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Peer-reviewedCC BYJournal of cosmetic dermatology

Periorbital Fat Loss From Prostaglandin Analogues: Dermatologic and Cosmetic Considerations

  • Lily Kaufman1
  • Aliza Khuhro1
  • Sierra Schwierking1
  • Lilia Valentic1
  • Sonja Kobayashi1
  • Lauren Malley1
  • Olivia Ueltschi1
  • Lucy Rose1
  • Brittany Dulmage2
  1. 1The Ohio State University College of Medicine Columbus Ohio USA
  2. 2Department of Dermatology The Ohio State University Wexner Medical Center Columbus Ohio USA
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Abstract

Background: Topical prostaglandin (PG) analogues, originally developed as first‐line therapies for glaucoma, are increasingly used in dermatology and cosmetic settings to promote eyelash and eyebrow growth. However, their use has been associated with prostaglandin‐associated periorbitopathy (PAP), a constellation of adverse effects including periorbital fat atrophy, deepening of the upper eyelid sulcus, ptosis, and skin hyperpigmentation. These changes can be subtle but carry significant aesthetic and psychosocial consequences, particularly in patients using PG analogues for cosmetic enhancement.

Aims: This review aims to synthesize current knowledge on the clinical features, pathophysiology, and reversibility of PAP, with an emphasis on implications for dermatologic practice.

Methods: A narrative review of the literature was conducted using PubMed, focusing on dermatologic, ophthalmologic, and cosmetic reports related to PG analogue use and PAP.

Results: Although PAP is well recognized in ophthalmology, dermatology‐specific data remain sparse. Many over‐the‐counter eyelash serums contain PG analogues yet lack accurate labeling and regulatory oversight. Diagnostic delays are common, and dermatologists may overlook serum use as a contributing factor in periorbital changes.

Conclusions: As the off‐label and consumer‐driven use of PG analogues continues to rise, dermatologists must remain vigilant in identifying PAP. Routine history‐taking should include inquiry about eyelash and eyebrow serums. Greater regulatory oversight, patient education, and dermatology‐focused research are needed to promote safe and informed use.

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Cite

BibTeXRIS
BibTeX
@article{kaufman2026periorbital,
  title = {{Periorbital Fat Loss From Prostaglandin Analogues: Dermatologic and Cosmetic Considerations}},
  author = {Lily Kaufman and Aliza Khuhro and Sierra Schwierking and Lilia Valentic and Sonja Kobayashi and Lauren Malley and Olivia Ueltschi and Lucy Rose and Brittany Dulmage},
  journal = {Journal of cosmetic dermatology},
  year = {2026},
  month = oct,
  doi = {10.1111/jocd.71254},
  url = {https://europepmc.org/article/PMC/PMC13720958},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Periorbital Fat Loss From Prostaglandin Analogues: Dermatologic and Cosmetic Considerations
AU  - Lily Kaufman
AU  - Aliza Khuhro
AU  - Sierra Schwierking
AU  - Lilia Valentic
AU  - Sonja Kobayashi
AU  - Lauren Malley
AU  - Olivia Ueltschi
AU  - Lucy Rose
AU  - Brittany Dulmage
PY  - 2026
DA  - 2026/10/30
JO  - Journal of cosmetic dermatology
DO  - 10.1111/jocd.71254
UR  - https://europepmc.org/article/PMC/PMC13720958
AB  - Background: Topical prostaglandin (PG) analogues, originally developed as first‐line therapies for glaucoma, are increasingly used in dermatology and cosmetic settings to promote eyelash and eyebrow growth. However, their use has been associated with prostaglandin‐associated periorbitopathy (PAP), a constellation of adverse effects including periorbital fat atrophy, deepening of the upper eyelid sulcus, ptosis, and skin hyperpigmentation. These changes can be subtle but carry significant aesthetic and psychosocial consequences, particularly in patients using PG analogues for cosmetic enhancement.  Aims: This review aims to synthesize current knowledge on the clinical features, pathophysiology, and reversibility of PAP, with an emphasis on implications for dermatologic practice.  Methods: A narrative review of the literature was conducted using PubMed, focusing on dermatologic, ophthalmologic, and cosmetic reports related to PG analogue use and PAP.  Results: Although PAP is well recognized in ophthalmology, dermatology‐specific data remain sparse. Many over‐the‐counter eyelash serums contain PG analogues yet lack accurate labeling and regulatory oversight. Diagnostic delays are common, and dermatologists may overlook serum use as a contributing factor in periorbital changes.  Conclusions: As the off‐label and consumer‐driven use of PG analogues continues to rise, dermatologists must remain vigilant in identifying PAP. Routine history‐taking should include inquiry about eyelash and eyebrow serums. Greater regulatory oversight, patient education, and dermatology‐focused research are needed to promote safe and informed use.
SN  - 1473-2130
SN  - 1473-2165
ER  -