Bridging the gap between cosmetic and medical: Eyelash extensions

The number of patients presenting with false eyelashes is increasing in frequency. Based on the U.S. Census data and Simmons National Consumer Survey (NHCS) 118.6 million Americans used mascara in 2016 to enhance their eyelash appearance1. Women desiring long beautiful eyelashes are turning to the growing trend of eyelash extensions. While certain types of false lashes are available for purchase at beauty salons and drug stores, many women seek services to have them applied professionally from certified Aestheticians and/or Cosmetologists.

Multiple types of eyelash extensions including single lash (one false lash applied to one natural lash), cluster lash (multiple false lashes applied to one natural lash), and strip lash (an entire row of false lashes applied to all upper or lower natural lashes) are available. From the naked eye, these different false lash types appear relatively similar. However, it is an entirely different story when viewed under magnification.

1) Eyelash extensions are the  healthiest option. The smaller surface area collects less debris and bacteria, and therefore single lash type is most easily maintained.

2) The cluster lashes tend to collect more debris and require more frequent cleansing and maintenance.

3) The Strip lashes require the most adhesive to remain in place. Strip lashes collect the most debris and are more likely to cause Blepharitis (inflammation of the eyelids associated with bacteria at the eyelash base) and Meibomian Gland Dysfunction (clogged eyelid glands causing decreased tear production and dry eye).

The adhesive used in lash application has chemicals that can cause red, irritated, swollen lids with associated itching and flaking when coming in contact with thin eyelid skin. A more severe reaction called Contact Dermatitis can occur which in many cases requires a steroid for treatment. If the lashes are applied to the skin, there can also be irritation from the glue mechanically pulling on the skin when the patient blinks. The eyes themselves are a mucous membrane and are openly exposed to contamination from toxic chemicals and bacteria. Cleaning and disinfecting of all materials used around the eye is of great importance. Individuals wearing eyelash extensions are more likely to present with these eye conditions if the extensions are not properly applied and maintained.

When applying false lashes, lash artists must use great skill when manipulating sharp instruments, adhesives and cleaning solutions in close proximity to the eyes. Risks for unintentional damage to the eyes exist during the lash application process. Standardized regulations/eye health education prior to performing eyelash extensions are not currently required. Despite this fact, it is important for Lash artists to obtain knowledge of basic eye anatomy and eye conditions to safely provide their lash extension services.

It is essential for Eye Doctors and Aestheticians/Cosmetologists to develop professional relationships. This allows lash artists to refer to an Optometrist if there is a concern regarding the eye health of their clients prior to applying lashes. If an individual presents for lash services and complains of any of the following, it is in the best interest of the lash artist and that individual to have an evaluation by an Optometrist prior to the application procedure:

  • Red irritated eyes
  • Any form of conjunctivitis (pink eye)
  • Eye pain or irritation
  • Sudden blurry vision or vision loss
  • Compromised corneal integrity
  • Sudden onset eyelid drooping
  • Questionable ocular surface disease
  • Suspicious lesions or growths
  • Significant light sensitivity
  • Persistent Itching, burning, redness, tearing or swollen lids

Lash artists have the opportunity to help their clients feel more beautiful with long, healthy eyelash extensions. If safe and proper lash application techniques are employed, lash artists will obtain loyal clients and create a lucrative business. Clients will hold their lash artist’s in a higher regard knowing they have received the proper application training and education on eye health. Similar to Eye Doctors, the goal of the lash artist is to ensure the health and safety of the clients’ eyes and lashes. This can only be achieved with proper training and education. A formal training program would provide the basic knowledge necessary to recognize early signs of eye disease and know when it is appropriate to recommend an evaluation by an Optometrist.


1) BCG Senior Vice President. “U.S.: Usage of Mascara 2016 | Statistic.” Statista. N.p., n.d. Web. 18 Dec. 2016.

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