3 Ways to Treat Chronic Blepharitis

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Blepharitis is a common condition causing red, irritated, flaky and sometimes crusted eyelids. Symptoms of blepharitis include redness, increasing the thickness of the eyelids, stinging and burning.

Many people with blepharitis have dry eye syndrome, often brought on by blepharitis. The condition produces flaky debris at the base of the eyelashes and can be quite unsightly in some cases.

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Blepharitis. DermNet / CC BY-NC-ND


Blepharitis typically doesn’t permanently damage eyesight and is a common problem among children and adults. 

Blepharitis can be associated with a bacterial infection. Usually, this bacteria is present at some level on all of our skin. However, for some reason, some individuals experience an overgrowth of this bacterial along the base of their eyelashes and dandruff-like particles form on the eyelids and lashes.

In some cases, blepharitis can be associated with poor hygiene, which is often the case in children and teens. Other causes of blepharitis include seborrheic dermatitis, acne rosacea, and allergic reactions to chemicals.

Another cause is Demodex, which is an eyelash mite that infests the eyelid margins and eyelashes. As we get older, Demodex tends to hang around a little longer and the critter just proliferates.


Blepharitis treatment varies depending on the cause, duration, and other systemic medical problems a person may have. The mainstay of blepharitis treatment is to apply warm compresses several times a day followed by eyelid scrubs once or twice per day.

Eyelid scrubs can be as simple as applying lathered baby shampoo onto a warm washcloth. The eye is closed and scrubbed with the washcloth using a gentle back and forth motion. Baby shampoo is recommended because it does not sting your eyes.

Your eye doctor may prescribe an antibiotic or antibiotic/steroid combination as eyedrops or an ointment the eyelid. Oral antibiotics may also be prescribed to quell the infection and inflammation from within.

Specific Treatments

Sometimes blepharitis can be very stubborn. The condition may resolve nicely only to return in a few weeks. Many people with blepharitis experience it chronically.

Three alternative treatments have been developed to offer a different approach to traditional warm compresses, messy lid scrubs, and antibiotics. Avenova, Claridex, and Blephadex bring something new to the table in chronic blepharitis treatment.


Avenova, produced by NovaBay Pharmaceuticals, is a daily eyelid and eyelash hygiene system that is easy to apply and very effective. Avenova contains pure hypochlorous acid 0.01%. 

Hypochlorous acid is a naturally occurring chemical that is released by neutrophils (white blood cells) to destroy organisms and neutralize their toxins. It is non-toxic and safe for the eyes.

In clinical studies, the main ingredient in Avenova, hypochlorous, was shown to be effective against the bacteria and organisms associated with blepharitis. 

Avenova works very quickly with an onset of just seconds. Simply apply two or three sprays to a round or oval cotton applicator and rub the eyelids and lashes in a horizontal movement at least three times.

Repeat on the lower eyelid, and on the other eye with a new cotton applicator. The company recommends it be used twice daily.


Blephadex, produced by Macular Health, is an in-office treatment that eye doctors use to treat blepharitis and especially Demodex-associated blepharitis. The applicator contains a gentle lid cleanser, tea tree oil, and coconut oil. Tea tree oil has shown to be an effective treatment for Demodex.

Both tea tree oil and coconut oil have anti-microbial properties but coconut oil also as some powerful anti-inflammatory and analgesic properties that improve the patient’s symptoms.


Cliradex, produced by Bio-Tissue, is a natural, preservative-free eyelid and eyelash cleanser that is effective against blepharitis but can also be used to clean the face after makeup removal.

Cliradex uses a moist towelette in individual packages to deliver melaleuca altenifolia, a type of tea tree oil to the eyelid and eyelashes. Cliradex contains 4-Terpineol, the active ingredient in tea tree oil. 4-Terpineol, when isolated, has been shown to be much more powerful than just tea tree oil alone.

This component of tea tree oil can be very helpful in managing the signs and symptoms of blepharitis. It is recommended to use Cliradex twice a day for about 10 days, and then once per day for 10 days for stubborn cases of blepharitis associated with Demodex. However, it is safe to use every day as an eyelid and facial cleanser.

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Additional Reading
  • Kabat, Alan, Sowka, Joseph. "New Blepharitis Treatments." Review of Optometry. 10/15/2014.