In recent years, we have seen several topical medications migrate both ways between aesthetics and ophthalmology. Few other ophthalmic pharmaceuticals have successfully transitioned into the aesthetic world like the topical drug, bimatoprost. Widely used for glaucoma, the drug’s side effect of increased eyelash growth led to its rebranding for aesthetic treatment of hypotrichiasis (Latisse, Allergan).
Unfortunately, in addition to the aerodynamic impacts on evaporative dry eye from the abnormal eyelash lengthening effect associated with overuse, prostaglandins can also create lid margin redness, discoloration, dermatitis, and exacerbation of MGD.
XAF5, a topical prostaglandin ointment by Topokine Therapeutics, is undergoing phase 2b/3 trials to assess its efficacy in treating lower eyelid steatoblepharon, capitalizing on the side effect of periorbital atrophy induced by topical ophthalmic prostaglandin analogs for aesthetic use.15
The potential for MGD exacerbations, dermatitis, eyelid hyperpigmentation, and other side effects associated with this modality of aesthetic treatment may pose issues if it becomes FDA approved.
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3. unpublished data
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