## 4 Discussion
[34] recruited 60 adult women with eyebrow hypotrichosis, defined as a Grade 1 or 2 on the GEBA scale, to investigate the efficacy and safety of 0.01% and 0.03% bimatoprost and 2% minor oxidil preparations. This was a well-designed, randomized, controlled trial. There was a significant improvement at 4 months, defined as at least a one-grade increase on the GEBA scale. The percentages were 100% in the 0.03% bimatoprost group, 80% in the 0.01% bimatoprost group, and 80% in the 2% minor oxidil group, with no significant differences between the study groups. All three groups showed a significant increase in hair diameter and hair count compared to the baseline. The largest numerical increase in hair diameter and count was observed in the 0.03% bimatoprost group compared to the other study groups, but it did not reach statistical significance. Patients using 0.03% bimatoprost reported significantly higher satisfaction with the treatment (8.0 \(\pm\) 0.65) compared to those using 0.01% bimatoprost (6.80 \(\pm\) 0.62; \(p\leq\) 0.01) and 2% minor oxidil (6.60 \(\pm\) 0.50; \(p\leq\) 0.01). Experts consider bimatoprost useful in the treatment of hair loss caused by different pathological conditions and in different body areas. [PERSON] and [PERSON] [35] underscore the potential use of bimatoprost in idiopathic hypotrichosis of the eyelashes and eyebrows, as well as in patients with alopecia areata of the eyelashes and eyebrows. Other potential areas considered by experts include the use of bimatoprost in patients who have lost hair during cancer treatment or have hormonal disorders in androgenetic alopecia. A recent comprehensive review by [PERSON] et al. [10] stated that for the improvement of the eyelashes, 0.03% bimatoprost solution has been supported by strong Level 1, Grade A evidence and 0.03% bimatoprost gel by Level 2, Grade B evidence. There is still a need for further research to gather evidence supporting the efficacy of bimatoprost in the treatment of eyebrow hypotrichosis. There is also a need for more regulated use of bimatoprost in cosmetics. The European Commission [36] noted an increase in the use of cosmetics containing prostaglandandins marketed for promoting hair growth. However, tracking the safety of such products is challenging due to consumers' lack of awareness regarding active ingredients and their dosages, as well as insufficient reporting of adverse events related to cosmetics. As a result, the European Commission issued a call to academic institutions, research institutes, authorities, and cosmetic product manufacturers to share any scientific information relevant to the safety assessment of prostaglandandins and their analogs used in cosmetics. This call was prompted by the significant adverse effects associated with the use of cosmetic products for eyelash growth, underscoring the urgent need for large well-designed studies on using prostaglandandins and their analogs for non-medical needs. Our study confirmed a favorable safety profile of bimatoprost preparation. All the reported adverse effects were minor and resolved spontaneously with similar frequency between the study groups. The rate of any adverse reactions in our study was 18.52%, which was comparable to the level of adverse reactions in the sweet almond oil group. Our findings are in line with those provided by other researchers. They included closed comedones and irritation of the application area (inflammation and itching). [PERSON] et al. [31] reported comparable levels of adverse events in subjects using bimatoprost once- and twice-daily, and in those using a vehicle (42.4%, 38.1%, and 35.5%, respectively). Adverse events related to skin and subcutaneous tissue occurred in 4.2%, 5.1%, and 2.5% of participants from the study groups, respectively. Actinic keratosis was reported in 1 subject from the bimatoprost once-daily group and 3 subjects from the vehicle group. Importantly, no cases of hyperpigmentation or conjunctival hyperemia were reported. [PERSON] et al.