Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regard to prescription medication.
Upneeq is a prescription medication eyedrop used to treat ptosis, which is a medical term for drooping of the eyelids. According to the brand's website, Upneeq is the only medication approved by the Food and Drug Administration (FDA) for this condition.
The generic name for Upneeq is oxymetazoline hydrochloride ophthalmic solution 0.1%. These two terms refer to the same active ingredient, so we will use them interchangeably throughout this article.
Can eyedrops really open the eyes and improve vision and appearance? Is Upneeq proven to work in medical studies? Does it cause side effects? And how do real users respond to this treatment?
In this article we’ll answer all of these questions and more as we review medical studies on Upneeq to determine if it’s a safe and effective treatment for drooping eyelids. We’ll highlight some of the side effects of the medication and share before-and-after images from real users.
Does Upneeq Work?
Ptosis, short for blepharoptosis, can affect both the aesthetic appearance and function of the eyes. According to the American Academy of Ophthalmology, this condition can limit or block vision.
For a ptosis medication to like Upneeq to work, it needs to help users open the affected eye(s) so that their vision improves and their face becomes more symmetrical (which improves aesthetic appearance).
A medical review published in the JAMA Ophthalmology journal examined whether Upneeq could improve vision. The study authors found that patients using Upneeq had a significant improvement in vision.
The number of points on a visual scale that the trial participants could see more than doubled when using Upneeq when compared to placebo treatment, from 1.8 points to 5.9 points on average.
A more recent clinical trial published in 2021 examined the effects of Upneeq for treating eyelid drooping. 304 patients with acquired blepharoptosis were evaluated in total. The eyelid elevation in the Upneeq patient group was superior to that in the placebo group to a statistically significant degree.
15 minutes post-treatment on day 1 of the trial, eyelids raised 0.93 millimeters (mm) in the Upneeq group versus 0.32 mm in the placebo group. 15 minutes post-treatment on day 14 of the trial, eyelids raised 1.11 mm in the Upneeq group and only 0.41 mm in the placebo group. These results show that Upneeq improved eyelid drooping by over 100% compared to placebo.
We can conclude from the available research that Upneeq is likely to be effective for both improving vision and improving eyelid appearance in patients with eyelid drooping.
Those interested in Upneeq can check out the product using this link to the website of an official distributor.
Upneeq User Review
One of the most popular user reviews of Upneeq is from a YouTube channel named “Gorgeously Aging Advanced.” The creator was prescribed Upneeq and uses the medication on camera. She explains the effects to users and provides some before-and-after images:
Upneeq Before and After Images
One of the most commonly asked questions from patients about Upneeq is whether there are before-and-after images available. Because ptosis can cause facial asymmetry, many patients are as interested if not more interested about the potential aesthetic benefit of this medication compared to the vision benefit.
Upneeq provides before-and-after images of real patients who used their medication, which can be seen below:
Upneeq is relatively expensive without health insurance. GoodRx reports that the average price is $263.32 at the time of updating this article.
Upneeq’s website details that their medication is also available for purchase directly from medical providers. We recommend that patients speak with both their doctor and their health insurer prior to purchasing Upneeq to see if they can get a reduced price for the medication.
On the Skin Solutions website, which is an official distributor of Upneeq, consumers have the option to make a one-time purchase for $240 or an auto-ship purchase for $220.50. Both options are for a 45-day supply and can be accessed at this link to the Skin Solutions page. Since this is a significant cost savings compared to retail price, this is the distributor we recommend.
Upneeq Side Effects
The safety of Upneeq has been extensively studied in medical trials.
A recent medical review analyzed the safety of Upneeq based on results from four individual clinical trials. The total adverse event ratio was 31.2% in patients using Upneeq and 30.6% in patients using placebo. This means that only 0.6% more patients reported side effects on Upneeq than on placebo. This is a relatively low “true” side effect ratio compared to most medications we’ve reviewed.
The most common side effects on Upneeq were punctate keratitis (a disorder that causes eyes to become irritated and sensitive to light), excess of blood vessels in the eye, dry eyes and blurry vision. None of these side effects were experienced by more than 3.5% of the study population.
98% of patients across all trials reported no or “mild” side effects.
How Does Upneeq Work?
The active chemical compound in Upneeq was initially prescribed as a nasal decongestant, and its use for treating ptosis is recent. Thus researchers aren’t entirely sure of the exact mechanism of action, but there are some theories in the medical literature.
The first-linked research review in the initial section of this article includes a statement where the study authors hypothesize that Upneeq may cause contraction of a muscle that is weakened or dysfunctional in patients with ptosis. Once this muscle is contracted, the eyelid is lifted like a lever: “It is hypothesized that oxymetazoline, 0.1%, stimulates α-adrenergic receptors on Müller muscle.”
Upneeq appears to work due to a nervous system response to the medication, because the weakened muscle which causes ptosis does not come in direct contact with the eyedrops.
Is Upneeq Better Than Surgery?
One of the most common treatments for ptosis is corrective surgery which repositions the eyelid. This surgery may treat the root cause of the disorder, but it also carries a risk of complications. A medical review of blepharoptosis treatment called this surgery “perhaps the most challenging in the field of oculoplastics.”
This surgery carries risks such as orbital hemorrhage, where bleeding in the eye can cause permanent vision loss. There’s also around a 10% risk that the surgery is done improperly and a second corrective surgery is required.
In our opinion, Upneeq seems like a superior first-line treatment for ptosis given its low risk and relatively mild side effect profile. It’s also much cheaper. We would recommend that patients speak with their doctor about Upneeq before considering surgery.
Upneeq User Reviews
Drugs.com is a good resource for finding user reviews of prescription medications.
At the time of updating this article, there are only three reviews of Upneeq on Drugs.com and all are positive. A user called “Kima” was impressed with the aesthetic benefit that the medication provided:
“I like the “opened-eye” look one drop a day gives me. Didn’t realize how sleepy I looked before my Opthomologist recommended for one eyelid that was drooping a bit. We discovered I needed one drop in each eye, otherwise my eyes looked uneven.”
A user named "Glam-Ma" claims that Upneeq improved their aesthetic apperance and quality of life:
"I have had a droopy eye due to Horners Syndrome for past 30 years. It was caused from a surgical procedure. This medication has changed my life. I love this eye drop and use it every day. It opens up my eye and literally takes away that tired look."