What trichiasis is
Trichiasis is the condition in which eyelashes grow in the wrong direction, turning inward so that they rub against the front of the eye instead of pointing safely outward. It can involve a single stray lash or many, on the upper or lower lid.
It is worth distinguishing from entropion, which is sometimes confused with it. In entropion the whole eyelid rolls inward, carrying the lashes with it. In trichiasis the lid sits in its normal position, but individual lashes are misdirected. The distinction matters, because it changes the treatment.
Why lashes turn inward
The commonest background is chronic inflammation of the lid margin, particularly long-standing blepharitis, which disturbs the lash follicles so that lashes regrow in the wrong direction. Trichiasis can also follow anything that scars the lid margin: a previous injury, eyelid surgery, burns, or certain infections and inflammatory conditions. It becomes more common with age as the lid tissues change.
Symptoms
The hallmark is a persistent foreign-body sensation, the feeling that there is something in the eye, because in a sense there is: a lash is brushing the surface with every blink. This commonly comes with watering, redness, and sensitivity to light. Because the lashes scratch the cornea, the clear window at the front of the eye, untreated trichiasis can cause surface abrasions and, in time, more serious damage, which is why it is worth treating rather than enduring.
How trichiasis is treated
The simplest treatment is to remove the offending lashes by epilation, simply pulling them out, which gives immediate relief but is temporary, as the lashes regrow within weeks. For a more lasting solution the follicle itself needs to be destroyed, and there are several ways to do this: electrolysis, cryotherapy (freezing), or laser, each aimed at stopping that lash regrowing. Where many lashes are involved, or where the problem is really an entropion, a small operation to reposition the lid or lashes is the better answer. Most of these treatments are done in the clinic.
The right choice depends on how many lashes are involved and the underlying cause, which is why an assessment is useful rather than persisting with repeated pulling.
When to seek help sooner
Trichiasis is irritating rather than dangerous in the short term, but a few features warrant prompter attention because they suggest the cornea is being affected.
- Persistent eye pain rather than just irritation
- Marked sensitivity to light
- Any reduction or blurring of vision
- A red, painful eye that is not settling
These can indicate a corneal abrasion or ulcer from the rubbing lashes, which needs to be assessed and treated rather than left.
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What is the difference between trichiasis and entropion?
In trichiasis the eyelid is in its normal position but individual lashes grow inward and rub the eye. In entropion the whole lid rolls inward, turning all the lashes against the eye. They feel similar but are treated differently, so it is worth having the cause identified.
Can I just pull the in-growing lashes out myself?
Pulling a lash relieves it temporarily, but it regrows within a few weeks pointing the same way, so it is a short-term fix rather than a cure. Repeated pulling can also irritate the lid. For lasting relief the follicle needs treating, which is best done in clinic.
Does trichiasis go away on its own?
It rarely resolves by itself, because the lash follicle continues to send the lash in the wrong direction. The underlying cause, often chronic lid-margin inflammation, also tends to persist. Treatment is usually needed to settle it for good.
How is trichiasis treated permanently?
By destroying the follicle of the offending lash with electrolysis, cryotherapy, or laser, or, where many lashes or an entropion are involved, with a small operation to reposition the lid. The approach is chosen according to how many lashes are affected and the underlying cause.
Can in-growing eyelashes damage the eye?
They can. Lashes rubbing the cornea with every blink can cause surface abrasions and, if left long enough, more serious damage. This is why persistent pain, light sensitivity, or any change in vision should be assessed promptly rather than tolerated.
This page is for general educational purposes and does not constitute medical advice. If you are concerned about your eyes or eyelids, please seek assessment from a qualified specialist. Last reviewed May 2026 by Chris Matthews, Consultant Ophthalmologist and Oculoplastic Surgeon.
