Part of our complete guide to Periocular Rejuvenation — this page covers Latisse® lash enhancement in depth.
What is Latisse
Latisse® (bimatoprost ophthalmic solution 0.03%) is the only FDA-approved prescription treatment for hypotrichosis of the eyelashes — a condition of inadequate or insufficient lashes. Bimatoprost, a prostaglandin analog originally developed to lower intraocular pressure in glaucoma patients, was discovered to have the side effect of eyelash growth. This observation led to its clinical development as a lash-enhancement agent.
Latisse is a prescription medication requiring evaluation and a prescription from a qualified physician. It is distinct from cosmetic lash serums available over the counter — those products do not contain bimatoprost and have not undergone FDA clinical trials. Latisse is frequently combined with upper blepharoplasty for comprehensive periorbital enhancement.
Mechanism of Action
Bimatoprost is a synthetic prostamide (prostaglandin F2α analog) that acts on prostaglandin receptors in the hair follicle. The eyelash growth cycle consists of three phases:
- Anagen (growth phase): Active lash growth — typically about 4–6 weeks in normal lashes
- Catagen (transition phase): Growth stops, follicle begins to regress
- Telogen (resting phase): Lash is retained but not growing; eventually shed
Bimatoprost extends the anagen (growth) phase and increases the proportion of follicles simultaneously in anagen. This produces longer, thicker, and more numerous lashes over a treatment period of 16 weeks.
Clinical Results
In the pivotal Phase 3 trial leading to FDA approval — a 16-week, randomized, vehicle-controlled study of 278 patients:
- Length: Mean increase of ~25% in upper lash length at 16 weeks
- Thickness/fullness: Mean increase of ~106% in lash fullness score
- Darkness: Mean increase of ~18% in lash darkness
- ~78% of patients showed significant improvement in Global Eyelash Assessment (GEA) score at 16 weeks vs. 18% with vehicle (placebo)
Results become noticeable at 8 weeks with full results at 16 weeks. Lashes return to pre-treatment appearance gradually over several weeks if treatment is discontinued.
How to Apply Latisse
Latisse is applied once nightly to the upper eyelid margin only:
- Remove contact lenses and makeup; clean and dry the face
- Using the sterile applicator brush included in the kit, place one drop of Latisse on the brush
- Draw the applicator along the skin of the upper eyelid at the base of the eyelashes — from the inner to the outer corner
- Blot any excess solution with a tissue; do not apply to the lower lid
- Replace contact lenses after 15 minutes if worn
Each kit contains single-use applicators; one applicator is used per eye nightly (refer to the current product packaging for the exact count and supply duration). Do not reuse applicators — each eye requires its own applicator to prevent contamination.
Side Effects
Latisse is generally well tolerated. Known side effects include:
- Conjunctival hyperemia (redness): Most common side effect — usually mild and transient. Reported in ~3.6% of patients in clinical trials.
- Eyelid skin darkening (hyperpigmentation): Periocular skin along the application site may darken from bimatoprost stimulation of melanogenesis. Usually reversible upon discontinuation. Minimized by careful application at the lash base only and blotting excess.
- Iris pigmentation changes: Prostaglandin analogs used as eye drops (for glaucoma) are associated with increased iris pigmentation — this is a well-documented effect with glaucoma dosing. With the lash application method, systemic absorption is minimal and iris pigmentation change has not been definitively associated with Latisse use in clinical trials. Patients with mixed-color (hazel, green-brown, or blue/gray-brown) irides should be informed of this theoretical risk; a baseline iris photograph is prudent.
- Periorbital fat atrophy: Prostaglandin analogs used as glaucoma eye drops have been associated with periorbital fat loss (prostaglandin-associated periorbitopathy — PAP) — deepening of the upper sulcus, enophthalmos, dermatochalasis. This is a known effect with topical ophthalmic use at glaucoma concentrations. The much lower systemic absorption from lash application makes this very unlikely at Latisse concentrations, though the risk is not entirely excluded with long-term use.
- Itching of the eyes or eyelids (pruritus)
- Dry eyes
Who is a Candidate
Latisse is appropriate for adults who want longer, fuller, darker eyelashes and who have inadequate lashes (hypotrichosis). Common scenarios include:
- Natural lash thinning from aging
- Lash loss from blepharitis, prior eyelid surgery, chemotherapy, or alopecia areata
- Patients who desire enhancement without false lashes or lash extensions
- Post-blepharoplasty patients seeking enhanced appearance
Contraindications and precautions:
- Not for use in patients with active ocular infections or inflammation
- Use with caution in patients with uveitis history, risk factors for macular edema, or known prostaglandin sensitivity
- Not established as safe in pregnancy; should not be used during pregnancy or breastfeeding
- Contact lens wearers: remove contacts before application; reinsert after 15 minutes
Latisse vs. Over-the-Counter Lash Serums
The market is saturated with over-the-counter eyelash growth serums claiming to enhance lash length and fullness. These products do not contain bimatoprost and have not undergone FDA approval for eyelash growth. Many contain peptides, biotin, panthenol, and conditioning ingredients that improve lash condition but do not affect follicle biology in the same way as a prostaglandin analog.
Latisse is the only FDA-approved prescription treatment with clinical trial evidence for eyelash growth. For patients seeking meaningful, verified lash enhancement, Latisse remains the gold standard. It requires a prescription and periodic follow-up evaluation by a physician.
Maintenance
Latisse must be used continuously to maintain results. Most patients transition from nightly application to every other night once full results are achieved (typically after 16 weeks) to maintain lashes while reducing cost and side effect risk. Stopping treatment results in gradual return to pre-treatment lash appearance over 4–6 weeks.
Frequently Asked Questions
- What is Latisse and how does it work?
- Latisse (bimatoprost ophthalmic solution 0.03%) is the only FDA-approved prescription treatment for hypotrichosis — inadequate or insufficient eyelashes. Bimatoprost is a prostaglandin analog that works by extending the anagen (growth) phase of the eyelash cycle and increasing the number of follicles simultaneously in the growth phase, resulting in longer, thicker, and darker lashes over 16 weeks of nightly use.
- How long does it take to see results from Latisse?
- Most patients notice improvement in lash length and fullness at 8 weeks, with full results at 16 weeks. In pivotal clinical trials, approximately 78% of patients showed significant improvement at 16 weeks compared to 18% with placebo. Mean increases: lash length +25%, fullness +106%, darkness +18%.
- What are the side effects of Latisse?
- The most common side effect is mild conjunctival redness (hyperemia), reported in approximately 3.6% of patients. Other potential effects include darkening of eyelid skin along the application site (usually reversible), eye itching, and dryness. Iris pigmentation changes are theoretically possible but have not been definitively documented at Latisse concentrations. Careful application technique — drawing the sterile brush along the upper lash margin only and blotting excess — minimizes most local side effects.
- Do lashes go back to normal if I stop using Latisse?
- Yes. Lashes gradually return to their pre-treatment appearance over 4–6 weeks after stopping treatment. Latisse must be used continuously to maintain results. Many patients transition from nightly to every-other-night application once full results are achieved at 16 weeks, which reduces cost and side effect risk while maintaining enhancement.
- How is Latisse different from over-the-counter lash serums?
- Latisse is the only FDA-approved prescription treatment with clinical trial evidence for eyelash growth. Over-the-counter lash serums contain peptides, biotin, panthenol, or conditioning agents that may improve lash condition, but they do not contain bimatoprost and have not undergone FDA approval or rigorous controlled clinical trials. For patients seeking meaningful, verified lash enhancement, Latisse is the gold standard.
Your Surgeon
Ronald W. Kristan, MD, FACS
Atlantic Eye
