Ashley Brissette, MD, on helping patients with dry eye choose cosmetics wisely

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Hi everyone, welcome to another episode of season two of Our View Healio Vlog, focusing on physician wellness and I'd like to welcome Ashley Brissette. Thank you for joining us.

Hi, I am Dr. Ashley Brissette. I practice at Weill Cornell Medicine in New York City, and I am a cornea, cataract and refractive surgeon with a special interest in the ocular surface as well.

Can you share your story about how you got involved in makeup and the beauty gadgets?

Yeah, well it's funny because I really had an interest in ocular surface. I think when I started my career and I think as a younger female ophthalmologist, a lot of my patients would ask me, well, what are your thoughts on certain types of makeup that I can be wearing around my eyes? What are your thoughts on this skincare that I use close to the eyes? Is this safe with my dry eye or not? And that kind of led me into exploring it because it's nothing that we really learn about when we're in medical school or when we're going through a residency or fellowship, and I think our understanding of how cosmetics affects the ocular surface has only grown over the past number of years. And so now we really have good research and data that can help inform decisions about what we can recommend for patients.

That's awesome, so what are the three tips that you would offer up to someone that wants to give information as well as utilize it on myself?

Yeah, I know it's interesting too, because as I got into this I was like, oh, there's some practices that I definitely need to adopt as well. So, the first thing I think that people ask about is how do I safely remove eye makeup if I'm wearing it? And so, I usually recommend to people that's one thing that you definitely have to be doing. No sleeping in the eye makeup because the particles can migrate and get into the eye underneath the lid and cause a lot of irritation and ocular surface issues. So, removing eye makeup is big. I usually recommend one of two ways: One is using what's called a cleansing bomb. So, these are kind of more oil-based bombs, which over closed eyelids, they help to melt away a lot of the makeup. And the reason why I really like the bombs is that you don't have to rub and pull and tug too hard to remove the makeup. It like, dissolves it and then it's rinsed off. Or a micellar water-based eye makeup remover that you would put on a cotton pad and use that to rub. So, it's more of like mechanical as well. I'll recommend both to patients because some people, if they have a lot of sensitivity, don't want there to be too much mechanical rubbing to remove it. And other people want to stay away from more kind of oil-based cleansers based on skin type. So, I'll recommend either one, and I'll say to patients that both of them can be great options. I think that's one thing. Something else that I think people ask a lot about are some of the cosmetic lash enhancers. So, lash serums have become extremely popular, but we all know that there's danger, especially with a lot of cosmetic products. So, the prostaglandin-based lash serums, we know that prostaglandins, although they do give you beautiful, long, thick lashes, have lots of side effects. What's interesting is often patients that come in, even if they're, say, having redness or styes — which are common side effects of the prostaglandin, even sometimes skin color changes because of the use of these serums. “When I tell them it's probably from the serum, you should stop it,” Some people don't want to, and the psychology behind beauty trends is very interesting. But the one thing that I say that will allow people to pause and maybe think twice about continuing to use these prostaglandin-based lash serums is when we talk about the periorbital fat atrophy which can occur, because I think nothing really ages the face more than sunken kind of hollowed out eye area. And so that often I think will give people pause. And so, I think just informing them, I try never to be judgmental. So, I'm not black and white with any beauty trends. If a patient comes to me, I'm not just like, no anything; no makeup, no this, no that. I don't think that's the right solution. I think it's like informing about risk and benefit and then allowing patients to make the right decision, and then maybe even recommending safer alternatives. So maybe, like, a peptide-based lash serum instead. You're not going to get the same effect as a prostaglandin-based lash serum, but you will have some conditioning and enhancement of the lashes and I think that'll be safer in the long run.

Ashley, those were really wonderful tips. Thank you so much. I think our audience will also appreciate tips coming from an expert like you. And lastly, is there a specific topic that you want to share with us that maybe doesn't get spotlighted or highlighted as much as you would like?

Yeah, that's a great question. I think a lot of patients still ask about lash extensions. I think that's something that people still like to experiment with. And so again, speaking to them about some of the risk involved with doing a procedure like that, my advice is always for a special occasion. So, if it's something that a patient wants to try, I usually say go somewhere reputable, maybe do a patch test of the glue first, somewhere else on the skin. And if you really want to do it for, say, a wedding or a trip or something that you're taking, again, I'm not black and white, but then I do say that you have to have great kind of maintenance of the eyelids and lashes to be able to maintain the health. So, if you're going to experiment with lash extensions or even wearing makeup or anything like that, make sure that you're taking care of the eyelids and lashes by doing regular daily eyelid hygiene. I think that's extremely important. And then making sure that you're washing, making sure that you're kind of removing any allergens, any dust pollutant, debris, anything that might be irritating the eyes on the ocular surface to maintain the health of the eyes, and then being cautious to not repeat beauty trends again and again and get into a cycle of getting addicted to them and giving it a break and then allowing you to kind of embrace your natural beauty.

In our offices, we have a lot of brands of lid wipes or lid cleansers. Do you recommend any brands in your practice?

I do. So, actually, all of this area of interest in this research led me to create my own eyelid cleanser. It's called Daily Practice, so you can find it — We're across optometry and ophthalmology practices across the US in pharmacies, specialty stores, etc. And we're online, so you can find us at dailypractice.com. And it's really a daily eyelid cleanser. And so, it's much more hydrating than I'd say some of the other cleansers that are available, but still with great efficacy in terms of removing some of that pollutant debris from the lids and lashes. So that's generally what I recommend to my patients, but I also give them lots of great options. I think some tea tree-based cleansers are great for people who have a significant amount of bacteria buildup. So again, really directing patients, if it's a very acute issue, they might need something more therapeutic, but for daily lid maintenance and hygiene, I think Daily Practice can be a great option. And for makeup, I've partnered with a leading brand Clinique, and I know everyone's kind of heard of Clinique, but one thing that stood out to me in terms of our partnership in getting this messaging out is they have all of their eye makeup backed by what they call their eye safe promise. So, they do safety testing on all of their eye makeup and their eye safe promise ensures that every single eye makeup product is ophthalmologist tested, safer contact lens wearers and safer sensitive eyes. All of their products are hypoallergenic and fragrance-free, and we know fragrance is one of the most common offenders that leads to sensitivity reactions. And so really being able to stand kind of behind their products because of the rigorous testing that they perform makes me comfortable in terms of recommending it to my patients. And what's nice is that patients can still get that cosmetic look that they're looking for, but that has the safety guarantee behind it.

And Ashley, is Daily Practice preservative free?

It's not preservative free, no. So, it comes in kind of like a full-size bottle, so it's not preservative free. But again, even with mine, the rigorous safety testing was performed. And so, we did safety testing on a number of subjects in the eye area and for sensitive skin. So even for people who might have some sensitivities or some irritation, we found it's been safe for use.

That's great, wonderful. Thank you so much for sharing your pearls and tips to keep our eyes beautiful, thank you.