Lashes, Lasers and Lifts: The Past, Present and Future of Lash Enhancement

February 20, 2020

Eyelash treatments are becoming more and more common in the cosmeceutical world, with more patients on the lookout for longer, lusher and fuller lashes.

Dr. Julie Ann Woodward, chief of Oculofacial reconstructive surgery at Duke University Medical Center, is a pioneer in lash treatments. In her 2019 CSF presentation, “The Lure of Lashes,” she examines the past, present and future of eyelash treatments and why patients desire fuller flutters.

“Long eyelashes make the eyes look bigger and more youthful,” says Dr. Julie Woodward. “They enhance non-verbal communication and expression. If the eyelashes are long and dark, people are able to wear less makeup and enjoy attention from their natural beauty.”

Why are there more patients desiring lash treatments in your waiting room?

Lashes were the biggest beauty trend of 2018, with a 152 percent increase in searches. Part of this increased interest is due to the popularity of false lashes, which have become a lot easier to apply and use due to advancements in the materials used to make and apply them.

“Many people want long, lush eyelashes,” says Woodward. “The enhancing of eyelashes has such a long and strong history that it can’t be ignored.”

That desire for longer, fuller lashes has led to a rise in the use of mascara and eye lash curlers as well. Unfortunately, this quest for better lashes has also led to an increase in the loss of lashes and allergic reactions, which can lead to blepharitis. False eyelashes, mascara use and eyelash curlers are three of the more common reasons people lose lashes.

What options are there for lash treatments?

There is hope for patients who have suffered lash loss. A number of different lash treatments, both surgical and non-surgical, are readily available.

What is the Woodward Laser Lash Lift (The WLLL)

Chemical applications may improve lash growth, or the appearance of lash growth, but they won’t change the vertical direction the eyelashes grow out of the eyelid margin. To make such an impact permanent change to eyelash direction must be administered.

“I developed a technique about two years ago using [a] laser to enhance the eyelashes,” says Woodward. “The procedure was originally developed to tilt the eyelashes out of the visual field for patients with floppy lid syndrome [and] it gradually evolved into a successful treatment for aesthetic patients with eyelash ptosis.”

The WLLL is performed by using an incisional hand piece to put a series of small point ablations on the lid above the eyelashes, usually in two rows with 25 to 30 spots in zig-zag fashion, one slightly closer to the eyelash follicle, as the globe is protected with a Jaeger plate.

“You can use any CO2 laser that has a 200-micron spot size or less with an incisional hand piece,” says Woodward. During treatment, it is imperative that a steel lid shield protect the globe at all times. Dr. Woodward recommends a jaeger plate and the healing time is typically about 7-10 days.

Woodward and her team did a retrospective study of 46 patients comparing those who had a blepharoplasty to those who had a blepharoplasty and the laser lash treatment. While both groups showed improved lash growth, those who had the procedure and the WLLL had better results. In fact, Woodward later discovered that patients who had not had a blepharoplasty and just the WLLL had even greater lash growth.

Topical Options for treating lashes

Latisse is the only FDA-approved treatment for growing longer, thicker and darker eyelashes.

“Eyelash-enhancing products are relatively safe, but do carry small risks,” says Woodward. “Bimatoprost is a prostaglandin drug that requires a prescription. It was originally developed to lower the intraocular pressure for patients with glaucoma, but works for lash growth as well by causing lashes to spend more time in the anagen – or growth – phrase of the hair growth cycle.”


Woodward published a paper at Duke in 2008 showing how bitmatoprost in gel form improved lash growth. This therapy was used on patients with chemotherapy-induced madarosis who lost their lashes due to chemotherapy side effects.

The goal of this study was to assess bimatoprost gel’s effects on eyelash growth, as well as the amount, pigment, and thickness in chemotherapy-induced madarosis induced.

According to Woodward the results were overwhelmingly positive. There was a statistical difference in median length after two and three months for eyelashes treated with bimatoprost. There was also an improvement in the number of lashes and a significant change in the pigmentation of treated eyelids. The most widely-known Bimatoprost prescription product is Latisse (an Allergan Pharmaceuticals treatment that is FDA-approved for growing longer, thicker and darker eyelashes).

Patients who decide not to use bitmatroprost may look elsewhere to find a product that will help with growth and the look of longer, thicker lashes. Woodward finds many patients will turn to the internet.

“A lot of products can be found on eBay,” says Woodward. “There are tons of them! And so, [at Duke] we ordered about 10 of these products and we thought, ‘let’s take them and culture them,’ and they grew all kinds of icky things, including Pseudomonas.”

One alternative to bitmatroprost is isopropyl cloprostenate, a prostaglandin analog. Although both have scientifically-proven benefits, isopropyl cloprostentate has been found to be less irritating to the eyes and can be used on both lashes and brows.

Bitamtroprast products carry the risk of hyperpigmentation, so for this reason Dr. Woodward recommends using lash products with isopropyl cloprostenate. “Both ingredients create the appearance of longer eyelashes,” says Woodward. “The eyelashes appear to be more in same direction with isopropyl cloprostenate where with bitmatoprost, the lashes tend to grow in slightly different directions.”

Out of the hundreds of products on the market that enhance the appearance of lashes, Woodward has one that she recommends to her patients.

“I myself, and my patients like neuLASH PROFESSIONAL™,” says Woodward. “It comes with an eyelash and eyebrow kit.”

What lash trends can we expect in the future?

“If you go to Google and type in ‘eyelash curler,’ it brings up 11 million hits,” says Woodward, referring to the public interest in lash treatments. “This is important… people want their eyelashes to be flipped up. Patients are always thrilled to have their lashes tilted upwards so they can get rid of their eyelash curler!”

The public desire for more beautiful lashes has forced lash therapy to the forefront. Woodward believes combination treatments pairing the WLLL with things like eyelash conditioners, eyelash tints, great mascara and/or eyelash extensions will be a trend in the very near future.

Want to hear more from Dr. Julie Woodward? Check out this video! 

Leave a Comment

Your email address will not be published. Required fields are marked *