Essential Trichomegaly of the Eyelashes.

Sir,

A 12-year-old girl, with no personal or family history of interest, attended to our dermatology unit complaining an excessive growth of eyelashes during the last 5 years, producing occasional discomfort. Systemic treatment or topical application of creams or eye drops was ruled out. On cutaneous examination, the measurement of both eyelashes reached 10 mm on the peripheral edge and 17 mm in the central area [Figures 1 and 2]. No other trichological, dermatological, or dental anomalies were detected. Complementary tests including blood cell count, general biochemistry, thyroid profile, and autoantibodies showed no abnormalities. Essential trichomegaly as a form of localized congenital hypertrichosis was the diagnosis concluded.

Figure 1

Eyelash trichomegaly (frontal view)

Figure 2

Eyelash trichomegaly (cenital view)

Eyelash trichomegaly is defined as thickening and lengthening with or without curvature than 12 mm in the central area thereof or 8 mm on the peripheral one.[1] In spite of what is commonly considered, eyelash trichomegaly may disturb significantly the quality of life and be the cause of corneal abrasions and eye disorders such as amblyopia. Eyelash hair has a growth cycle of 5–6 months with a short anagen phase. Only 50% of these hairs can be found on this phase in contrast with scalp hair where the anagen phase lasts approximately 3 months and 70% of the hairs are included in this phase.[2]

Causes related to this entity include congenital, pharmacological, and acquired disorders and are summarized in Table 1. In the pathophysiology of this disorder, some immune factors such as prostaglandins and epidermal growth factor appear to be involved. Both mediators increase the duration of the anagen period on the hairs in this area. The treatment is symptomatic and sometimes requires the use of artificial tears to prevent associated meibomitis.[3]

Table 1

Etiology of eyelash trichomegaly

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