For centuries, long, lush eyelashes have been regarded as a sign of beauty. Early attempts to enhance them were found at archaeological digs in ancient civilizations including Egypt, the alleged birthplace of mascara. 

But a growing number of women are ditching their lash-enhancing wands in favor of a more semi-permanent or permanent solution. Some are opting for eyelash extensions that are attached to the lid by a trained technician. Others are looking to eyelash enhancers, products you apply topically to your lash line in an attempt to thicken lashes and make new lashes grow.

If you’re considering extensions or enhancers, learn how the products work and the safety concerns for each.

Eyelash extensions

Made of silk, mink or polyester, eyelash extensions are lightweight and hard to detect and may leave admirers wondering if the lashes are the real deal. With extensions there’s no need for mascara. They typically last 3 to 4 weeks and do not damage your natural lashes.

A complete set can cost anywhere between $70 and $300. Periodic reapplications (called “fills”) are typically half of the price of the initial set.

When done properly, eyelash extensions are carefully applied to each individual eyelash using a tiny tweezers and adhesive glue. Depending on the skill level and experience of the lash specialist, a full set takes an hour or more to apply. If you decide you no longer want the lashes, or are ready for a new set, a technician must remove them.

Safety pointers:

  • Choose a certified technician. Licensing requirements for lash technicians vary by state. In states like New York and New Jersey, eyelash technicians must also be licensed cosmetologists and/or estheticians. Other states have less regulation and accountability.
  • Make sure the technician follows good protocol. The spa or salon should be clean and the procedure should be painless. The technician should place protective tape over your lower lashes to minimize the chance of adhesive getting into your eyeballs or gluing your lids together. Adhesive glue will not harm your eyes or affect your vision. But if some gets into the eye it may sting slightly. The technician should have a solvent on hand designed specifically to remove excess lash glue from the eye.
  • Report allergic reactions to your eye doctor right away. The adhesive contains ingredients, including latex that can trigger an allergic reaction. Actress Kristin Chenoweth reacted to the formaldehyde in the glue when she had eyelash extensions put on. She famously described her swollen eyes as “eyelid lips.” Drops and an antihistamine were prescribed to treat the reaction. Spot testing the glue in advance of having a full set of lashes applied might help determine if you are sensitive to any of the ingredients. But not everyone will react immediately. And since the eyelash glue is considered a cosmetic product, and therefore not regulated by the FDA, it can be hard to identify what’s in the glue that’s causing the reaction. Women have also reported irritation to the skin inside the lids and the cornea — caused by direct contact from the lashes and/or hypersensitivity to the glue. Marla Mackey, OD, a board-certified optometrist practicing in Northern New Jersey, prefers lash extensions to eyelash enhancing serums. “My recommendation to patients are lash extensions because they have fewer side effects,” she says. “But proper maintenance and periodic removal is necessary to prevent bacterial growth.”

Eyelash enhancers

Cosmetic companies sell serums that can be applied directly to the lashes that they claim will lengthen and thicken lashes. But again, because these products are labeled cosmetics, the FDA does not regulate them, and companies are not responsible for supplying data to back up their claims. Cosmetic companies are also not required to make safety data available to consumers, to divulge ingredients or report bad reactions.

David Shafer, MD, a New York City-based plastic surgeon, says the only eyelash enhancing serum that is FDA-approved is a medication called bimatoprost ophthalmic solution (marketed as Latisse). “In its previous life, Latisse was a glaucoma medication (called Lumigan) which reduced eye pressure,” he says.

To encourage the growth of longer, thicker, darker lashes, users apply the solution to the upper eyelid. This effect is said to last as long as you use the product. The medication works by activating prostaglandins, a type of hormone not secreted from a gland (like other hormones) or carried through the bloodstream. Instead, prostaglandins work locally — in receptor sites found in specific areas of the body, in this case the eyelid.

Depending on the mark-up, one bottle of Latisse can cost between $89 and $150. A bottle typically lasts 6 to 8 weeks, according to Shafer.

Mackey says in her experience the only eyelash enhancer that really works is Latisse. “Due to the prostaglandin analog in it, it has more side effects such as redness, dry eye and inflammation than the other lash enhancers that are more of a vitamin/nutrient-based product,” she says. “But unfortunately, the latter does not produce great results.”

Safety pointers:

  • Be vigilant about good hygiene. Latisse comes with a supply of sterile brushes. “Each one is used only once,” Shafer explains. “You throw it out after one use so there’s no risk of contamination from dirty countertops or other areas.”
  • Leave enough time to properly apply the serum. Some people find the application method difficult, especially since the manufacturer recommends removing contact lenses before application and leaving them out for at least 15 minutes following application.
  • Don’t use Latisse on the lower lash line. The medication has not been approved for use there.
  • Be careful where you place the serum. Eyelashes can grow in places beyond the targeted area — such as your cheeks or temples — if the medication drips off the lid.
  • Let your doctor know if irritation doesn’t let up. “Most of what I’ve seen is redness which generally goes away once the body gets used to the medication,” Shafer says. You can also get dry eyes and darkened eyelids that return to their regular color once Latisse is no longer being used.
  • Consider the permanent risks. One of the reported side effects is permanent dark brown pigmentation in light blue or hazel eyes. A scary — but remote — possibility, says Shafer. He says that he’s been prescribing Latisse for five years without incident and has never heard of a colleague having a patient who experienced a change in eye color from using the medication as prescribed.

Ann Matturro Gault is a freelance writer and editor whose work has appeared in national magazines and many websites. She lives with her four kids, dog, cat and spouse in New Jersey.