How To Treat Eyelid Dermatitis
The best treatment for eyelid dermatitis is to avoid the trigger for your symptoms. Unfortunately, that isnt always possible.
Eyelid dermatitis flare-ups are often treated with topical medications . Your healthcare provider might prescribe a steroid cream to decrease inflammation. The potency of the cream will be low because the skin around your eyes is fragile compared to other parts of your body. In severe cases, your doctor might also prescribe oral steroid medication.
Topical calcineurin inhibitors are another type of ointment or cream used to treat eyelid dermatitis. These medications block the action of chemicals in your immune system. They are safer for your eyelid skin than steroid creams. But they can make your eyes sensitive to light.
Does Eyelid Dermatitis Require A Doctors Visit
If you notice that new soap or makeup seems to make your eyelids red or itchy, stop using it immediately and see if the irritation clears up. That could be all there is to it.
Unfortunately, many cases are harder to resolve because the cause isnt so clear. If you think youre experiencing symptoms of eyelid dermatitis, contact an eye doctor for proper assessment and treatment.
Anything that creates discomfort in your eyelids is going to make your life unpleasant, so its a good idea to set up an appointment if eyelid dermatitis, or any other condition, has started bothering you or affected your vision.
Page published on Wednesday, January 27, 2021
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Guide For The Natural Treatment Of Eyelid Dermatitis
Do you ever experience itchy or swollen eyelids? Although eyelid eczema also known as eyelid dermatitis can be caused by a variety of external or internal factors, most cases are characterized by several common symptoms including itching, stinging and/or burning. It is also quite common to experience red, swollen or flaky skin.
If youre suffering from eyelid dermatitis, were here to help you heal your eczema naturally and safely.
Please keep in mind that although these treatments can relieve eczema, we are in no way medical professionals. If youre experiencing severe eczema symptoms like fever or an infection, it is best to seek medical advice immediately.
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Common Triggers For Eyelid Eczema
If you are suffering from eyelid eczema due to irritants, then your first step is asking yourself what might be the main cause of your eczema:
- Do my eyes itch or swell after I pet my dog, cat, etc?
- Do my eyes tear and/or itch when I use a certain type of mascara, eye shadow or eyeliner?
- Do my eyes change in appearance based on temperature?
- Have I gotten an insect bite on or near my eyelid recently?
If you are able to answer at least one of these questions, the first step is simple: AVOID THE TRIGGER.
For patients with pets where avoidance is not an option, one strategy is to keep pet dander/saliva away from the face and eyelids. Another strategy is to wash the hands immediately after direct contact or avoid direct contact. Keeping pets off the bed or sofa and anywhere you may rest your head is a good idea as well.
As stated prior, its important to avoid scratching your eyelids and periorbital areas. Scratching can introduce bacteria to the irritated skin leading to a superimposed infection. This can affect both the skin and the eye.
If you cannot identify an obvious source of your eczema, then your condition might need a little more care.
How To Treat Dry Flaking Eyelids:
If youre not sure whats causing your dry eyelids, the first step will be to check in with a dermatologist. They may want to conduct some patch testing to see if you have an undiagnosed allergy, Dr. Kassouf says. However, there are a few measures you can take on your own if youre having eyelid eczema and dealing with an excess of flakes.
1. First, simplify your skin-care and makeup routines.
Start by avoiding as many products as possible, keeping eyelids clean and dry and using just a bit of moisturizer, Dr. Kassouf advises. Once your eyes have improved, then you can restart one product every few days, she says. If irritation occurs, then you should be able to identify which product you are sensitive to and remove that from your routine.
Its also important to streamline your eye-makeup routine. Reassess whether or not you need to use all of those products, like primer, shadow, liner, and mascara, all of which have preservatives or even fragrance than can cause a reactionsometimes weeks, months, or years after beginning to use a product. All of these contain ingredients with potential irritants or allergens.
2. Swap eye creams for simple ointments for the time being.
Instead, opt for a simple emollient such as Aquaphor Healing Ointment or Vaseline during a flare-up, which Dr. Kassouf says can be easier on the eyes during periods of irritation. Something like Vaseline All-Over Body Balm Stick may be easier to take on-the-go, Dr. Zeichner says.
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Emollients And Mild Topical Steroids
A person applies topical creams and ointments directly to the skin.
Doctors generally advise using low concentration steroid ointments on the eyes. This is because the eyelid skin is very thin and delicate.
Some topical treatments are available over the counter, but others require a prescription.
A doctor may prescribe a moderate potency steroid for a severe eczema flare-up. However, they would only prescribe this for a short period of time, such as 5 days.
Whats The Best Eyelid Eczema Treatment
If you do have eczema on your eyelids, youll want to do your best to avoid your triggers. This can range from pretty easy to completely ludicrous, depending on what specifically incites your eczema. If you cant steer clear of your triggers, or if doing so isnt enough to calm your eyelid eczema, you may need some extra help from a pro.
This is one of the hardest forms of eczema to treat with medication because of the sensitive area we are treating, Dr. Rodney says. We have to make sure your eyemeaning your eyeballis safe, as some prescriptions can lead to complications like glaucoma.
To treat any form of eczema, experts will often recommend topical corticosteroids to battle inflammation, the Mayo Clinic says, but these can be too strong on your delicate eyelid skin. If your doctor decides a corticosteroid cream is the best treatment for your case of eczema, theyll likely only prescribe it for a short period of time because it can cause thinning of your eyelids and the skin around your eyes, Cynthia Bailey, M.D., a diplomate of the American Board of Dermatology and president and CEO of Advanced Skin Care and Dermatology Inc., tells SELF. This treatment needs to be supervised by a physician, Dr. Bailey says.
Dr. Rodney also suggests placing a thin layer of petroleum jelly around and on your eyelids twice a day to reinforce the protective skin barrier, hydrate the dry skin, and reduce itching.
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As You Treat Your Eyelid Eczema Keep In Mind That It Can Cause Some Other Eye Issues For You Too And Look Out For The Symptoms
The more severe your eyelid eczema, the more likely it is that you might experience other eye problems, the American Academy of Dermatology says. The organization specifically highlights three eye conditions that people with eyelid eczema should have on their radar: pink eye, keratitis, and keratoconus.
Pink eye, also called conjunctivitis, happens when your conjunctiva becomes inflamed. Pink eye can cause bloodshot eyes, itching, tearing, a gritty feeling, and crustiness, the Mayo Clinic says.
Keratitis is an inflammation of your cornea that may cause eye pain, sensitivity to light, redness, a feeling that something is in your eye, excessive tearing or other discharge, and blurry vision, among other symptoms.
Finally, keratoconus is when your cornea changes from its usual round shape into a bulging cone shape instead, creating blurry or otherwise distorted vision, sensitivity to light and glare, needing to change your eyewear prescription too frequently, and cloudy vision, according to the Mayo Clinic.
These issues could also be tied to using those too-harsh medications that thin out your skin, Dr. Silverberg says. Scratching and rubbing that extra-thin skin can create tiny tears or irritate your eyes, making you more vulnerable to infection and inflammation that may present as pink eye or keratitis. That rubbing can also change the shape of your cornea, leading to keratoconus, the AAD says.
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Safe Periocular Steroid Use For Eyelid Dermatitis
What kind of steroid cream is safe for dermatitis of the eyelid and periorbital area, and how long can it be used? Are there any adjunct measures that can be taken? How real is the danger of thinning the skin of the eyelid and/or increasing intraocular pressure? Mansurur R. Khan, MD, Pasadena, Calif.
Given the side effects of topical corticosteroids, especially around the eyes, I routinely recommend the use of a nonsteroid preparation, such as topical pimecrolimus or tacrolimus .
If a steroid is used, I choose a low-potency formulation, such as hydrocortisone cream 1% or 2.5%, or an ophthalmic preparation. The risk of thinning the eyelids is real, as is the possibility of increased intraocular pressure. I limit the use of these agents to one to two weeks, while nonsteroids can be used without limitation. Jeffrey M. Weinberg, MD
These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a question, submit it here.
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Types Of Eczema On Eyelids And Around Eyes
The terms eczema and dermatitis are often used interchangeably to describe dry, itchy skin. Technically, eczema refers to atopic dermatitis, a common form of dermatitis.
The inflammation associated with dermatitis can affect any area of skin, including the eyelids and skin surrounding the eyes.
It occurs more often in the eye area in individuals who already have it on other parts of the body. Some of the common types of dermatitis affecting the eye area include atopic, contact, and seborrheic.
Are You Confident Of The Diagnosis
Eyelid dermatitis is an umbrella term describing a group of inflammatory skin disorders that localize to the eyelids and resemble eczema. There are many causes of eyelid dermatitis, hence it is a vexing problem for patients and can represent a diagnostic and therapeutic dilemma. Knowledge of the common causes and their key features can focus the history and physical examination and alert the clinician to more serious conditions.
Time course, patient age, symptoms, presence or absence of scale or edema, distribution help differentiate the different types of eyelid dermatitis. This chapter reviews the common periorbital dermatoses with emphasis on their distinguishing features.
Most common causes of eyelid dermatitis are
Contact dermatitis , 50% to 76% of cases
Atopic dermatitis, 12% to 17%
Seborrheic dermatitis 8% to 16%
Rosacea, less than 5%
There are other conditions of the eyelids that mimic eyelid dermatitis and are not to be missed, such as dermatomyositis. The broader differential diagnosis includes other connective tissue diseases , psoriasis, contact urticaria, infections , and drug reactions. Neoplasms benign or malignant can also mimic dermatitis and can localize to an eyelid. Discussion of those conditions is beyond the scope of this chapter.
Figure 1.
Discoid lupus erythematosus plaques on the eyelids. Photographs are courtesy of Dr Alfons Krol, Dr Eric Simpson and Dr Fran Storrs.
CONTACT DERMATITIS OF THE EYELIDS
What to be alert for in the history
Figure 2.
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What Triggers Irritant Eyelid Contact Dermatitis
Irritant contact dermatitis may be triggered by contact with irritating substances and/or physical triggers.
Irritating substances that may cause irritant contact dermatitis of the eyelids include:
- Chemicals such as chlorine under goggles worn when swimming
- Hydrophobic substances
- Cosmetics such as eyeliner, eye shadow, mascara and sunscreen
These substances may touch the eyelids directly or be transferred from the fingers .
Physical triggers that may cause irritant contact dermatitis include:
- Temperature extremes
- Humidity extremes
How Should I Care For Atopic Skin On My Eyelids
Atopic Dermatitis has two distinct phases, so adapt the way your care for your skin to the phase it is in:
On a daily basis and in the periods between flare-ups: Because the skin around your eyes is particularly delicate, choose gentle, fragrance-free eye make-up removers, cleansers and moisturisers . Try to avoid cosmetic products that contain fragrances and preservatives as these may irritate your skin.During the acute phase when skin flares-up:Ask your doctor for advice on how to calm and care for skin in the eye area during a flare-up. He or she may prescribe Cortisone which can be effective at relieving symptoms.You can read more about the possible triggers of a flare-up, as well as how to soothe and care for atopic skin during a flare-up, in Identifying and managing flare-ups.
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Irritant Contact Eyelid Eczema
The second known type of Eyelid Eczema is the irritant contact eyelid eczema which occurs when the skin around the eye comes in contact with an irritating substance even when you arent allergic to the substance. The most common substances that may cause irritant eyelid eczema are the makeups and eye creams you use every day. These skin care products may cause skin irritation and chronic pains or discomforts even without being allergic to their content or ingredients.
Note: Some of the substances responsible for Allergic Contact Eyelid Eczema can also cause irritant dermatitis. However, the difference between the two conditions is mostly dependent on the reaction of your immune system.
Some irritants that may cause Contact Eyelid Eczema include:
- Intensive hot or cold temperatures
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How Is The Diagnosis Of Irritant Eyelid Contact Dermatitis Made
Diagnosis of eyelid irritant contact dermatitis is made by identifying its characteristic features.
- An itchy rash that affects one or both eyelids, which may occur intermittently or continuously
- Suspicion that it has been caused or aggravated by contact with an irritant .
- Patch tests to suspected contact allergens are negative
It may be difficult to identify the precise cause.
Eye Shadow Causes Most Eyelid Eczema In Women
In my cosmetic dermatology practice, more than 90 percent of the time, the culprit that causes eyelid eczema is eye shadow.
Eyelid skin is thin and delicate. It is not designed for eye shadow. When applying eye shadow, you stretch the skin to hold it taut so the shadow goes on smoothly. When you stretch the skin, you make tiny microscopic cracks. When you make tiny little cracks, then stuff gets into the under layers of the skin that usually doesnt. That stuffcreams, lotions, powders, colors, fragrancesall cause irritation.
Powder and cream-to-powder eye shadows are drying to the skin. To apply pencils and crayon type sticks smoothly, the skin must be stretched. The absolute worst is shimmer shadow or any eye shadow that lists mica in the ingredient list. Shimmers and iridescent shadows use mica to give shine. Mica is a sheet of reflective mineral with very sharp edges. Some are more finely ground than others, but all make microscopic cuts to the top layer of skin. Applying eye cosmetics containing mica is like rubbing little tiny glass slivers into the skin. Your eyelids dont appreciate that.
Sponge tipped applicators worsen the problem by abrading the skin.
Using a synthetic pad, toilet paper, or Kleenex to remove eye makeup is very damaging to the delicate eyelid skin. Those products are too rough in texture and the fibers abrade the skin.
Occasionally, the rash is from a true allergic reaction to a specific color dye in the eye shadow.
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An Eye For Warning Signs Can Save Your Eyesight
If you have AD, its important to play close attention to your eyes. When an eye problem lasts more than a few days, make an appointment to see your dermatologist or eye doctor.
You should also have eye exams as often as your eye doctor recommends. Ophthalmologists are the experts at diagnosing eye disease. Caught early, the eye diseases linked to AD are highly treatable.
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ReferencesHeiting G. Eye problems and diseases. AllAboutVision.com. Website last accessed January 31, 2018.
Leung DYM, Eichenfield LF, et al. Atopic dermatitis. In: Wolff K, et al. Fitzpatricks dermatology in general medicine. McGraw Hill Medical, USA, 2008:152.
Thyssen JP, Toft PB, et al. Incidence, prevalence, and risk of selected ocular disease in adults with atopic dermatitis. J Am Acad Dermatol. 2017 77:280-6.
All content solely developed by the American Academy of Dermatology
The American Academy of Dermatology gratefully acknowledges the support from Leo Pharma, Inc., and Sanofi and Regeneron.