Eyelid Dermatitis: Overview and More

Eyelid dermatitis is irritation of the thin, sensitive skin around your eyes. Often caused by contact with an irritating substance or allergen, eyelid dermatitis causes red, itchy, swollen, and sometimes crusty eyelids.

Also called eyelid eczema, periocular dermatitis, or periorbital dermatitis, eyelid dermatitis can be diagnosed by your primary healthcare provider. In some cases, you may be referred to a dermatologist or allergist.

Treatment of eyelid dermatitis depends on the cause, but typically involves topical medications, such as steroid creams. Oral medications, including steroids and antihistamines, may also be needed to clear up the rash.

This article discusses eyelid dermatitis, including its symptoms, types, and causes. It also explains how eyelid dermatitis is diagnosed and treated.

Symptoms of Eyelid Dermatitis

There is more than one type of eyelid dermatitis. Your symptoms can vary depending on which type you have:

Eyelid dermatitis symptoms can include:

• Redness
• Dry, scaly, or rough skin
• Itching around your eyes
• Swollen eyelids
• Oozing or crusted skin

Eyelid dermatitis can lead to stress, sleeping trouble, and decreased quality of life.

It can also raise your risk for other eye conditions, such as conjunctivitis (pink eye) and keratitis (inflammation of the cornea, the clear outer layer of the eye).

If you rub your eyes long enough, you can actually change the shape of your cornea. This condition is called keratoconus. It can lead to loss of vision.

See your doctor if you notice any of the following problems:

• Pain in your eyeball
• Sticky, wet, or crusted eyelashes
• Sensitivity to light
• “Gritty” feeling in your eye
• Blurry vision
• Any other changes to your vision
  

Allergic Contact Dermatitis

Allergic contact dermatitis happens when you're exposed to an irritating substance so often that your body becomes hypersensitive or allergic to it. Your eyelids may become red in places. They may itch or sting.

Causes

Allergic contact dermatitis is caused by an immune reaction in your body. If you're exposed to certain substances over and over, immune cells "remember" them. When you come into contact with them again, your cells respond with inflammation.

If your skin barrier doesn't work properly, too much of an allergen can seep into your body. That makes it more likely you'll have allergic contact dermatitis. Your genetic background has a lot to do with how well your skin barrier works.

Irritant Contact Dermatitis

Irritant contact dermatitis occurs when your skin has a negative reaction to something that touches it, such as soap or a cosmetic product.

This form of eyelid dermatitis can be painful, but is temporary. Your symptoms should go away soon after you remove the irritant.

Causes

Irritant contact dermatitis can be triggered by many common substances. Flare-ups in symptoms can be caused by:

• Household chemicals
• Cigarette smoke
• Fragrances
• Metals, such as nickel
• Certain fabrics
• Dyes
  

Atopic Dermatitis

Atopic dermatitis (eczema) is different than contact dermatitis. With this condition, your body identifies a substance (called an allergen) as “foreign.” It then tells your immune system to fight it off, which causes your uncomfortable symptoms.

There’s no cure for atopic dermatitis. Symptoms can ebb and flow.

Causes

Atopic dermatitis often runs in families. You might have a genetic difference that makes you more prone to the condition. With this difference, your body doesn’t produce enough of a protein called filaggrin which helps to keep your skin strong.

If you have other allergies, such as hay fever, you are also more likely to develop eczema around the eyes or other parts of your body. Weather conditions, such as dry air or large temperature changes, can also trigger flare-ups.

Seborrheic Dermatitis

Seborrheic dermatitis is the same skin condition that causes dandruff in adults and cradle cap in babies. It's part of your body's immune reaction to a type of yeast that is normally found on the skin.

Causes

Seborrheic dermatitis is often caused to an overgrowth of Malassezia yeast. When too much of it grows on the skin at one time, it can lead to irritation and flaking. This is especially true if your skin barrier isn't protecting you as well as it should.

This condition is often triggered during times when there's a lot of hormonal activity in your body. Birth, puberty, and adulthood from ages 30-60 are peak periods.

Sometimes another health condition makes it more likely that you'll get this type of eyelid dermatitis. Some of the conditions linked to it include:

• HIV
• Psoriasis
• Eczema
• Substance use disorder
• Depression
• Acne
• Parkinson's disease
• Disordered eating
• Epilepsy
  

Risk Factors for Eyelid Dermatitis

You may be more likely to develop eyelid dermatitis if you have certain risk factors, including:

Age

Babies and young children can be more vulnerable to atopic dermatitis and seborrheic dermatitis. These conditions can return in adulthood, usually between ages 30 and 60. Some older people may also face a higher risk because of thinner skin and slower wound healing.

Genetics

Genes play a role in how sensitive you are to irritants and allergies. If people in your family have skin conditions or allergies like these, you are more likely to have them.

Certain Professions

Jobs and hobbies where you use chemicals that strip away your skin's protective barrier raise the risk of dermatitis. Veterinarians, mechanics, hospital workers, and agriculture workers are good examples.

Poor Hygiene

Eyelids that aren't regularly cleaned and massaged can raise your risk of developing inflammation or becoming infected.

Some Medications

Many medications can cause a skin reaction. NSAIDS, antibiotics, biologic treatments, and antifungal medications can all cause dermatitis.

Health Conditions

If you hay fever, asthma, allergies, or eczema, you have a higher chance of developing a skin condition that could affect your eyelids.

Diagnosing Eyelid Dermatitis

Your primary care doctor may be the first person to diagnose your condition. You may need a specialist, such as a dermatologist or an allergist, to find the underlying cause.

Your healthcare provider will examine your eyes, ask questions about your symptoms, and take your medical history. Before your office visit, you may want to track your symptoms and make notes about the products you're using.

You may also need one or more tests. Skin tests can help diagnose allergic contact dermatitis. Most of the time, your healthcare provider won't use lab tests to diagnose atopic dermatitis, irritant contact dermatitis, or seborrheic dermatitis. They'll be able to tell simply by looking closely at your skin.

In the case of seborrheic dermatitis, your healthcare provider may gently scrape some skin flakes to rule out other causes such as psoriasis.

Skin Patch Test

An allergist can identify which substances trigger your symptoms by placing patches that contain different allergens on your skin. They apply the patches to your arms or your back. The patches stay in place for up to 48 hours. After removing them, your allergist checks for signs of inflammation.

Skin Prick Test

An allergist can also lightly scratch your skin with tiny needles that have been exposed to different allergens. After about half an hour, the allergist checks your skin to see which scratches show signs of inflammation or allergic reaction.

Intradermal Test

For some allergens, the best test involves injecting a small amount of the possible allergen into your skin. Within a few minutes, your skin may show signs of an allergic reaction or immune response.

Radioallergosorbent (RAST) Test

A RAST test checks a blood sample for antibodies that show you are having an allergic reaction to a specific substance. When your body responds to an allergen, it produces immunoglobulins, which are proteins that target specific allergens.

Using this test, an allergist can tell which substances are causing the reaction. It takes longer to get blood test results back from the lab, but some people prefer them because there is no chance of allergic reaction.

How to Treat Eyelid Dermatitis

The best treatment for eyelid dermatitis is to avoid the trigger for your symptoms. Unfortunately, that isn’t always possible.

Eyelid dermatitis flare-ups are often treated with topical medications (applied directly to your skin). 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.

Complications

It's important to talk to a healthcare provider about eyelid symptoms. Some symptoms go away on their own when you're not exposed to irritants or allergens. Sometimes untreated symptoms lead to worse health conditions.

Skin Infections

Rubbing and scratching your eyelids can create small wounds. These small injuries can become infected with bacteria, fungus, or viruses.

Eye Infections

The surface of your eye (the conjunctiva) can also become infected if you rub or scratch too much. Conjunctivitis can make your eyes itchy, watery, and sore. In some cases, you may notice a yellowish weeping from the corners of your eyes. You might also notice tiny blisters. If you see these symptoms, it's time to check in with an eye doctor or dermatologist.

Difficulty Sleeping

When your eyes burn and itch, the discomfort can keep you up at night. If your eye is infected, the loss of sleep could be more severe.

Neurodermatitis

When you scratch an itchy eye, the skin in that area can eventually thicken. It may become scaly, too. The thickening may keep the skin from tearing, but it does not stop the itch.

Coping

Even if you don’t know the exact cause of your symptoms, there are steps you can take to help prevent a flare-up and keep symptoms from getting worse:

• Limit eye makeup. If you think your makeup might be causing your eyelid dermatitis, go without it for a few days and check your symptoms. If you have artificial nails, consider having them removed as well. They can contain plastic materials called acrylates that cause or worsen eyelid dermatitis.
• Nix the itching-scratching cycle. The more your fingertips touch your eye area, the more you risk infection. Scratching can also damage delicate eye tissues.
• Use anti-itch products. Talk to your healthcare provider about whether itch relief creams are suitable for your symptoms and, if so, which ones.
• Keep track of your diet. Food allergies can sometimes cause a flare of symptoms. You may be able to identify foods that make itching or redness worse.
• Check the label. Use facial cleansers, moisturizers, and makeup products free of fragrances, dyes, and other common irritants. Many of these products are labeled “made for sensitive skin.” Toss any product that is past its expiration date.
• Use gloves. Consider wearing gloves when cleaning or doing laundry. Be sure to take off your gloves and wash your hands before touching your face.
• Moisturize. Dry skin can be prone to itching. Unscented moisturizers may soothe them.
• Reduce stress. When you’re stressed, your body releases hormones that can trigger a flare-up in dermatitis symptoms. Make deep breathing or other relaxation techniques part of your routine.
• Use less soap. Soaps and harsh detergents can dry your eyelids and make them extra uncomfortable.
• Cleanse with a warm compress. Unblock your oil glands by gently massaging and cleansing the eyelid with a warm washcloth.
• Keep sweat in check. Sweat can trigger dermatitis flare-ups. Consider sporting a headband when you work out to stop excess sweat from dripping onto your eyelids.

Outlook

If your eyelids are irritated because of a chronic condition like dermatitis, you may have flares from time to time. If an allergen or irritant is bothering you, you may be able to cure the problem by limiting your exposure to whatever triggers your symptoms.

In both cases, topical medications can ease symptoms and treat infections. How well the treatment works depends partly on how soon you seek medical care.

Summary

Eyelid dermatitis can be painful. Other symptoms of the condition, such as redness, itching, swelling, oozing, or crusting, can be caused by a reaction to an allergen or irritant. They can also be the result of weather conditions or infection.

To find out exactly what's causing the inflammation of your eyelids, your healthcare provider might need to ask questions about products you use or are exposed to on the job. You might also need blood or skin allergy tests.

You can clean your eyelids daily and avoid using products with harsh ingredients to lower your risk daily. It's also good to limit makeup, use gloves when cleaning, lower stress, and eliminate foods that worsen your symptoms.

A Word From Verywell

Eyelid dermatitis or other types of dermatitis can significantly impact your daily life. Talk to your doctor about treatments that can reduce your symptoms and help prevent flare-ups. Consider joining a support group for more encouragement.