A recent study in the Journal of Drugs in Dermatology (JDD) reports significant changes in the appearance of the eyelids after topical application of bimatoprost (Latisse®, Allergan, Inc, Irvine, CA). Bimatoprost is a medication used to treat glaucoma and is the active ingredient in Latisse® (topical bimatoprost 0.03%). Latisse is also used for eyelash enhancement, giving darker, longer eyelashes.
Deborah Sarnoff, MD, the author of the JDD study, discovered that after she began to use Latisse for eyelash enhancement, the overall appearance of her eyelids improved such that people were asking her if she had had eyelid surgery. Her eyelids became tighter, she had less hooding of the upper eyelids and it improved the bags of the lower eyelids (decreased the fat under the eye lids).
Good or Bad
It turns out that Opthamologists had noted these side effects of bimatoprost for many years but since so many of their patients were only using the drops in one eye it was considered a negative side effect because of the asymmetry it produced. Dr Sarnoff argues that on close inspection the treated eye appears more youthful. The side effects have been labeled Prostaglandin Associated Periorbitopathy (PAP).
The desirable side effects are:
1. Improvement of hooding and overhanging upper eyelids
2. Decrease in the fat (eye bags) surrounding both the upper and lower eyelids
3. Tightening of the lower eyelid skin.
Potential negative side effects are:
- Darkening of the iris in green or hazel colored eyes that starts at the pupil and goes outward
- Darkening of the eyelid skin
The change in eye color is irreversible or very slowly reversible over a long time. The darkening of skin is reversible upon discontinuation of the medicine.
Is Topical Eyelid Rejuvenation Right for Me?
The eyelid enhancing effects of Latisse occur when it is used as directed on the eyelid margin. The improvement can take as early as one week to detect, but may also take months or longer. And the effects may be different from one eye to another.
Patients who may not be candidates for this treatment are:
- Those who already have deep set eyes and/or who have already undergone blepharoplasty or eyelid surgery with removal of fat pads.
- People with green or hazel eyes, who are not willing to accept the possibility of eye color darkening.
Good candidates for eyelid rejuvenation with Latisse are:
- Those with excessive upper eyelid skin with hooding
- People with puffiness of upper and lower eyelids.
Getting Started
It is important to start Latisse under the guidance of your Dermatologist, Ophthalmologist or Cosmetic Physician who can take before pictures and monitor your progress. When the desirable effects occur from daily use of Latisse it is recommended to reduce treatment from daily to 2-3 x per week. If rare complications are noted such as a lowering of upper eyelid (called ptosis) or too much lowering of lower lid (called scleral show) then discontinuation of treatment may be warranted.
While Latisse is available now, there are other new topical treatments being developed. A new ointment, known currently as XAF5 by Topkine Therapeutics, is being tested and looks to be very promising for reduction of excess eyelid fat or “eye bags”.
The future looks bright for anti aging, with the development of safe topical products. It is a good time to be in your Prime!
