From Glaucoma to Glamor: The Dual Role of Bimatoprost in Eye Care and Cosmetics

written by Dr. Bolanle Aina - Feb 19, 2024

One of the most intriguing things about science is that you never know what you will discover. There are always surprises. Therefore, scientists are always on their toes keeping watch for what their next discovery could be. Bimatoprost is one of the most common eye drops used to reduce eye pressure in glaucoma patients. During the clinical trial of bimatoprost for Glaucoma, it was discovered that the drug also increases growth of eyelashes.

Fast forward to today, the use of bimatoprost has been adopted in the cosmetic world for the thickening of eyelashes and in the treatment of hypotrichosis, which is poor hair growth. Here we have the case of the same drug but with different purposes. This is just one of many examples where drug side effects are being exploited in a positive way.

From Glaucoma to Glamor: The Dual Role of Bimatoprost in Eye Care and Cosmetics

Ophthalmologists prescribe prostaglandin analogs like bimatoprost, latanoprost and travoprost to treat glaucoma and ocular hypertension. However, bimatoprost also finds special application in cosmetic dermatology due to its desirable side effects in glaucoma patients.

Latisse vs Vistitan

The active ingredient of ophthalmic and cosmetic preparations is the same. But that’s not to assume you can swap them for each other. Essentially, Latisse and Vistitan contain the same drug but the labeling, packaging and how to use them differ significantly. For instance, Latisse (the cosmetic formulation) comes with brushes for application to the upper eyelid margin. Vistitan (the eye drop) does not have this special applicator and comes as regular eye drops. Experts advise against off-label use of both products.

This article discusses the dual role of bimatoprost and how to use it safely in glaucoma and eyelash growth treatment.

Bimatoprost for Glaucoma: What You Need to Know

Your eyes produce a clear, watery liquid called aqueous humor. This liquid nourishes the eyes and keeps them inflated. An equal amount of this liquid flows out of the eyes. But in glaucoma, an excess of this liquid is produced or there’s a problem with the outflow. Such imbalance causes pressure to build up in the eye, which may eventually lead to glaucoma or ocular hypertension. Prolonged elevation of eye pressure may lead to potential damage down the line. Thus, it is important to take precautions and keep the pressure in control.

Bimatoprost is believed to work by increasing the outflow of aqueous humor, significantly reducing intraocular pressure by 6.5 to 8.9 mmHg. It comes in two strengths: 0.01% and 0.03%. Your doctor will determine the appropriate strength for you. However, the recommended dose is one drop to the affected eye, applied in the evening. Do not take a make-up dose if you missed your dose the previous day. And if you used too many drops accidentally, talk to your prescriber. Keep in mind that bimatoprost is a prescription medication, so you must consult your ophthalmologist.

How to Apply Bimatoprost for Glaucoma

Remember to remove your contact lenses before you apply the eyedrop. Then wait for 15 minutes after the application before wearing your contacts.

1. Wash your hands to avoid contaminating the medication

2. Tilt your head backward and face the ceiling

3. Gently pull down your lower eyelid to form a small pocket

4. Invert the bottle and softly squeeze to release a drop into the pocket of your eyelid

5. If the drop does not land in your eye, repeat the process

6. Close your eyes for about 30 seconds

7. If both eyes require treatment, repeat the above steps for the other eye

If you’re using Vistitan with another eye drop, wait at least five minutes before applying another eye drop.

Bimatoprost for Eyelash Growth- What you need to know

Since people who used this medication for eye tre saw significant changes in their eyelashes, getting longer, thicker, and darker, another formulation of bimatoprost was made to treat poor eyelashes growth.

Latisse is the marketed form of bimatoprost recommended for treating eyelash hypotrichosis – hypotrichosis refers to a deficiency in hair follicles usually at birth. The condition should not be confused with alopecia, which is loss of hair.

The exact mechanism by which bimatoprost promotes the growth of eyelashes is not well understood but evidence suggests it causes the eyelashes to spend more time in the growth phase. As a result, the number of hairs in this phase increases.

The recommended regimen for eyelash growth is to apply Latisse using a single-use applicator at the base of the upper lashes. Like Vistitan, it’s best to apply in the evening. It should be noted that Latisse is approved for use in upper lashes only. Therefore, it should not be applied to the lower lashes and should not be applied directly to the eye.

People who use Latisse for eyelash improvement may begin to see results 4 weeks after consistent use and it takes 16 weeks to see full results. Keep in mind that discontinuation will return the eyelash to normal. And remember that Latisse should not be used without the recommendation of a dermatologist.

How to Apply Bimatoprost for Eyelash Growth

Remember to remove your contact lenses before you apply the product. Then wait for 15 minutes after the application before wearing your contacts.

I. Wash your hands, face, and remove makeup

II. Instill one drop of bimatoprost (Latisse) on a disposable sterile applicator

III. Use the sterile applicator to apply product evenly along the skin of the upper lashes

IV. Wipe away any excess solution that may run outside the upper eyelid margin

V. Discard the applicator after one use

VI. Repeat for the opposite upper lashes using a fresh sterile applicator

What Are The Side Effects of Bimatoprost?

Despite its dual role, bimatoprost is not without some side effects. Remember one of its side effects led to the discovery of its role in cosmetics. However, some side effects may not be palatable, underscoring the need to use the medications as prescribed.

The most commonly reported side effects include:

* burning sensation in the eye

* inflammation of the eyelid

* eyelid darkening

* red and itchy eyelids

* eye irritation

* longer eyelashes

* changes in eyelash color

In a few cases, pigmentation of the iris may accompany the use of bimatoprost. The change is likely to increase as long as you use the drug. So, talk to your doctor if you notice a change in color of your iris.

Balancing The Dual Role of Bimatoprost

Since the eye drop and eyelash formulation contain the same active ingredient, there is the temptation to misuse the medication. However off-label use may lead to more undesirable reactions.

Dr Jovi Boparai, an Ophthalmic Surgeon and CEO of CorneaCare says he manages glaucoma and cosmetics patients differently. “I focus the discussion around the medication’s purpose, proper usage, potential side effects, and the importance of regular follow-ups, says Dr Jovi”

Eye experts discourage the concomitant use of two or more bimatoprost together. So, talk to your doctor if you’re using one. The use of bimatoprost is also discouraged in people having active eye problems.

Talk to your healthcare professional if you:

* are on any medications

* are pregnant or breastfeeding

* have liver or kidney problems

* develop another eye condition

Note that bimatoprost isn’t recommended for people under 18 years.

What Professionals Say About Bimatoprost

Here is the key message from the position statement of the American Academy of Ophthalmology:

“If you have an eye condition, such as glaucoma, macular edema or eye inflammation, consult with your ophthalmologist, Eye MD, before using Latisse.’’ They emphasized the need for patients to follow the instructions for use of the drug. Patients are advised to see their ophthalmologists in the event of any concerns.

Dr Jovi’s final thoughts closely align with this message. "In both medical and cosmetic applications, it is important for individuals to consult with their healthcare provider before starting bimatoprost treatment. They should discuss their medical history, potential interactions with other medications, and any concerns regarding side effects. Regular monitoring by a healthcare professional ensures the safe and effective use of bimatoprost in either context", says Jovi.

Final thoughts

Latisse and Vistitan are the same drug but have different applications, instructions for use, labeling and packaging. So, patients are advised to avoid off-label use of either drugs.

Both drugs are prescription medications and should only be used as prescribed by your doctor. The bottom line is to use the right drug for the right indication and in the right way.



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While the above article is based on thorough research, we do not claim to offer a substitute for medical advice from a qualified healthcare provider. The article was written for information and educational purposes only. We aim to provide helpful information to our readers, but cannot provide a treatment, diagnosis, or consultation of any sort, and we are in no way indicating that any particular drug is safe or appropriate for you and your individual needs. To receive professional medical attention, you must see a doctor.