Derms Warn Against This Viral Eye Cream Hack

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The latest eye cream hack going viral on TikTok takes an entirely new approach to upper eyelid tightening, but it’s being met with criticism, and there’s also no proof that it’s safe for skin. Philip Cowley, aka @philsmypharmacist who dubs himself a “pharmacist mixmaster extraordinaire” and has 1.4 million followers, took to the platform yesterday to share a hack that “fixes your eye cream in less than a minute.”

The Hack

“Droopy eyelids are the worst,” he says in the video, which has nearly 40,000 likes. “Afrin [nasal spray] has oxymetazoline in it, and oxymetazoline is the same active ingredient in the new drop [Upneeq] that goes in the eye. We’re going to make a cream that goes on the outside of the eye.” In his caption, he writes: “Take 15 ml of eye cream with retinol in it. (I love this eye serum from Murad). Mix it with 7.5 ml of Afrin. Put it back in the bottle and apply at night!”

The Ingredient

According to Boca Raton, FL oculoplastic surgeon Steven Fagien, MD, the main ingredient in Upneeq, oxymetazoline hydrochloride, is the same primary ingredient in the decongestant nasal spray. “It has been well known that Afrin nasal spray works in the nose by a similar effect of vasoconstriction which opens swollen nasal airway passages. The thought was that an eye formulation using the same compound would work the same with a reduction change in concentration to maximize effects with reducing side effects.”

Woodbury, NY oculoplastic surgeon David Schlessinger, MD says Upneeq opens up the eye by lifting an upper eyelid muscle. “It causes blood vessels to contract,” he explains. “When placed in the eye it causes one of the lifting muscles of the eyelid, the Mueller’s muscle, to contract. It typically lifts the eyelid about 2 millimeters and its useful in treating ptosis which is when the eyelid closes due to weakness in the lifting muscles of the eyelid. It doesn’t work for patients that have baggy eyelids due to excess skin or drooping eyebrows.”

Should You Try It?

New York dermatologist Shereene Idris, MD, who has a prescription for Upneeq eyedrops for her mild ptosis, is very familiar with the ingredient and is not impressed with this concoction. “Do not waste your money on this hack,” she says in her reaction video. “When you apply oxymetazoline topically, it does jack sh*t. When you insert oxymetazoline into your eye through an eye drop—I’m not saying put Afrin in your eye—it works differently because it is lipophilic; it is a vasoconstrictor. You have mucus membranes on the whole inner lining of your eye and they’re loaded with blood vessels, so it’s going to get absorbed and constrict the blood vessels. In the process, it constricts your muscles, allowing them to lift.

When you apply it topically, your muscle is not going to contract—it just doesn’t work that way. Plus, the molecular weight of oxy is 260, which is small enough to penetrate the skin, but not small enough to penetrate deep enough to hit the muscle. If it’s as if I said I’m going to apply Botox topically and I’m going to be frozen—it does not work that way. And to make matters worse, he wasted an $89 retinol eye cream because he added the Afrin spray, which might be destabilizing to the retinol. Plus, he put the retinol on his upper eyelids and his eyelids look red and bloodshot toward the end of the video.”

“Expecting it to lift an eyelid by placing it on the skin is like expecting a nasal decongestant to work by placing it on the nasal skin instead of placing into the nostrils,” adds Dr. Schlessinger. “I also don’t recommend that retinols be used on eyelids on a daily basis. Leave treatment of your eyelids to the experts.”

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