Double Eyelashes (Distichiasis)

What Are Double Eyelashes?

Distichiasis (you might hear it called double eyelashes) is a rare condition where you have two rows of eyelashes. The second row might be a full set of eyelashes, or it might be one or a few. They also might be thinner or shorter than your first row of eyelashes.

Causes of Double Eyelashes

There are two main ways you can get double eyelashes. If you're born with it, that's called congenital distichiasis. You can also get it later in your life. That's acquired distichiasis.

Congenital distichiasis happens when a cell that's supposed to be part of the system that protects your organs -- called the epithelium -- morphs into something called a pilosebaceous unit. That includes, among other things, a hair follicle.

In some cases, the cause of this form of double eyelashes is a mutation of the FOXC2 gene. It plays a role in the development of many organs and tissues before you're born.

Congenital distichiasis can be a sign of a rare genetic condition called lymphedema-distichiasis syndrome (LDS). In addition to double eyelashes, LDS causes a buildup of fluid called lymphedema.

Acquired distichiasis can happen if your eyelids get injured or inflamed. You might get this type of double eyelashes if you have:

Symptoms of Double Eyelashes

If you have distichiasis, you might not have any other symptoms besides the extra lashes. But you could have:

  • Eye pain
  • Swelling
  • Redness
  • Irritation
  • Vision loss
  • Sensitivity to light
  • Styes (small, painful bumps on your eyelid)
  • A feeling that something is rubbing against your eye when you blink (foreign body sensation)
  • Scarring of your cornea, the clear outer layer of your eye
  • An open sore on your cornea called a corneal ulcer
  • Droopy eyelids

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Who Gets Double Eyelashes?

A family history of double eyelashes makes you more likely to get congenital distichiasis.

There’s a higher change you’ll get acquired distichiasis if you:

  • Are older, since some conditions that lead to this form of double eyelashes happen with age
  • Are a woman, since OCP is twice as likely in women
  • Have eyelid inflammation
  • Wear contacts, since they're tied to MGD

Treatments for Double Eyelashes

The goal of treatment for double eyelashes is to get rid of the extra lashes or to ease any symptoms you have.

Your doctor could recommend:

Argon laser thermoblation. In this treatment, lasers destroy the hair follicles that create the extra eyelashes.

Cryotherapy. Extreme cold gets rid of the extra eyelashes, as well as any tissue that causes them.

Electrolysis. This treatment uses electricity and short-wave radio frequency to remove the extra lashes.

Epilation. The extra eyelashes are plucked. This is a temporary treatment because the lashes will grow back.

Lid splitting. In this surgical procedure, your doctor will split your eyelid open so the follicles of your eyelashes are exposed. Then, they'll remove the extra eyelashes. In many cases, you'd get this along with cryotherapy or electrolysis.

Your doctor might also suggest eye drops to ease any pain or softer contact lenses to protect your cornea.

WebMD Medical Reference Reviewed by Whitney Seltman on July 20, 2020

Sources

SOURCES:

American Academy of Ophthalmology: “Distichiasis,” “Trichiasis,” “What Is a Corneal Ulcer (Keratitis)?”

American International Medical University: “Distichiasis: Causes, Diagnosis and Management.”

National Organization for Rare Diseases: “Lymphedema-Distichiasis Syndrome.”

Ophthalmology: “Meibomian gland disease: the role of gland dysfunction in dry eye disease.”

StatPearls Publishing: “Ocular Pemphigoid.”

UpToDate: “Ocular cicatricial pemphigoid.”

U.S. Department of Health and Human Services: “Eye, Conjunctiva – Edema,” “Ocular cicatricial pemphigoid,” “Stevens-Johnson syndrome/toxic epidermal necrolysis.”

Moran Eye Center: "Ocular cicatricial pemphigoid."

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