I am sure you have seen the commercials on TV with Brooke Shields, actress and former model, who talks about using a prescription eyelash-growing serum. In one People magazine article Shields confesses that she destroyed her eyelashes by wearing false ones continuously for years on Broadway. Yet is there such a thing as having “inadequate lashes”? Does this condition need to be treated or is this simply a cosmetic issue? To help answer these questions and more we have asked for the expertise of our consulting dermatologist, Dr. Lawrence Green, a practicing dermatologist and Assistant Clinical Professor of Dermatology at the George Washington University School of Medicine.

To find out more about Dr. Green please visit his website: Aesthetics, Skin Care, and Dermasurgery.

Question: The medical term for lack of lashes is hypotrichosis. What is hypotrichosis and what causes this condition? Is it ever harmful for the individual who has this?

Dr. Green: Hypotrichosis means a decrease in the number of eyelashes when compared to the normal level. Eyelashes do help protect the eye, but you don’t need to have a full amount to have adequate protection. Complete absence of eyelashes does leave your eyes more open to the environment and without protection. Hypotrichosis, or decrease in number of eyelashes, can be caused by autoimmune diseases (such as alopecia areata), trauma, someone with a habit of pulling them out on their own, some unusual infections (like leprosy), hormone problems (such as low thyroid levels), chemotherapy, radiation, or just plain aging normally.

Question: How is hypotrichosis treated? What are the options?

Dr. Green: Treatment of hypotrichosis centers on finding out the cause (of which some are listed above) and then treating it-if possible. Also, when possible, the use of an eyelash growth enhancer such as Latisse can help improve this condition. Latisse is thought to work by increasing the amount of eyelashes in the active growth phase, compared to them staying in the inactive resting stage.

Question: Will insurance cover the use of Latisse? Or is this considered a cosmetic concern rather than a medical one?

Dr. Green: Unfortunately, insurances do not cover the use of Latisse-even if you are using it to help improve an autoimmune disease like alopecia areata. This is because the FDA has approved the use of Latisse only for cosmetic reasons (ie to make normal eyelashes fuller). Although Latisse may help conditions like alopecia areata, there is no proof of this from clinical trials, yet. Therefore, without proof, the FDA can only approve of Latisse’s cosmetic use. And insurance companies do not cover cosmetic products.

Question: What are the side effects of using this treatment?

Dr. Green: Any side effects of Latisse applied to the eyelids are unusual, especially if it is applied carefully, just as your doctor tells you. Some of the occasional adverse events include: eye itching, redness of the conjunctiva, darkening of the skin around the eye, redness or eye irritation, and dry eye symptoms. If you do not consistently apply Latisse carefully to the lashes and it gets in your eye, there is also a risk of permanently darkening of the iris in the eye.