Safety and Efficacy of Bimatoprost for Eyelash Growth in Postchemotherapy Subjects

Eyelashes are important for self-image1,2 and to protect the ocular surface from particulate matter.3,4 Hypotrichosis of the eyelashes is characterized by reduced eyelash growth.2 Although its etiology is often unknown, eyelash hypotrichosis or complete eyelash loss may develop as an adverse effect of cytotoxic chemotherapy. For many, hair loss including eyelash loss can negatively affect self-image and can lead to impairments in psychosocial functioning.5,6 Following chemotherapy completion, new hair growth is generally finer and thinner; it may take several hair cycles before hair characteristics are restored to prechemotherapy levels.7 Mascara, used to darken, thicken, and lengthen eyelashes, may not be a viable option when eyelashes are sparse or missing.8 Bimatoprost is a synthetic prostamide F2α analog approved for treatment of eyelash hypotrichosis.9 Once-daily application of bimatoprost 0.03% to the upper eyelid margins significantly increases eyelash prominence, length, thickness, and darkness compared with vehicle in subjects with idiopathic hypotrichosis.10 The 0.03% concentration is the same as that found in bimatoprost ophthalmic solution used for treating other ophthalmic conditions.11-13 Mechanistically, bimatoprost is thought to induce eyelash growth through prostamide-sensitive receptors in hair follicles, which promote transition of the follicle from the telogen (resting) to anagen (growth) phase of the hair cycle and prolong the duration spent in anagen.14 The present study was designed to evaluate the long-term safety and efficacy of bimatoprost 0.03% in subjects with chemotherapy-induced eyelash hypotrichosis.