Distichiasis (Double Eyelashes)

What is distichiasis (double eyelashes)?

Distichiasis refers to having an extra row of eyelashes. You might have a complete extra set, or you might have one or two or more extra lashes on each lid. Distichiasis is pronounced di-stuh-kai-uh-suhs. It was also called Blatt distichiasis after the optometrist who wrote about the condition.

If you have distichiasis, both eyelids have extra lashes. The extra lashes might be shorter or thinner than your first set.

The condition may be present at birth (congenital) or may happen later in life as a result of something else happening (acquired).

The extra eyelashes grow from a different place on your eyelids than the usual lashes. The extra lashes of distichiasis grow from your meibomian glands. These glands have the job of helping to lubricate your eyes.

How common is distichiasis?

Distichiasis is estimated to happen in about 1 in 10,000 people.

What is lymphedema distichiasis syndrome?

Lymphedema distichiasis syndrome is an inherited condition. People who have it have both lymphedema and distichiasis. Lymphedema is a condition of the lymphatic system that involves excess lymphatic fluid (lymph) collecting in the body’s soft tissues, usually in the arms and legs. This causes swelling. The syndrome is caused when people inherit variants of the FOXC2 gene.

About 94% of the people with this syndrome will have both lymphedema and distichiasis.

Other conditions that you may have if you have lymphedema distichiasis syndrome include:

• Drooping eyelids (ptosis).
• A curved spine (scoliosis).
• Heart defects.
• Early development of varicose veins.
• Cleft palate.
• Irregular heartbeat (arrhythmia).

What are the symptoms of distichiasis?

Signs and symptoms of distichiasis include:

• Having visible extra eyelashes.
• Redness, swelling or irritation of the eyes. You might feel like you have something in your eye.
• An infection of the eyelid that causes a painful bump (stye).
• Photophobia (sensitivity to light).
• Watery eyes.
• Frequent bouts of pink eye (conjunctivitis).
• Eye pain.
• Scratches or scars on your cornea.

What causes distichiasis?

Different types of congenital distichiasis have different causes.

Causes of congenital distichiasis

The cause of congenital distichiasis is a genetic issue that happens during conception. In some cases, the cells of your eyes develop incorrectly and you end up with hair follicles where they aren’t supposed to be located. In some of these cases, the gene involved is the FOXC2 gene. This particular gene is involved in the development of many other things besides double eyelashes.

Causes of acquired distichiasis

Many factors may cause acquired distichiasis, including:

• Blepharitis: This is a form of eyelid inflammation that may be chronic (long term).
• Stevens-Johnson syndrome: This is a serious disease in which your skin peels off due to an allergic reaction.
• Ocular cicatricial pemphigoid: This is an autoimmune disorder and a type of conjunctivitis that leaves scars.
• Chemical injury to your eye.
• Dysfunction in the meibomian glands: These glands provide an oily lubrication to your eyes.
• Ocular rosacea: This condition causes inflammation, discoloration and other eye irritation.

Is distichiasis contagious?

No, distichiasis isn’t contagious.

How is distichiasis diagnosed?

Your healthcare provider can diagnose distichiasis (double eyelashes) with an eye exam that includes a slit-lamp test. A slit lamp is a microscope that lets your provider see your eye under magnification.

There are many eye conditions, including an entropion (the inward turning of your eyelids), that may cause some of the same symptoms as distichiasis. Your provider may need to order additional testing to confirm their diagnosis.

How is distichiasis treated?

Many people who have double eyelashes won’t need treatment.

Nonsurgical treatments may include wearing certain types of contact lenses and using eye drops to reduce irritation.

If you need treatment, your healthcare provider will remove the extra lashes. The ways that your provider will remove the extra hairs include:

• Laser thermal ablation.
• Cryotherapy.
• Plucking.
• Electrolysis.
• Lid splitting: Your provider will divide your eyelids and remove hair follicles. This may happen along with cryotherapy and electrolysis. The combination of therapies may keep the extra lashes from growing back.

Plucking will only last two to three weeks. It’s likely that you’ll need several sessions of cryotherapy, electrolysis or laser thermal ablation to eliminate all hairs.

If you have lymphedema distichiasis syndrome, you may need other types of treatment.

How can I prevent distichiasis?

You can’t prevent congenital distichiasis. You may want to consult a genetic counselor if you have lymphedema distichiasis syndrome.

You may be able to prevent getting distichiasis as a result of chemical burns or other injuries to your eye if you wear proper protective equipment when working with chemicals or with equipment related to fires.

What can I expect if I have distichiasis?

The outlook for someone with distichiasis is generally good. You may have to have repeated treatments to rid yourself of the extra eyelashes that are bothering you. You may be able to stop any irritation with lubricating drops.

When should I see my healthcare provider?

Always contact or see your healthcare provider if you have eye irritation that you can’t get rid of or if you have eye pain. If you have a distichiasis diagnosis, ask your provider what kinds of symptoms you should watch for. Ask what type of situation would require emergency care. If you do have lymphedema distichiasis syndrome, you may want to ask about genetic counseling or support groups.

What is the difference between trichiasis and distichiasis?

Trichiasis is when your eyelashes are misdirected or aren't in the right position.

What is the difference between distichiasis and districhiasis?

Distichiasis refers to having two rows of eyelashes, while districhiasis refers to having three rows of eyelashes.

A note from Cleveland Clinic

You might think that having something called double eyelashes would be a good thing. And distichiasis isn’t really a bad thing. You may, however, have eye pain or irritation because of distichiasis. You may have repeated infections like pink eye or styes. You may also have the somewhat more serious condition of lymphedema distichiasis syndrome. Talk to your eye care provider as early as possible if you have, or your child has, these issues. Early detection leads to early treatment and early relief.