Clinical management of trichotillomania with bimatoprost.

PURPOSE: This case report presents the use of bimatoprost 0.03% to help regrow eyelashes on a patient suffering from trichotillomania. Trichotillomania is characterized by repetitive compulsive hair pulling that leads to noticeable hair loss. Trichotillomania sufferers are affected by this condition in many ways including shame, embarrassment, guilt, and lower self-esteem. Although a formal therapy regimen does not exist, current treatment approaches include behavioral therapy and pharmacotherapy. In cases where a patient pulls the eyelashes, topical bimatoprost (Latisse) may be used to treat madarosis of the eyelashes by increasing growth, including length, thickness, and darkness.

CASE REPORT: A 55-year-old white female presented to the clinic with an interest in using bimatoprost ophthalmic solution (Latisse; Allergan). The patient reported a history of eyelash pulling since age 12 and began treatment to control the impulses with amitriptyline 1 week before her appointment. Follow-up appointments showed increased lash growth bilaterally over a 4-month period as a result of Latisse usage.

CONCLUSIONS: Those who pull their eyelashes may benefit from using bimatoprost 0.03%. The management of trichotillomania involving the eyelashes presents an opportunity for eye care professionals to collaborate with mental health providers for the betterment of shared patients. By expediting the patient's lash growth, Latisse can improve patients' self-image, reinforce compliance, and play an important adjunctive role in any therapy regimen.