How to Prevent and Handle Misdirected and Ingrown Eyelashes

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Trichiasis is a common eyelash problem that causes eyelashes to grow abnormally. Instead of growing outward, a few eyelashes may grow inward toward the eye. Because eyelashes are often very coarse, trichiasis can feel like a needle poking into your eye and that often causes pain and irritation—but it can also cause damage to your eye if not resolved.

Symptoms of Trichiasis
Verywell / Cindy Chung 

Symptoms of Trichiasis

Trichiasis can cause your eyelashes to rub against the conjunctiva and the cornea, causing pain and irritation. The constant irritation to the cornea can sometimes cause a corneal abrasion. Inflammation and vision loss can also occur if the condition becomes chronic or ongoing.

People with trichiasis often complain of the following symptoms:

  • Foreign body sensation
  • Eye redness
  • Blurry vision
  • Watery eyes
  • Eye pain

Many say they feel like something is scratching their eye or they think that there is a piece of sand in their eye.

Contact your eye healthcare provider when you feel eye irritation, as a corneal abrasion or infection can develop.


Sometimes healthcare providers do not find a reason why the eyelashes grow the wrong way. This is called an idiopathic cause. The eye appears healthy, but the eyelash just tends to grow inward. 

However, a very common cause of trichiasis is blepharitis. Blepharitis causes infection and inflammation of the eyelids and eyelid margin. When this occurs, the hair follicles can become misdirected and cause trichiasis.

There are a few other eye conditions that may cause the eyelashes to be misdirected or grow abnormally:

  • Entropion: The eyelid loses its normal elasticity and flips or folds inward. This is sometimes due to age or being overweight. It is seen more commonly in adults.
  • Injury: If the eyelid is torn or injured, the position of the eyelashes may change and grow inward. This can happen as a result of the surgical repair of an injured eyelid.
  • Distichiasis: An extra row of eyelashes develops and grows inward, rubbing against the eye.


The irritation caused by trichiasis is usually enough to prompt a person to make an appointment with an eye healthcare provider. By examining your eye with a slit lamp, your eye healthcare provider will be able to tell if you are in fact suffering from trichiasis.

Your healthcare provider will also instill a staining solution to show potential damage that may have occurred to your cornea due to the repeated irritation. This test can reveal how serious your condition may be.

Treatment Options

The following options may be used to treat trichiasis. Your healthcare provider will decide which treatment option is best for you. If the initial treatment your healthcare provider chooses is not sufficient, they may decide to explore other treatment options on this list. 

  • Epilation: The first line of treatment is to epilate or pluck the misaligned or misdirected lashes with special forceps. Eyelashes will typically grow back in two or three months.
  • Electrolysis: Electrolysis uses an electric current to damage the hair follicle, preventing re-growth. Recurrence occurs in 40% to 50% of patients.
  • Surgery: In severe cases, eyelid surgery may be performed to eliminate trichiasis.
  • Bandage contact lens: A soft bandage contact lens is applied to the cornea to help it heal and to protect it from eyelashes that have not been epilated yet.

Frequent visits to your eye healthcare provider are recommended when you have trichiasis. The life cycle of an eyelash is around three months. If you have trichiasis that is recurrent, schedule your healthcare provider visits every two and a half months so that the healthcare provider can check to see if any new eyelashes are growing the wrong way.

Complications of Trichiasis

If left untreated, trichiasis can turn into a serious eye problem. A corneal abrasion, which may develop from a coarse eyelash, can cause considerable damage to your eye. If an infection occurs, your healthcare provider may prescribe antibiotic eye drops and anti-inflammatory medicines.

A Word From Verywell

You may require a few office visits, but that's much better than winding up with a bad case of trichiasis on the weekend and being in pain for a few days. If you suspect trichiasis, be sure to seek the advice of a professional.

Frequently Asked Questions

  • What's the first-line treatment for trichiasis?

    If only a few lashes are involved, most ophthalmologists (eye doctors) will start with epilation—pulling the eyelashes out by the root—but this tends to be a temporary fix. When the plucked lashes grow back, they're likely to continue pointing the wrong way. That said, research has found repeated epilation to be as effective as surgery in many cases and so may be preferable for some people.

  • Are there permanent options for treating trichiasis?

    When epilation doesn't work or more than a few lashes are involved, there are a number of treatment approaches that may solve the problem for good, including:

    • Eyelash trephination, in which lashes are removed by using a tiny tube to bore out the lash follicle
    • Classic electrolysis
    • Radiofrequency electrolysis
    • Argon laser therapy
    • Cryotherapy (often effective for large areas of misdirected lashes)
    • Surgery
  • What is the difference between trichiasis and a stye?

    Although both conditions have strikingly similar symptoms—pain, swelling, and redness along the lash line—in the case of trichiasis these symptoms are caused by one or more eyelashes growing the wrong way (i.e., toward the eyeball). A stye typically is caused by a bacterial infection in a lash follicle or oil gland.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Academy of Ophthalmology. Trichiasis symptoms and treatment.

  2. American Academy of Ophthalmology. What is trichiasis?.

  3. American Academy of Ophthalmology. EyeWiki: Trichiasis.

  4. Habtamu E, Rajak SN, Tadesse Z, et al. Epilation for minor trachomatous trichiasis: four-year results of a randomised controlled trialPLoS Negl Trop Dis. 2015;9(3):e0003558. doi:10.1371/journal.pntd.0003558

  5. Review of Ophthalmology. Trichiasis: Lashes gone astray.

  6. Merck Manual Consumer Version. Trichiasis.

  7. American Academy of Ophthalmology. What are styes and chalazia?

By Troy Bedinghaus, OD
Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association.