Your Essential Guide to Eyelid Dermatitis
Doctor’s Note
As dermatologists, we understand that living with eyelid dermatitis can be incredibly uncomfortable. Everyday activities like reading, working on a computer, or even blinking becomes cumbersome. For patients, it's often hard to know what will help - we hope our online info will help you learn everything you need to know about eyelid dermatitis.
What is Eyelid Dermatitis?
Eyelid dermatitis is a common skin condition that affects the delicate skin on and around your eyelids. It causes the skin to become red, itchy, and swollen. Sometimes, the skin can crack and peel, making it uncomfortable and sometimes painful. Although it's often bothersome, eyelid dermatitis can be managed effectively with the right care and treatment.
Eyelid Dermatitis Symptoms
If you have eyelid dermatitis, you might notice these symptoms:
Tukaj S, Zillikens D, Kasperkiewicz M. Topically applied low-dose calcitriol ameliorates atopic eyelid dermatitis. JAAD Case Rep. 2018 Nov 27;5(1):5-6. doi: 10.1016/j.jdcr.2018.09.012. PMID: 30533473; PMCID: PMC6262778.
Red and Swollen
Kim JH, Kim HJ, Kim SW. Allergic contact dermatitis of both eyes caused by alcaftadine 0.25%: a case report. BMC Ophthalmol. 2019 Jul 24;19(1):158. doi: 10.1186/s12886-019-1166-2. PMID: 31340775; PMCID: PMC6657074.
Blisters and Infections
Elliott JF, Ramzy A, Nilsson U, Moffat W, Suzuki K. Severe intractable eyelid dermatitis probably caused by exposure to hydroperoxides of linalool in a heavily fragranced shampoo. Contact Dermatitis. 2017 Feb;76(2):114-115. doi: 10.1111/cod.12738. PMID: 28095632; PMCID: PMC5299492.
Dry and Flaky
Moreira J, Gonçalves R, Coelho P, Maio T. Eyelid Dermatitis Caused by Allergic Contact to Acrylates in Artificial Nails. Dermatol Reports. 2017 May 29;9(1):7198. doi: 10.4081/dr.2017.7198. PMID: 28603598; PMCID: PMC5452630.
Itchy and Burning
What Causes Eyelid Dermatitis?
Eyelid dermatitis can be caused by several factors, often making it tricky to pinpoint the exact reason. Here are some common causes:
Allergies: Allergic reactions to substances like makeup, skincare products, or even pollen can cause eyelid dermatitis.
Irritants: Harsh chemicals in soaps, shampoos, or cleaning products can irritate the skin on your eyelids.
Medical Conditions: Conditions like atopic dermatitis (eczema) or psoriasis can also affect the eyelids.
Contact Dermatitis: This occurs when your skin comes into direct contact with an allergen or irritant, causing a reaction.
The Most Common Eyelid Dermatitis Allergies Are:
Fragrances
Preservatives (skincare, cosmetics)
Nickel (eyelash curlers)
Thiuram (rubber sponges, masks, balloons, and toys)
Cocamidopropyl (shampoos)
Tosylamide (nail polish)
Gold 🥇
What Makes Eyelid Dermatitis Worse?
Certain factors can worsen eyelid dermatitis, so it's essential to be aware of them:
Scratching: Scratching the affected area can make the condition worse and lead to infections.
Exposure to Irritants: Continued exposure to irritants like harsh soaps or certain cosmetics can aggravate the skin.
Stress: Stress can trigger or worsen eyelid dermatitis for some people.
Environmental Factors: Extreme weather conditions, such as very dry or cold air, can make symptoms worse.
What Makes Eyelid Dermatitis Better?
Managing eyelid dermatitis involves taking steps to soothe and protect your skin:
Avoid Triggers: Identify and avoid allergens or irritants that cause your symptoms.
Gentle Skincare: Use mild, fragrance-free cleansers and moisturizers designed for sensitive skin.
Short, Lukewarm Showers: Keep showers short with lukewarm water.
Cold Compresses: Applying a cold compress can help reduce inflammation and itching.
Hydration: Keeping the skin hydrated with gentle, hypoallergenic moisturizers can improve the skin's barrier function.
Step-by-Step Instructions: Manage Eyelid Dermatitis Flares
If your eyelids become red, itchy, or swollen, it’s best to intervene early. Here is your list of practical tips for soothing irritated eyelids:
Step 1: Identify Triggers
Take note of any environmental changes, diet, skincare products, or stress levels. Common triggers include allergens, irritants, stress, and weather changes. If you suspect a specific trigger, avoid it!
Step 4: Topical Steroids
If desired, apply over-the-counter hydrocortisone to the eyelids twice daily x 1 week. Ideally, apply after showering while your skin is still damp. In general, we prefer a greasy ointment over a white cream. Do not overuse topical steroids, but generally using sparingly for only a week at a time is okay.
Step 2: Simplify Routine
STOP ALL UNNECESSARY PRODUCTS. THIS INCLUDES PRODUCTS YOU USE ON YOUR HAIR, OTHER PARTS OF YOUR FACE, BODY, FRAGRANCE, NAIL PRODUCTS, SHAVING CREAM, ETC. Inevitably, these products get on our fingers, we touch our face, and potential irritants transfer to the eyelids. This step is not forever, this is just while your eyelids are flared.
Step 5: Moisturize
After hydrocortisone, apply plain Vaseline twice daily x 1 week. NOT AQUAPHOR. NOT NEOSPORIN. NOT BACITRACIN. NOT OTHER MOISTURIZERS. The idea of this strict regimen is to give your skin a very plain, but protected environment while it heals.
Step 3: Gentle Skincare
Use a gentle, fragrance-free cleanser. Avoid hot water; opt for a short, lukewarm shower. If your skin stings or burns when applying moisturizer, use plain petroleum jelly.
Step 6: Cool Off
If needed, apply a cold washcloth or a cold compress to reduce swelling and itching.
Best Prescriptions for Eyelid Dermatitis
Sometimes, over-the-counter creams and lotions aren't enough to handle eyelid dermatitis. When that happens, doctors often prescribe stronger medicines that you can only get with a prescription. These prescription topicals are usually more powerful and can help manage the symptoms better. If over-the-counter options aren't working, it's important to talk to your doctor about getting a prescription. The most common prescriptions we use for eyelid dermatitis include:
Topical Steroids
- Reduces inflammation and itching
- Low strength steroid used for the eyelid
- Prolonged use can thin the skin (we try not to use steroids for too long!)
Elidel + Protopic
- Reduces inflammation and itching
- Not a steroid
- Safe for daily use
- Used for sensitive areas like the eyelids
Best Procedures for Eyelid Dermatitis
If you experience prolonged flares (meaning more than 4-8 weeks) or repeated flares, you might consider patch testing. Patch testing is a test used to identify specific allergens that may be triggering your eyelid dermatitis. Small amounts of various substances are applied to the skin using adhesive patches, and the skin's reaction is observed to pinpoint the cause of the inflammation. The typical patch testing schedule is:
If we're being honest, patients hate this test because you cannot shower for the week, or do anything that will make you sweaty. Despite its challenges, there is tremendous insight to be gained from this test! What test do we typically use?
The T.R.U.E Test is a commonly used system for patch testing. It tests for 36 allergens in total. To see what allergens are tested, see below.
Another commonly used system is called the North American 80 Comprehensive Series (NAC-80). It tests for 80 allergens in total. To see what allergens are tested, see below.
Friday Picture: Mann J, Caruana D, Luo E, Gottesman E, Agrawal N, Lozeau D, Hessel J, Neumann M, Khanijo S, Hasan Z, Rizvi K, Gunther R, Donovan D, Chan D, Lee-Wong M, Szema AM. Attenuation of Human Growth Hormone-Induced Rash With Graded Dose Challenge. Cureus. 2022 Aug 12;14(8):e27920. doi: 10.7759/cureus.27920. PMID: 36110455; PMCID: PMC9464419.
Eyelid Dermatitis FAQs
What is the best eyelid cream for eczema?
The best eyelid cream for eczema should be fragrance-free, hypoallergenic, and contain soothing ingredients like ceramides and hyaluronic acid. These creams help to moisturize and repair the skin barrier without causing irritation. Look for products specifically labeled for sensitive skin or eczema.
Can I use an eyelid cream for itching caused by dermatitis?
Yes, you can use an eyelid cream for itching, but make sure it's designed for sensitive skin and is free from harsh chemicals and fragrances. Ingredients like colloidal oatmeal, aloe vera, and chamomile can provide relief from itching and reduce inflammation.
What is the best eye cream for eye eczema?
The best eye cream for eye eczema should be gentle and hydrating. Look for products with soothing ingredients like ceramides, hyaluronic acid, and niacinamide. These ingredients help to strengthen the skin barrier and provide long-lasting moisture.
How can I soothe irritated skin around my eyes?
To soothe irritated skin around your eyes, follow these steps:
Use a Gentle Cleanser: Wash with a mild, fragrance-free cleanser.
Apply a Cold Compress: Reduce swelling and soothe the skin.
Moisturize Regularly: Use a hypoallergenic moisturizer to keep the skin hydrated.
Avoid Rubbing Your Eyes: This can worsen the irritation and cause more inflammation.
What is the best sunscreen for eczema-prone skin?
The best sunscreen for eczema-prone skin is a mineral-based formula containing zinc oxide or titanium dioxide. These ingredients are less likely to irritate sensitive skin. Also, choose a sunscreen that is fragrance-free and contains moisturizing ingredients to keep your skin hydrated.
Can I use hydrocortisone for eyelid dermatitis?
Yes, hydrocortisone can be used for eyelid dermatitis, but it should be used with caution. Hydrocortisone is a mild steroid cream that can help reduce inflammation and itching. However, because the skin on the eyelids is very thin, it's important to use it only as directed by a dermatologist to avoid potential side effects.
What should I look for in an eczema eye cream?
An eczema eye cream should be free from fragrances and harsh chemicals. Look for ingredients like ceramides, hyaluronic acid, and colloidal oatmeal that help to soothe and repair the skin. These ingredients can provide relief from itching and keep the skin around your eyes hydrated.
Are there any good eyelid creams for wrinkly eyelids?
Yes, some eyelid creams can help with wrinkly eyelids. Look for products with ingredients like retinol, peptides, and hyaluronic acid. These ingredients can help improve skin elasticity, reduce the appearance of fine lines, and keep the skin hydrated.
Is it safe to use cortisone on my eyelids?
Using cortisone on your eyelids should be done with caution and under the guidance of a dermatologist. Cortisone is a type of steroid that can reduce inflammation and itching, but the skin on the eyelids is very thin and sensitive. Overuse can lead to thinning of the skin and other side effects.
What are some good eyelid ointments for eczema?
Good eyelid ointments for eczema should be gentle and free from irritants. Look for ointments that contain soothing ingredients like ceramides, petrolatum, and lanolin. These ingredients can provide a protective barrier on the skin and help to retain moisture.