Beauty and the (tiny) beast

The eye health risks of eyelash extensions were explored as part of research presented at European Society of Cataract and Refractive Surgeons Congress (ESCRS) (11–15 September, Excel London).

Dr Tetiana Zhmud, a doctor of medical science and ophthalmologist at the Pirogov Memorial National Medical University in Ukraine, led a survey of 345 young women between the ages of 16 and 28.

Of the survey respondents, around one in four had previously had eyelash extensions. Microscopic examination of the eyelashes of 25 women who regularly undergo eyelash extensions found the presence of demodex folliculorum in 24 of the samples.

Clinical manifestations of demodicosis were observed in 18 study participants, including itching and irritation of the eyelid margins, hyperaemia, oedema, eyelash sticking, scales, and cylindrical dandruff at the base of the lashes.

Among the study participants who had undergone an eyelash extension procedure more than 10 times, meibography demonstrated signs of meibomian gland dysfunction in 85% of cases.

Speaking with OT at ESCRS, Zhmud highlighted that eyelash extensions are a popular cosmetic procedure, particularly among young women.

“In our clinical practice, we started noticing changes in the eyelid margin and meibomian glands of women who regularly used eyelash extensions,” she said.

“What particularly interested us was that some of these women had signs of demodex, even thought they had no symptoms,” Zhmud shared.

“There is limited research on the relationship between regular eyelash extensions and demodex, so we decided to investigate the issue more closely,” she said.

Zhmud highlighted that she was surprised at the high prevalence of demodex among women who regularly use eye extensions.

She added that demodex does not necessarily mean the presence of disease.

“Demodex can be present on the normal eyelid margin. It becomes clinically important when an increased mite load is associated with signs,” Zhmud explained.

These signs can include collarettes, itching, redness, inflammation, or meibomian gland dysfunction.

Zhmud shared that the presence of demodex may also contribute to tear film instability and dry eye symptoms.

“These problems can affect everyday comfort, particularly during prolonged computer use, reading, or contact lens wear. However, it is important to remember that demodex can also be asymptomatic, and this was something we frequently observed in our study,” she said.

Reflecting on her focus for future research, Zhmud told OT she would like to explore whether the changes that were observed in the initial research are reversible once someone stops using eyelash extensions.

“We would also like to investigate how the duration of wear, number of procedures, type of adhesives, and daily eyelid hygiene affect demodex load and meibomian gland health,” the ophthalmologist highlighted.

“Larger prospective studies are needed to determine whether lash extensions themselves promote demodex proliferation or whether other factors explain this association,” she added.