How to identify and treat eyelid dermatitis

If you buy something through a link on this page, we may earn a small commission. How this works.

Eyelid dermatitis is a common condition that causes the skin on or around the eyelid to become dry, itchy, and irritated.

The term may refer to eczema, psoriasis, or seborrheic dermatitis on the eyelids. When the cause is an allergen or irritant, the condition is called eyelid contact dermatitis.

This article discusses how to manage eyelid dermatitis, using treatments and home remedies. It also looks at the symptoms and causes of the condition.

Treatment

For all kinds of eyelid dermatitis, people should keep the eye area clean and avoid touching it or scratching. This helps to prevent further irritation or infection.

Where possible, it is helpful to identify and avoid contact irritants and allergens that can cause flare-ups. These can include:

• certain makeup brands
• sunscreens
• perfumes
• swimming goggles
• eye drops
• false eyelashes
• contact lens solution
• airborne allergens

To treat eyelid dermatitis caused by atopic dermatitis (eczema) or psoriasis, and for immediate relief from symptoms, a person can:

• Moisturize. Moisturizing creams can relieve dryness and itching. A wide range of creams is available with and without prescription. They are most effective for treating mild dermatitis.
• Use calcineurin inhibitors. This medication is used to treat inflammatory disorders, including atopic dermatitis and psoriasis. It can be applied as cream or taken orally. It should be used with caution, as it may suppress immune function. Calcineurin inhibitors are available to purchase in pharmacies, health stores, and online.
• Use corticosteroids. Steroid-based creams can be applied directly to the eyelids to treat inflammation and reduce dryness. For widespread cases of dermatitis or eczema, corticosteroids can be taken in tablet form. The strength of the medication depends on the severity of the symptoms. Corticosteroids are available to purchase in pharmacies and online.

People should use corticosteroid creams cautiously as they can lose some of their effectiveness if applied for too long. When used close to the eye, there is a risk of glaucoma if used for long periods of time.

These creams can also induce certain short-term side effect, such as acne, hair growth on the treated areas, and thinning of the skin.

Corticosteroid tablets are reserved for the most severe symptoms, as their side effects can be serious. Possible effects include high blood pressure, diabetes, and osteoporosis.

Symptoms

Dermatitis on the eyelids causes inflammation of the thin, sensitive skin around the eyes. The eyelids become irritated, swollen, dry, and reddened. It can affect one or both of the eyes.

If this condition persists, the eyelids can become thickened in a process called lichenification.

When caused by an irritant or allergen, symptoms typically occur within a few hours or days of contact with a trigger substance. Symptoms should subside when the trigger substance is removed.

Types and causes

Common forms of eyelid dermatitis include:

• Allergic contact dermatitis develops because of an allergic reaction that causes inflammation of the skin, such as pollen in a person with hay fever. Some cosmetic products or metals, such as nickel, are common causes of allergic skin reactions.
• Irritant contact dermatitis is caused by the eyelid coming into direct contact with a substance that damages the outer layer of the skin, such as certain types of makeup, soaps, and detergents.
• Atopic dermatitis is a form of eczema that can affect the eyelids.
• Seborrheic dermatitis is a common condition that causes the skin to become inflamed and flakey. It often occurs on the scalp but can also affect oily areas of skin, such as the eyelids.

It is unclear what causes conditions such as atopic dermatitis, though there seems to be a genetic component, and it can run in families.

Prevention

The following actions may help to prevent outbreaks of eyelid dermatitis:

• Avoid scratching or rubbing eyelids. This can cause further damage to the skin and increases the risk of infection.
• Make dietary changes. Food allergies can trigger eyelid dermatitis. Dairy products, in particular, can cause symptoms of atopic dermatitis to emerge. A person should consult a doctor before making any significant dietary changes.
• Try anti-itching products. Over-the-counter medications can reduce the urge to itch. A hot or cold compress may also help.
• Avoid certain moisturizers. Products containing formaldehyde, lanolin, parabens, or with a fragrance, may cause additional irritation to the skin.
• Wear protective gear. Shielding the eyes from potential irritants, using goggles or glasses, can help.
• Moisturize regularly. Using a moisturizer on the eyelids each day may prevent symptoms from developing. People should take care not to get moisturizer in the eyes.
• Use less soap. Taking shorter showers or baths will reduce the time skin is exposed to potential irritants. It may also help to use milder soaps, antibacterial soap, or soaps without fragrance.
• Restrict makeup use. Using makeup around the eyes, such as eye shadow or mascara, can irritate the sensitive eye area. Using less or switching to hypo-allergenic brands can be helpful.

The causes, types, and triggers of eyelid dermatitis vary. It may be necessary to try several of these actions before finding the most effective ones.

Risk factors

The skin around the eyes is thin and delicate, and so the eyes are especially sensitive to irritation.

While it is hard to predict who will develop eyelid dermatitis, certain factors may increase the likelihood of the condition developing. These include:

• Age. Infants are more susceptible to certain types, such as seborrheic dermatitis, also called cradle cap.
• Genetics. Skin conditions often run in families.
• Poor personal hygiene. Not keeping the skin clean can lead to the condition.
• Certain professions. These include any with frequent exposure to potential trigger substances, such as agricultural, construction, cosmetic, and beauty workers.
• Certain medications. Medications, such a neomycin or beta-blockers, can be triggers.
• Medical conditions. Hay fever, asthma or other skin conditions, such as acne or psoriasis.

Diagnosis

It is possible to self-diagnose eyelid dermatitis if the cause is obvious. Through trial and error, it is possible to identify and avoid triggers without the need for medical attention.

A doctor can often diagnose the form of dermatitis through a physical exam. They may ask about risk factors, such as hay fever.

When an allergic reaction is suspected as the cause, a doctor may recommend a patch test. Here, a common allergen is placed on the skin to test for an allergic reaction.

If an irritant is the suspected cause, a repeated open application test (ROAT) can be used. This involves exposing the skin to the irritant over several days to test for problematic skin reactions.

It can be more difficult to determine a specific irritant compared with an allergen.

Complications

Some complications that may occur with eyelid dermatitis include:

• Skin infections. Scratching or rubbing the eyes can make the skin vulnerable to infections.
• Eye infections. Bacteria can get into the eye from repeatedly touching or rubbing the region, causing infections.
• Difficulty sleeping. The symptoms of eyelid dermatitis can cause discomfort while sleeping.
• Other skin conditions. It is possible for eyelid dermatitis to occur before skin inflammation on other areas of the body.
• Neurodermatitis. Chronic scratching or rubbing can increase the urge to itch. Persistent scratching can cause the skin to become discolored and leathery.

Outlook

Eyelid dermatitis poses no serious health risks, though it can be uncomfortable and can interfere with daily life.

In most cases, the symptoms are easily managed with treatment and by avoiding triggers. It can, however, become a long-term and recurring condition.

When triggers cannot be identified or avoided, treatment will be used to manage symptoms as best as possible.

The effectiveness of treatments can depend on the extent of exposure to triggers, and the sensitivity of the skin.

Using strategies to prevent symptoms, such as avoiding itching or rubbing the eyes, will help to improve and reduce the severity or onset of symptoms. A doctor or skin specialist can recommend actions that are most suitable for each person.

Written by Aaron Kandola

SOURCE: MEDICAL NEWS TODAY