Michelle Washington reveals the science behind eyelash and eyebrow serums
Throughout history, eyelashes and eyebrows have been at the forefront of our concept of beauty. In modern times, the beautification of the eye area is as popular as ever. Trends in the shape and style of eyelashes and eyebrows have changed significantly over the decades, from the Marlene Dietrich skyscraper arches to the Cara Delevingne power brows. Despite this, long lashes and strong eyebrows have remained an intrinsic factor to many patients’ perceived idea of femininity and attractiveness, as well as playing an important role in improving their overall confidence.
Practitioners continue to hear patients bemoan the fact that their brows and lashes no longer give them the ‘wow’ factor. Age, hormones, illness, stress and genetics all influence the growth and density of lashes and brows, while some patients suffer from madarosis, the clinical loss of eyelashes and eyebrows,1 which can have a range of causes that include the menopause and systemic disorders such as hypothyroidism, lupus and alopecia areata.1
Options for artificially improving the appearance of lashes and brows include: tinting, micro pigmentation, fake eyelashes, fibres, mascara and eyelash extensions.
In extreme cases eyelash transplantation surgery is undertaken, which involves follicles being taken from the back of the scalp and implanted into the lid margin. Artificial enhancements are not everyone’s first choice of treatment, for a variety of reasons. In the case of surgery, the hair resulting from implanted follicles needs maintenance and is cost prohibitive to a lot of people, with significant risks involved.2 Similarly, the use of eyelash extensions has fallen because users have reported undesirable side effects after lengthy use.3 Since the development of glaucoma eye drops in 2001, patients and practitioners have reported, anecdotally, that a side effect of glaucoma treatment is an increased thickness, darkening and lengthening of the lashes. It was found that the key ingredient promoting the side effect of thicker, longer lashes was the Prostaglandin analogue (PG) Bimatoprost. There are different types of PGs used clinically, but those with the index F2 have captured the attention of lash serum manufacturers.4 Given consumers’ desire for long, natural lashes, Over The Counter (OTC) preparations were developed. In 2003, The Dermatology Online Journal published a paper, ‘Prostaglandin analogs (PGs) for hair growth: Great Expectations’5 anticipating the growth of OTC products in the cosmetic industry. In my experience, I have noticed a significant increase in OTC eyelash conditioning serums since 2005. Since then, cost barriers have reduced and, from my experience, it seems that many women now regard them as mandatory items within their daily grooming products. In 2012, the estimated revenue of the whole US cosmetic market was $54.89 billion5 and, with the advent of internet-based cosmetic companies, this is anticipated to increase even more.6 PG’s are hormone- like lipid compounds, which work locally as messengers between cells stimulating eyelash growth on the lid line. Testing of PGs for eyelash growth has been undertaken in both animals7 and humans8 showing the efficacy for hyportrichosis. Some countries, such as Sweden and Australia regard all PGs as medicines, thus they are banned from OTC preparations.9 Incidentally, research undertaken in Sweden in 2013 found that some manufacturers were not declaring the inclusion of a PG as an ingredient.9
Nowadays, consumers have a huge choice of OTC products to choose from with a price range that varies just as widely. Commercially available serums fall into two basic categories: those with PGs and those without. The only Food and Drug Administration (FDA) approved PG for eyelash growth is Bimatoprost, attained in 2008 following clinical trials.10
Since the development of glaucoma eye drops in 2001, patients and practitioners have reported, anecdotally, that a side effect of glaucoma treatment is an increased thickness, darkening and lengthening of the lashes
The common practice nowadays is for manufacturers to use non-prescription PGs, in conjunction with additional ingredients (e.g. peptides, vitamins, conditioning agents and minerals) as part of OTC formulations, to assist in the conditioning of the newly formed hair. Many of these OTC growth serums are not subject to FDA premarket approval and the strict regulations of pharmacological assessment and, as a result, it could be considered that their efficacy remains to be clinically substantiated. The OTC products are not marketed as growth serums and avoid government regulatory agencies. Instead they are marketed as conditioning serums and thus, treated as cosmetics. It’s important to understand that the eyelash and eyebrow follicle cycle differs from scalp hairs; the anagen phase is significantly shorter, with a longer telogen phase. The PG works to extend the growth cycle of the lash follicle and is believed to increase the percentage of active follicles. Daily application of growth/conditioning serums is typically recommended throughout the active growth phase, followed by a maintenance dosage to preserve the results. Typically, the application of a maintenance dosage would be every other day. Some products require new sterile applicators daily. In my experience, this is to preserve the integrity of the solution. The majority of OTC serums, however, are applied in the same method as liquid eyeliner. There are also a number of potential risks associated with the use of PGs, which include, but are not limited to, ocular irritation, hyperemia, iris colour change, macular edema, ocular inflammation, hyperpigmentation of the iris and lash line, erythema, contact dermatitis, dry eye, fungal infections, and interference with glaucoma therapy.11 In addition, PGs for ophthalmic use are currently classified as Pregnancy Class C. This classification means that there have been no human studies of the drug, but that animal studies have revealed some potential abnormalities.11
For safety reasons I believe that these products should be purchased from reputable clinics where you should provide a consultation and address potential side effects.
When consulting patients in the use of these products, following manufacturers’ instructions is of the upmost importance. Common safety guidelines include: application to clean dry skin, do not overdose, do not use on broken or irritated tissue, and avoid cross contamination with makeup and facial products. It is also important to increase awareness amongst consumers of counterfeit products, with unknown manufacturing standards and potential issues.
In summary, eyelash and eyebrow conditioning serums containing PGs are more likely to give patients visible results compared to those serums containing purely vitamins and conditioners. For safety reasons I believe that these products should be purchased from reputable clinics where you should provide a consultation and address potential side effects. Patients can then have their expectations managed accordingly and enjoy the experience of thicker, longer lashes and brows. Overall, we find that improved eyelashes and eyebrows can be a highly enjoyable and safe experience for most patients.