Regular use of eyelash extensions linked to skin mites, eye irritation and blocked glands

by European Society of Cataract and Refractive Surgeons

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A study among young women who regularly have eyelash extensions has found most have tiny mites, called Demodex folliculorum, living on their lashes. These mites can cause a painful skin reaction called demodicosis.

The research, presented Saturday at the 44th Congress of the European Society of Cataract and Refractive Surgeons (ESCRS), also shows that many of the women have symptoms of eye irritation and most have problems with the tiny glands near the eyelashes, called meibomian glands, that produce an oily substance to prevent the eyes from drying out.

Researchers say that some simple hygiene steps, such as cleaning the eyelashes and treating mite infestation when needed, could make eyelash extensions much safer.

The study was presented by Dr. Tetiana Zhmud, from the Department of Ophthalmology, National Pirogov Memorial Medical University, Vinnytsia, Ukraine. She said, "Eyelash extensions are an extremely popular cosmetic procedure among young women because they provide the appearance of longer and fuller eyelashes without the need for mascara. At the same time, there is growing evidence suggesting that this procedure may create problems on the surface of the eye, including irritation, dry eye symptoms, and meibomian gland dysfunction. However, the relationship between eyelash extensions and demodicosis remains poorly understood."

Survey points to frequent irritation

Zhmud and her colleagues carried out a survey of 345 women ages 16 to 28. They found that almost a quarter had ever had eyelash extensions. More than half (58%) had eyelash extensions every three to four weeks. Almost half of those who had eyelash extensions (47.6%) said they had discomfort, redness, tearing or itching after the procedure.

The researchers used a technique called meibography, in which infrared light makes it possible to see the meibomian glands through the eyelids. Among the women who had had eyelash extensions at least 10 times, researchers found most (85%) had signs of meibomian gland dysfunction. This means the glands were blocked or not producing the right oil to keep eyes hydrated.

Next, the researchers used a microscope to examine samples of eyelashes from 25 women who regularly had eyelash extensions. In all but one of the women, they found the Demodex folliculorum skin mites. In 18 of the women, there were signs of skin irritation typically caused by skin mites, including itching and irritation around the eyelids, redness, swelling, eyelashes sticking together, and scaly skin at the base of the lashes.

Zhmud said, "Our findings do not suggest that people should completely avoid eyelash extensions. However, they highlight the importance of proper eyelid hygiene, awareness of symptoms and timely assessment when symptoms arise. For optimal care of eyelash extensions, the use of a preservative-free, hypoallergenic gel designed for therapeutic eyelid hygiene may be recommended twice daily using an eyelash cleansing brush. In individuals with confirmed Demodex infestation, a course of antiparasitic treatment may be considered.

Limits of the early evidence

"For clinicians, these findings emphasize the importance of considering demodectic blepharitis in patients presenting with chronic eyelid irritation, particularly those who regularly use eyelash extensions. For beauty professionals, our results may support the development of recommendations regarding eyelid hygiene and the need to inform clients about potential ocular health risks associated with repeated eyelash extension procedures."

The researchers caution that this is a small study that did not include a comparison with young women who had not had eyelash extensions. They say further research should include a larger group of people with and without eyelash extensions to look at how many mites are present and how the frequency of eyelash extensions compares with eye health and symptoms of mite infestation.

Professor Sorcha Ni Dhubhghaill, chair of the ESCRS Cornea Committee, head of department and corneal and cataract specialist at UZ Brussel, Belgium, who was not involved in the research, said, "Although these mites are common, we don't typically see a lot of them in younger women. Usually, if they are present on the eyelashes, we spot them by the 'collarettes' they leave around the eyelashes. These are waxy rings made up of dead mites, mite feces and mite eggs, mixed with skin and oil. Since the adhesive used during eyelash extension procedures is applied near the base of the natural lashes, where collarettes are typically located, it could be much harder to spot them in women using eyelash extensions.

"It is important to emphasize that the presence of Demodex folliculorum does not necessarily indicate disease, as these mites may be part of the normal ocular microbiota. But it is important to detect them if they are causing symptoms, signs of inflammation and meibomian gland dysfunction."

Clinical categories

OphthalmologySkin & Hair careCommon illnesses & Prevention Provided by European Society of Cataract and Refractive Surgeons Who's behind this story?

Gaby Clark

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