Eye Surgeon Raises Red Flag on Popular Lash Trend

Medscape

11 hours ago

Eyelash extensions are growing in popularity among young women, promoted widely on social media for their glamorous appearance and low-maintenance appeal. In a column sent to the French press, Romain Nicolau, MD, an ophthalmic surgeon in Paris, France, warned about the underestimated risks associated with eyelash extensions. In an interview with Medscape's French edition, he expanded on these concerns, detailing complications ranging from conjunctivitis and allergic reactions to more serious conditions like keratitis and corneal ulcerations.
Why did you decide to write an opinion piece warning about the dangers of eyelash extensions?
In my practice, I've seen several patients develop conjunctivitis after receiving eyelash extensions. These cosmetic procedures are increasingly promoted on social media, often promising a glamorous look and striking eyes with minimal effort. However, behind this pursuit of aesthetic enhancement lies a frequently underestimated risk to ocular health.
What are the risks associated with eyelash extensions?
Eyelashes serve to protect the eyes from external irritants. Extensions are applied to a particularly sensitive area and are not without risks. I'm seeing a growing number of patients presenting with dry eye, eyelid inflammation, conjunctivitis, allergic reactions to adhesives, or infections. Extensions also place added weight on the natural lashes, and over time, this repeated trauma can lead to lash loss. While regrowth may occur initially, it can eventually result in eyelash alopecia or misdirected regrowth, where lashes curve inward toward the eye rather than outward — causing significant discomfort.
In more severe cases, complications such as keratitis or corneal ulcerations may develop.
What causes these complications?
The glues used to apply false lashes can be harmful. Some contain substances known to cause irritation and allergic reactions, such as formaldehyde or cyanoacrylates. Using these just millimeters from the cornea can trigger inflammation. Any eye injury is serious and can result in severe, even irreversible, complications. Application technique can also be an issue. Many beauty salons don't follow strict hygiene protocols and may spread bacteria like staphylococcus. There's often no requirement for technician training, so mistakes in handling extensions or improper disinfection of tools can occur.
What precautions should be taken by those considering eyelash extensions?
The reputation of the salon should be carefully checked. Staff should wear gloves and masks, disinfect their hands, and use sterilized, single-use tools. The procedure occurs very close to the eye, which is delicate, and must be performed correctly. Extensions should also be used sparingly. It's not about banning them, but common sense and moderation should take priority over beauty at all costs.
If the individual has a history of allergies, this should be discussed in advance with their primary care doctor or allergist. Some salons also use UV lamps to speed up glue curing, but UV exposure is harmful to health — for both the client and the technician. Salons using UV should be avoided. Finally, if after the procedure the person experiences discomfort or a sensation like sand in the eye, they should seek medical attention immediately.
This article was translated from Medscape's French edition.