Your patients may turn to you as an expert resource to help them achieve their aesthetic goals, especially on their faces. Eyes are an important part of the face—they’re the window to the soul. Beyond noninvasive aesthetic products that can address the appearance of the skin around the eyes, eyelashes can be another area patients may be interested in discussing.

Eyelash growth serums are one of the most popular ways to achieve thicker, darker eyelashes. Eyelash extensions and mascara are other alternatives.  So, how do each of these products work, and what are the pros and cons?

Eyelash growth serum: an overview.

Although you won’t be applying the serum for your clients, you can discuss their overall facial appearance goals with them, and if eyelashes are an area of concern, you may want to discuss the benefits of eyelash growth serums.

There are different types of eyelash growth serums, both prescription and over-the-counter. Prescription growth serums contain ingredients that actually help treat hypotrichosis of the eyelashes, whereas over-the-counter products don’t actually grow lashes but rather use ingredients that help condition and strengthen existing lashes.

Hypotrichosis is the congenital deficiency of hair. Hypotrichosis of the eyelashes applies specifically to eyelashes that are thinning or not growing at all.¹

Available prescription products to treat hypotrichosis contain an ingredient called bimatoprost that has been clinically proven to increase their growth, including length, thickness, and darkness. The product must be placed on the skin of the upper eyelid margin at the base of the eyelashes once nightly and upon treatment discontinuation, eyelash growth is expected to return to pretreatment levels. The concomitant use of bimatoprost with other prostaglandin analogs for the treatment of elevated intraocular pressure (IOP) may interfere with the desired reduction in IOP and patients should consult their physician prior to its use and be monitored for changes to their intraocular pressure. Increased iris pigmentation has occurred when bimatoprost solution was administered which is likely to be permanent. Bimatoprost has been reported to cause pigment changes (darkening) to periorbital pigmented tissues and eyelashes but has been reported to be reversible upon discontinuation in most patients. Use with caution in patients with active intraocular inflammation, in aphakic patients, in pseudophakic patients with a torn posterior lens capsule, or in patients with known risk factors for macular edema. The most frequently reported adverse reactions (<4% of patients) were eye pruritus, conjunctival hyperemia, skin hyperpigmentation, ocular irritation, dry eye symptoms, and periorbital erythema.²

Over-the-counter (OTC) eyelash growth serums contain ingredients like biotin, peptides, and hyaluronic acid, all of which condition and strengthen existing eyelashes but do not actually promote new growth.³

Now, let’s take a closer look at other products we use on our lashes.

Eyelash extensions: the semipermanent solution.

Semipermanent eyelash extensions have gained popularity over the years as an effective eyelash enhancement method. The requirements needed to perform lash extension applications vary on the state level. In most states, licensing in concert with training as a cosmetologist or aesthetician is required.⁴ These semipermanent lashes come in various materials ranging from synthetic to animal fur to silk and are customizable to suit the patients’ desired length, thickness, and color. For people who are constantly on-the-go, semipermanent lashes are a good option because of their convenience (not having to apply and wash off mascara every day) and how long they last.

However, extensions can be time-consuming as the process often takes two hours or more. Extensions may also be expensive, with each treatment costing around $200 every two months. Additional extension treatments may be less expensive but require more frequent appointments, as often as every 3-4 weeks. The maintenance and upkeep can be a large commitment to make.⁵

Extensions can also cause long-term, irreversible damage to the eyelashes, causing them to fall out more easily and grow back less frequently.⁶ Still, they have become a popular alternative to mascara.

Mascara: versatile and single-use.

Eye makeup has been around for centuries, with mascara as a commercial product first appearing in the early 1900s. We all know how mascara works: we apply it to our eyelashes (often multiple coats), and we often forget to remove it before bedtime (no matter how hard we try).⁵

Formulations range from volumizing to lengthening to separating to waterproof to vivid colors, with applicators that run the gamut from bristles to silicone to motorized oscillating wands. Waterproof mascaras are usually made with a higher oil content and a lower water content to help set the product onto lashes. The trade-off is that these products are often harder to remove. Similarly, volumizing mascaras are often more viscous than lengthening or separating mascaras, which can also make them more challenging to remove.⁵

Contemporary mascara manufacturers have paid close attention to consumers’ wants and needs, creating all-natural and vegan formulations without parabens, metals (like iron or carbon, which are often incorporated as lash-darkening ingredients), or even gluten.⁵ More recently, manufacturers have realized the lasting effects of long-term mascara use. While the products themselves are primarily harmless, we know that constant rubbing and pulling and stretching of the delicate skin around the eyes can wear it down, making the skin appear saggy and older than it is. Still, mascara remains a product of choice because of its ease, lower price, and the versatility of changing eyelash looks on a daily basis.⁷

Eyelash growth in focus.

Opening your patients’ eyes to all the different options they have when it comes to their eyelashes can help broaden the scope of your relationship to include a more holistic approach to their aesthetic goals.