The Role of Bimatoprost Eyelash Gel in Chemotherapy-induced Madarosis: An Analysis of Efficacy and Safety

OBJECTIVES: Breast cancer patients suffer from madarosis (loss of eyelashes) due to chemotherapy side effects. An effective treatment or prevention for alopecia or madarosis induced by chemotherapy is not available. Potential drug side effects of bimatoprost solution include increased eyelash length, darkness, and number. A formulation of bimatoprost which maximizes eyelash enhancement and minimizes intraocular and systemic side effects has not been reported. MATERIALS AND METHODS: An Institutional Review Board (IRB) and Investigational New Drug (IND) approved, randomized, single-blinded, prospective, internally controlled trial compared bimatoprost eyelash gel in relation to eyelash enhancement of madarosis patients. Forty eyelids of 20 chemotherapy-treated breast cancer patients were randomized to treatment or control (fellow eyelid). Both patient and surgeon (blindly) evaluated bimatoprost gel's effectiveness in improving eyelash appearance at baseline and at monthly intervals. RESULTS: The median follow-up time was 3 months (range 1-4). There was a significant difference between treated and fellow eyelash length during month 2 [1.00 mm (P=0.004)] and month 3 [1.00 mm, P=0.02)], in eyelash pigment [month 1 (2.5, P=0.04); month 2 (2, P=0.0009); month 3 (3, P=0.06)] and thickness [month 2 (2, P=0.002); month 3 (3, P=0.01)]. There was an improvement in the patient satisfaction scale from baseline 16 (median, range 7-21) to 26 (median, range 17-33, P=0.002) at last follow-up. CONCLUSIONS: Bimatoprost eyelash gel appears promising for chemotherapy-induced madarosis. Patients may find the effects restorative and cosmetically enhancing.