The intensity and color of skin change seen in this case series has similarities to the skin hyperpigmentation reported with Lumigan (Allergan Inc) and other prostaglandin analogues for the treatment of glaucoma. 1 However, detailed descriptions of the degree, distribution, and time course of skin hyperpigmentation have not been described. The observations in this series suggest that the direct application of bimatoprost to the upper eyelid margin appears to cause periocular hyperpigmentation, as suggested by the packet insert. We describe 4 cases of Latisse-induced hyperpigmentation of the eyelid skin using the eyelid delivery method and discuss the findings of these cases compared with previously reported data with Lumigan. These common adverse events have been described in less than 4% of patients. The most common adverse events caused by Latisse use are described as eye pruritus, conjunctival hyperemia, skin hyperpigmentation, ocular irritation, dry eye symptoms, and erythema of the eyelid. The prescribing information for Latisse 1 includes warnings related to skin changes such as possible lid pigmentation of the periorbital tissue and hair growth outside the treatment area. For the treatment of hypotrichosis, Latisse is used as a single drop on a sterile applicator and applied to the patient's upper eyelid skin at the eyelash margin daily at night. Shared Decision Making and Communicationīimatoprost solution, 0.3% (Latisse Allergan Inc, Irvine, California), is a synthetic prostaglandin analogue indicated for the treatment of hypotrichosis and dispensed separately to lower intraocular pressure (Lumigan, 0.3% Allergan Inc).

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