Blepharitis: Eyelid Inflammation

Both types can be treated to manage symptoms

Blepharitis is an inflammation of the eyelids that often results in flaking and itching. It affects people of all ages, but blepharitis tends to occur more often in people with oily skin. It is classified into two types: anterior and posterior.

Anterior blepharitis impacts the outside of your eyelid along the eyelash line. Posterior blepharitis affects the inner eyelid near the eye.

This article explains the different types of blepharitis and how you can treat it at home and with medical care.

Blepharitis

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Anterior Blepharitis

Anterior blepharitis affects the outside of the eyelid where the eyelashes attach. Anterior blepharitis can occur as seborrheic or ulcerative.

Seborrheic blepharitis

Seborrheic blepharitis is associated with dandruff. This type typically causes the eyelids to become red and produces waxy scales to build up on the eyelashes, causing the eyes to itch. The scales initially develop due to an abnormal amount and type of tear film being produced by the glands of the eyelids.

Ulcerative blepharitis

Ulcerative blepharitis is less common than seborrheic blepharitis, and usually begins in childhood. It is caused by bacteria. Ulcerative blepharitis is a more severe form that causes hard crusts to form around the eyelashes. These crusts often become matted during sleep, making it difficult to open the eyes in the morning.

Posterior Blepharitis

Posterior blepharitis develops when oil glands in the inner eyelid allow bacteria to grow. It can occur as a result of skin conditions such as acne rosacea and scalp dandruff.

Posterior blepharitis is also referred to as meibomian gland dysfunction. Meibomian gland dysfunction (MGD) is a much more common type of blepharitis. Meibomian glands function to secrete a type of oil. With the force of the blink, oil is secreted into the tears. This oil is designed to prevent tear film evaporation.

When these glands have inflammation, either too much or too little oil is secreted. People with MGD often complain of red, burning eyes or dry eyes. Vision tends to fluctuate because the tear film is unstable.

Self-Care Options for Blepharitis

Blepharitis is usually a chronic condition, so things people can do at home help manage symptoms.

Warm Compresses and Eyelid Scrubs

Blepharitis is treated often by applying warm compresses with a very warm washcloth followed by eyelid scrubs. Eyelid scrubs can be done in several different ways. In the past, healthcare providers recommended using baby shampoo with 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. 

Fatty Acids

Omega-3 fatty acids are shown to stabilize the meibomian glands and create an anti-inflammatory effect on the eye. It may take three months or longer before a definite beneficial effect is seen.

Check with a healthcare provider before taking any extra supplements, especially if you have any other medical problems.

Increased Blinking

This may sound silly, but it is the action of blinking that causes the expression of the oil in the meibomian glands. However, as we concentrate when we read, or use the computer or any digital device, we tend not to blink as often.

Our blink rate actually decreases with age also. So, think about it. Four times per day, blink hard 20 to 30 times.

Medical Treatment for Blepharitis

Home care may not be enough to manage blepharitis. Medicine may need to be prescribed.

Topical Antibiotics

Azithromycin is available in a topical form called Azasite. Healthcare providers will often tell patients to apply a small amount of Azasite to the eyelid margin with their finger at bedtime. Azasite tends to have an anti-inflammatory effect as well as anti-infective.

People also use antibiotic ointments for blepharitis management, such as erythromycin and bacitracin, are also prescribed, although they are a little thicker.

Oral Antibiotics

For stubborn cases, oral antibiotics may also be prescribed. Oral tetracycline, minocycline, or doxycycline prescribed anywhere from 30 days to much longer can be quite effective. This is helpful especially for patients with a more severe form of blepharitis called ocular rosacea.

Corticosteroids

Although steroids can bring unwanted side effects and risks, they are very effective at quelling inflammation when more traditional methods do not work.

Healthcare providers will prescribe them for blepharitis management for short-term inflammation control to minimize potential complications.

Frequently Asked Questions

  • Is blepharitis caused by poor hygiene?

    Blepharitis is not always caused by poor hygiene, but it can be. Bacteria that normally live on the skin can multiply when it's not cleaned often. Washing your eyelids with cleanser and water may help prevent blepharitis. However, it can also occur due to some skin conditions, like eczema, rosacea, and contact dermatitis.

  • Can Covid cause blepharitis?

    Some studies have found a correlation between blepharitis and COVID-19. However, while it is known that COVID-19 can enter the body through the secretions in the eyes, it is less clear whether the virus has infectious potential on ocular fluid.

  • Can posterior blepharitis be cured?

    Some people are more prone to recurring blepharitis. However, you can manage it when it occurs with eyelid scrubs, warm compresses, and medication. In addition, you can help prevent blepharitis by regularly washing your eyelids.

  • What deficiency causes blepharitis?

    Vitamin A and D have been linked to eye problems, including dry eye and blepharitis. In addition, omega-3 fatty acids may be beneficial for posterior blepharitis.

  • What can make blepharitis worse?

    Some things can aggravate blepharitis. These include cold air, excessive screen use, not enough sleep, wearing contacts, and dehydration. In addition, certain skin conditions like rosacea and dandruff can make blepharitis worse.

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11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading
  • Lavine, Jay B., MD. The Eye Care Source Book. Contemporary Books.