Image: Brooke Shields for Latisse
latisse.com
The Food and Drug Administration last week sent a warning letter to Allergan saying that Latisse's promotional materials "minimize the risks.
By
msnbc.com contributor
updated 10/1/2009 4:47:02 PM ET 2009-10-01T20:47:02

Rosemary Abendroth sums up the problem in two words: eyelash envy.

“I’m a blonde and when you’re a blonde you always wish for longer, thicker, blacker lashes,” says the PR director from Manhattan. “You want them just naturally, without makeup.”

So Abendroth spent years dying her eyelashes, coating them with conditioner, and becoming an expert in a dozen different mascaras. She also checked regularly with her dermatologist to see if there was anything that could help her grow her own lush lashes. No such luck.

And then came Latisse, Allergan’s FDA-approved eyelash-enhancing treatment. Given the green light in December 2008 as a treatment for hypotrichosis of the eyelashes (yes, people with sparse lashes actually have an official condition), the prescription drug has inspired disbelief, devotion, and at least one major lawsuit (a patent-infringement suit).

Last week, Latisse made headlines when the FDA sent a warning letter to Allergan stating the promotional materials posted on the product’s Web site were “misleading because they omit and minimize risks associated with Latisse.” Among the risks, the FDA notes, is that the active ingredient can cause hair to grow in other places besides the lash area, cause inflammation of the cornea — and can make lighter-colored eyes turn brown.

Even before the FDA warning, the treatment — currently being hawked by bright-eyed actress Brooke Shields — has provoked much discussion and debate. In bars and blogs and beauty forums like Truthinaging.com, Realself.com and Essentialdayspa.com/forum, eyelash-crazed consumers rate the product’s efficacy and discuss its side effects.

On one side of the aisle are those concerned about safety and/or the product’s high price tag. A small bottle — which comes with 60 individual eye applicators — costs about $120 and lasts 30 days with recommended daily usage. (Fullresults take three to four months and yes, you have to keeping using the stuff to maintain the effect.)

On the other, Latisse-lovers who are willing to pay any price, monetary or otherwise, for long lush lashes.

“I don’t care if my eyes bleed,” one fan recently posted on Twitter. “I use it and love it!”

But at a time when poverty, unemployment and home foreclosures are at an all-time high, is a bottle of magic eyelash potion — particular one with a hefty price tag and hair-raising side effects — actually worth it?

Should you or shouldn’t you?
“For me, it’s my beauty secret,” says Abendroth. “It’s like that old Clairol commercial, ‘Does she or doesn’t she?’ It’s one of the first things I’ve spent money on in the beauty arena that did what it said it was going to do.”

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Abendroth’s experience with Latisse is echoed by many. The eyelash enhancer, which is applied like a night-time eyeliner, is currently the “top rated treatment” on RealSelf.com, a consumer ratings site for cosmetic treatments and plastic surgery, with 86 percent of reviewers rating it as “worth it.”

Thousands of consumers seem only too willing to swap cash for lash. In the first half of 2009, the product pulled in $25.4 million with anticipated net sales for the year of around $60 million, according to Allergan’s sales figures.

Latisse was developed after the company realized that eyelash growth was an odd but welcome side effect in patients using its glaucoma-fighting eye drop Lumigan, but remarkably its makers don't actually know why it makes lashes grow. The product's Web site says the company believes the active ingredient bimatoprost increases the length of the eyelash growth cycle and increases the number of hairs formed during that cycle, but "the exact way it works is unknown."

However it works, not everyone is thrilled with the results.

Fourteen percent of Realself.com’s consumer reviews rate Latisse as not worth the price, citing no new lash growth, unruly lash growth, bloodshot eyes, and blotchy eyelids.

Sara Piña, a 28-year-old real estate agent from Cypress, Calif., says she decided to try Latisse in mid-July to fill in a small patch on her left eye that a childhood bout with chicken pox had left bare, but instead of growing new lashes, her eyelashes started falling out.

“The first night, I put it on right before I went to sleep and in the morning, one or two eyelashes had fallen out,” she says. “I didn’t think it was a big deal so I used it again and then lost another little bit. I quit using it after three days, but they’re still falling out. Friends are asking, ‘What happened to your eyelashes?’”

Piña says she went to a doctor, who told her she might be having an allergic reaction, then contacted both Allergan and the medispa where she purchased the Latisse. (To report adverse reactions, consumers can contact Allergan at 1-800-433-8871 or the FDA at 1-800-FDA-1088.)

“The girl from the spa said at first her eyelashes were falling off but she kept using it and then her eyelashes grew and grew back longer, but I’m not going to take that risk,” says Pina, who in late August was still losing lashes — although not as much. “I’m thinking it’s not for me.”

Eye color change?
A trial of 278 people who used Latisse documented other notable side effects. According to the study, Latisse produced eye redness in 3.6 percent of patients, itchy eyes in 3.6 percent and skin hyperpigmentation in 2.9 percent. (On the upside, it produced a 25 percent increase in eyelash length, a 106 percent increase in thickness and an 18 percent increase in darkness.)

But the side effect that seems to catch the most attention is the permanent eye color change mentioned in the TV commercial.

“It changes your eye color? How is that acceptable?” one woman recently posted Twitter. “I am totally freaked out by Latisse.”

According to the FDA, Lumigan, which uses the same formulation as Latisse, “may gradually change eye color, increasing the amount of brown pigment in the iris,” a change that occurs slowly and may not be noticeable “for several months to years.” Doctors, however, say this side effect is associated exclusively with dropping medication directly into the eye as opposed to painting it along the upper lash line. And that it’s extremely rare.

“Based on collective experience, people with crystal clear blue eyes don’t develop the iris pigmentation,” says Dr. Arielle Kauvar, clinical associate professor of dermatology at New York University School of Medicine. “The people who are susceptible to it are individuals with brown eyes or hazel eyes or greenish-blue eyes. But the overall risk is less than 1 percent and that’s with the medication going directly into the eye.”

The FDA also warns of the “potential for hair growth … in areas where Latisse comes in repeated contact with the skin surface.”

While there have been reports of a few hairy cheeks in online forums — a 2004 case study in the American Journal of Ophthalmology also details a glaucoma patient who experienced “hair growth on her upper left cheek … approximately 4 weeks after starting the eye drops” — doctors say this isn’t something they’re hearing a lot about.

“The most common complaint is that some people develop eye irritation,” says Kauvar. “Obviously that goes away immediately once you stop it. And potentially if someone is applying it wrong, there’s also the possibility of developing pigmentation of the eyelid, which is reversible.”

Heather Katt, senior manager of corporate communications for Allergan says the safety and satisfaction of patients using Latisse is of primary concern to the company.

“Allergan vigilantly monitors the safety of all of its products, including Latisse,” she says. “In the clinical study, there were no reports of eyelash loss or increased brown iris pigmentation. That said, as the label states, patients need to be aware of the potential risk for increased brown iris pigmentation which could be permanent.”

Cheri Buchanan, a 50-year-old administrative assistant from Campo, Calif., says she’s experienced some side effects such as darkening of the eyelid and red eyes, but neither have effect has dissuaded her from continuing to use the product.

“There’s a slight change in the color of my eyelid — it’s maybe one shade darker than it used to be — and I’ve had some of the red eyes,” she says. “But I just use Clear Eyes. I don’t see a whole lot of negativity to the side effects.”

Taking risks
Buchanan is far from alone. Some consumers appear to be so enamored with long lashes they don’t seem to care what the FDA — or Allergan — has to say.

Beauty bloggers and online forum participants routinely talk about swapping out Latisse’s sterile applicators for tiny eyeliner brushes in order to conserve the expensive fluid. Others dab Latisse onto their eyebrows — an as-of-yet untested, off-label use — in order to fill in gaps left by over-plucking or age. Still more talk about saving money by ordering the glaucoma drug Lumigan from offshore pharmacies. A few talk about creative combos they’ve come up with on their own, such as using a mix of Lumigan and Travoprost, another glaucoma drug, in an attempt to grow even longer lashes.

Dr. Andrew Iwach, spokesperson for the American Academy of Ophthalmology, says even something as minor as swapping out the prescribed applicator may put consumers at risk.

“There are reasons why the FDA has set up rather stringent rules and procedures to evaluate new drugs and as tempting as it is to improvise, there’s inherent risk in doing so,” he says.

As for those willing to experiment with various glaucoma drugs to save a few bucks or out-lash their friends? They’re not exactly seeing the big picture, says Iwach.

“These are very potent molecules and if you look at how we use them, the concentration is very low,” he says. “If you improvise, you could increase the concentration. You might get the desired effect at first, but what’s the price? What’s the risk of additional side effects? The eye is quite delicate and we’re talking about something that’s applied for weeks or months or potentially years. It’s a cumulative risk.”

Iwach says those considering enhancing their lashes should have their eyes examined first by an ophthalmologist to make sure there are no underlying risks and to help “figure out if they should even be thinking about this.”

"Ophthalmologists have over 10 years experience using these drugs,” he says. “We can give you the latest data and talk to you about the side effects. People are used to using mascara or other cosmetics around their eyes, but this is a different ball game. Most people will do fine, but these are powerful drugs.”

Powerful drugs that even diehard fans admit can be a strain on their pocketbook — and perhaps even their closest relationships.

“My 18-year-old daughter has really short lashes and I would definitely recommend it for her,” says Cheri Buchanan, who currently rations herself to one drop of Latisse a day. “But I wouldn’t buy it for her. It’s too expensive.”

© 2013 msnbc.com.  Reprints

Video: Cure for skimpy lashes?

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    >>> supplement insurance plan.

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