you stop using Latisse the eyelashes eventually go back to the way they were prior to treatment.

"Latisse has a few side effects. It can cause a brown discoloration of the eyelid skin. This coloration is reversible but in one of my patients in whom this side effect happened, she eventually stopped the Latisse because the brown discoloration was less appealing than the beneficial effect that the agent produced in lengthening and thickening her eyelashes.

"Latisse can also cause an irritation of the eyelid skin so if you have very sensitive skin, be a bit cautious when you first starting.

"The worst potential side effect is that Latisse can cause a permanent brown discoloration of blue eyes. As long as the drops are applied just to the eyelashes and not into the eye itself this should not happen. However, if you do have blue eyes and you’re fearful that this might happen, I would stay away from this product. Otherwise I think it is a wonderful new addition to our options for so many women in America whose eyelashes are not quite as thick as they would like."

Jeff Dover, M.D., Dermatologist. Visit SkinCare Physicians of Chestnut Hill.

Dr. Dover is the author of "The Youth Equation: Take 10 Years Off Your Face".

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Jeffrey Poole, M.D., Dermatologist(January 20, 2010) "My patients have been thrilled with Latisse, being both very effective and rapid in onset. I have had virtually no complaints from patients to date, beyond some occasional eyelid irritation.

"I do not require eye exams before or during treatment. The FDA does not recommend this, and current data does not support this. Despite this, if a patient has any history of ocular disease, I recommend they seek approval from their Ophthalmologist prior to the use of Latisse.

"Similarly, if a patient develops ocular issues while on the medicine, I would seek the assistance of my colleagues in Ophthalmology."

Jeffrey Poole, M.D., Dermatologist. Visit Poole Dermatology.

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Nelson Lee Novick, M.D., Dermatologist(January 21, 2010) "In my experience, Latisse has proven to be an effective and relatively easy-to-use product for promoting true eyelash growth and lengthening. Since there is no FDA requirement for prior ophthalmologic examination, and reports of eye problems quite rare, most of us who prescribe the product routinely do not request an eye check prior to initiating treatment. However, as a rule, I am cautious about prescribing it to anyone with a history of eye inflammation of any kind, rosacea (an adult acne condition that is sometimes associated with eyelid irritation), and dry eyes. In such instances, I typically insist that they get clearance from their eye doctors before beginning Latisse."

Nelson Lee Novick, M.D., Dermatologist. Visit Younger Looking Without Surgery.

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William Paronish, M.D., Dermatologist(January 23, 2010) "At Evolution Medical Spa we have had a very significant exposure to patients treated with Latisse and have been very pleased not only with the results but also with the paucity of problems associated with its use.

"We screen all patients in our office and extensively review use and precautions. We do not suggest an ophthalmology clearance unless our patients have significant underlying eye related diseases or medical concerns that might lead to eye complications. Across the board, our results have been excellent, resulting in a very happy group of patients. Side effects have been minimal. Mild irritation is very common the first week but quickly resolves spontaneously.

"The only occasions in which I've had to stop Latisse so far has been because of darkening in the lateral cheek region that resulted from the lid application of the product, which resolved quickly with discontinuation of the product and returned with retrial. Of course, this problem occurred in my wife!! Otherwise, Latisse is a great option for our patients that has proven very safe and effective in our hands at Evolution Medical Spa."

William Paronish, M.D., Physician. Visit Evolution Medical Spa.

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© 2010 Vivacare.

Last updated: January 23, 2010.

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