Latisse and Trichotillomania

Trichotillomania is a condition characterised by compulsive plucking of hair from an individuals own body. It can effect anyone of either sex and any age, but most commonly starts in the teenage years and effects three times as many women as men.

Many people are quick to play it down but the condition can have a profound effect on a sufferers life. The cause is unknown. Sometimes it is seen as secondary to another condition, such as post traumatic stress disorder, but often there is no obvious trigger. There is ongoing research that suggests that there may be a genetic component to the condition.

The most common location that hair is pulled from is the scalp but eyebrows and eyelashes are also very common sites. Hair loss in any way can be distressing and may lead to further anxiety. This may act as a stimulus for further pulling and a viscous circle begins. Pulling of hair is not always a conscious decision and it is thought that 80% of sufferers pull ‘automatically’ without consciously choosing to do so.

The treatment for trichotillomania is not primarily pharmaceutical. It requires therapy that acts to change the behaviour of the sufferer to limit then stop pulling of hair. If you think you have trichotillomania, and have not already done so, I strongly recommend talking to your GP; they will be able to provide you with help and arrange for a structured treatment plan. When medications are used, they are used as an adjunct to support the ongoing therapy.

Latisse is the brand name in America for bimatoprost. It comes as a solution and was originally used as an eye drop for glaucoma. It was noted that individuals using this drop were developing longer eyelashes. When applied to the skin at the base of the eyelashes, it acts to stimulate their growth cycle and results in increased eyelash growth. This effect is also seen when used on the eyebrows. It received FDA approval in 2008 and since then, millions of people have grown their eyelashes longer, thicker and darker.

People with trichotillomania have been using Latisse as a treatment for eyelash and eyebrow pulling. When used alongside a treatment plan, such as behavioural therapy, it can help improve the outcomes. Since the eyelashes and eyebrows grow faster, the improved cosmetic results of complying to the therapy is seen quicker and this helps the user adhere to the therapy and reinforces the benefits of doing so.

Latisse should never be considered a cure for trichotillomania and it should not be used as a front line therapy for the condition either. When used to encourage the patient it could help the success rate and recovery time. Current independent clinical evidence supporting its use is sparse and consists of case studies rather than randomised controlled trials. Anecdotally, internet forums and blogs suggest that individuals sufferers are finding a benefit to using the treatment. As the popularity of the treatment as a cosmetic treatment grows one would hope that further research is carried out on its use for non-cosmetic purposes, as has already happened with the use of Latisse in patients that have lost their eyelashes from chemotherapy.

Written by Dr Tom Walker