Upneeq is a prescription eye drop that lifts a droopy upper eyelid. You put one drop in each affected eye once a day, the lid rises over the next couple of hours, and the effect lasts through most of the day. It is FDA-approved for acquired blepharoptosis in adults, which is the medical name for an upper lid that has slowly dropped with age. At Uplifting Medi Spa, we prescribe it at our New Braunfels and Spring Branch clinics after an eyelid consult.
It is not surgery and it does not change the lid for good. When you stop using the drops, your lids go back to where they were.
How does Upneeq work?
The active ingredient is oxymetazoline hydrochloride 0.1%. It acts on Müller's muscle, a small muscle inside the upper eyelid that helps hold the lid open. When that muscle tightens, the lid edge sits a little higher and more of the eye shows.
That is why the lift is modest. Upneeq adds a small amount of height to a lid that already works. It cannot fix a lid that droops because of loose, heavy skin hanging over it.
How fast does it work, and how long does it last?
In the clinical studies behind its approval, the lift peaked about two hours after the drop and was still there eight hours later. Many people use it in the morning so the effect covers the workday. The drop wears off on its own, so you use a new one each day you want the lift.
Who is a good candidate?
Upneeq suits adults whose upper lids have drooped slowly over time and who want a small lift without surgery. People often say they look tired, or that their eyes look uneven in photos.
It is a poor match when the droop is mostly extra skin, sometimes called hooding. That is a skin problem, not a muscle problem, and the drops won't change it. A surgeon can tell you whether an eyelid lift, called blepharoplasty, fits better.
When we would send you elsewhere first
A droopy lid is sometimes a sign of a nerve or muscle condition, such as myasthenia gravis, Horner syndrome, or a stroke. If your droop came on suddenly, affects one eye much more than the other, or comes with double vision, headache, or weakness, we will refer you for a medical exam before anything else.
Who should use caution with Upneeq?
Oxymetazoline belongs to a class of drugs that can affect blood pressure. Tell us if you have heart disease, high or low blood pressure that isn't under control, or you get lightheaded when you stand up. The label also advises caution for people with poor blood flow to the heart or brain, Sjögren's syndrome, or untreated narrow-angle glaucoma.
Bring a list of your medications. Blood pressure drugs, beta-blockers, heart medicines like digoxin, alpha-blockers, which are often prescribed for an enlarged prostate, and MAO inhibitors all need a closer look first. There is not enough data on Upneeq in pregnancy or breastfeeding, so we talk through those cases one by one.
What are the side effects?
In the clinical trials, side effects were uncommon and usually mild. Each of these happened in about 1 to 5 percent of people: dry eye, red eyes, blurry vision, eye irritation, pain when the drop goes in, small spots of irritation on the surface of the eye, and headache.
Get medical care right away if you have eye pain with redness, blurred vision, and sensitivity to light. Those can be signs of an acute glaucoma attack, which is rare but serious.
How to use Upneeq
Each dose comes in its own small single-use vial. Twist it open, put one drop in each droopy eye, and throw the vial away, even if some liquid is left. Don't let the tip touch your eye or anything else.
If you wear contact lenses, take them out first and wait 15 minutes before putting them back in. If you use other eye drops, space them at least 15 minutes apart from Upneeq.
Upneeq vs. surgery and Botox
An eyelid lift is surgery. It removes or tightens tissue, the results last for years, and it comes with recovery time. Upneeq is a daily drop with no downtime that lasts only as long as you keep using it. Some people use the drops first to see how they like a more open look before they think about surgery.
Botox works differently. It relaxes muscles, and a provider may use it to raise the brow slightly. Upneeq works on the lid itself. If your lid dropped after a Botox treatment, tell us. That kind of droop usually fades as the Botox wears off, and your provider will tell you what can help in the meantime. Our Botox guide covers what to expect from that treatment.
What does Upneeq cost?
Upneeq is sold in cartons of 30 single-use vials, about one month of daily use in both eyes. Because you keep using it to keep the lift, it is an ongoing cost rather than a one-time visit, and many people save it for workdays, photos, or events. We go over current pricing at your consult, and you can see our other services on the pricing page.
Common questions about Upneeq
Is Upneeq permanent?
No. The lift lasts through most of the day and fades by the next morning. Your lids return to their usual position when you stop.
Do I need a prescription for Upneeq?
Yes. It is a prescription drug, so a provider needs to check your eyelids and health history before prescribing it.
Can I use Upneeq with contact lenses?
Yes. Take your lenses out before the drop and wait 15 minutes before putting them back in.
Can I use Upneeq every day?
Yes. It is meant for once-daily use. In the clinical trials, people used it every day for six to twelve weeks.
Will Upneeq fix hooded eyelids?
Usually not. Hooding comes from extra skin above the lid, and the drops work on a muscle inside the lid. We will tell you honestly at your consult if surgery is the better fit.
Can I use Upneeq for one eye only?
Yes. The label allows one drop in one or both droopy eyes, so you can treat only the droopier eye if your lids are uneven.
Book an Upneeq consult
If you are in New Braunfels, Spring Branch, Bulverde, or nearby and your upper lids look heavier than they used to, start with a consult. We will check how your lids move, go over your health history and medications, and tell you plainly whether the drops are likely to help. You can book online or read more on our Upneeq treatment page.
This article is for education only. Individual results vary. Your provider will review your health history before prescribing any treatment.