Eyelid Dermatitis | Eczema Around Eyes

It is common for people to suffer from eye irritation and problems at least once in their life. This irritation can be due to something bothering the sensitive nerve endings of their eye.

However, there are times when it is not the eyeball causing all the problems, instead, it is the skin of the eye causing discomfort. This condition is usually called ‘Eyelid dermatitis.’

Eyelid Dermatitis (Eyelid Eczema)

Our eyelids form the protective skin barrier that stops any harmful particles from entering the inside of the eyes. Inflammation of the eyelids can happen for several reasons and can result in a condition that causes constant pain and itching.

Eyelid dermatitis goes by many names such as eyelid eczema, periorbital dermatitis, and periocular dermatitis. It is usually caused when the skin of your eyelids comes in contact with a certain irritant or allergen. It can cause the eyelids to become red, swollen, and itchy. 

What are the symptoms seen with eczema on eyelids?

Eyelid eczema can cause severe dryness, crusting, scaling, and even redness. It has been seen that eyelid eczema often presents in adults and teenagers, and is more rarely seen in children.

The most common symptoms seen with eyelid dermatitis are discussed as follows;

• Dry skin

One of the most common symptoms associated with eczema on other parts of the body is dryness. It remains true for eyelid eczema as well. Cold and dry weather often results in high incidences of eyelid eczema, especially in older people.

• Crusting

It has been seen that with dryness and irritation, some part of the skin loses its luster and start crusting and peeling.

• Scaling and fissures

Eyelid eczema may contain the presence of scales and fissures at the eyelid margins.

• Lichenification of skin

Due to the constant rubbing, scratching, and irritation, the folds of the skin of the eyelid become thick and hard. This thickness of skin is also known as, “lichenification.”

Causes Of Eyelid Dermatitis/ Types Of Eyelid Eczema

Eyelid dermatitis can involve the lids and area surrounding the lids. The site of inflammation causes an uncomfortable sensation that can lead to pain.

It has been seen over the years that there is no single cause that results in eyelid dermatitis, instead, there are several factors that are responsible for this condition. Eyelid dermatitis can result from 

• atopic dermatitis
• psoriasis
• autoimmune conditions
• irritants or allergens in the environment
• seborrheic dermatitis
• dry eyeballs. 

When atopic dermatitis is the culprit there may be seasonal variation in the eyelid irritation.

Some of the most common types of dermatitis along with their causes, have been discussed below:

Irritant Contact Dermatitis

A product that you are using to take care of yourself or accessorize with may be to blame for the dry, scaly, and itchy eyelids you are experiencing.

The eyelids have skin that is thin and can very easily get damaged or irritated due to the use of chemicals. These chemicals are usually present in skin, hair, and nail care products that stick to the skin of the eyelids and cause constant irritation and itchiness. 

Within one of those cosmetics, there may be a fragrance, a preservative, or a drying soap. You could also have a piece of jewelry, commonly worn, that contains a metal that causes the problem.

Causes

Some common triggers that cause irritant contact dermatitis on eyelids are:

• Fragrances
• Metals
• Dyes
• Certain fabric
• Chemicals
• Soaps and detergents
• Dust 

Allergic Contact Dermatitis

The most common cause of eyelid eczema is due to allergic contact dermatitis. It is worth explaining briefly. In “allergic contact dermatitis” (ACD) the body gets exposed to a molecule from the environment, like the metal nickel for example, and then when re-exposed the body makes a reaction to it 3-4 days later. 

This is opposed to “irritant dermatitis” whereupon contact the body gets irritation immediately.  It can be hard to flush out allergic contact dermatitis vs. irritant contact dermatitis and may require the help of an allergist to do skin testing.

Causes

Certain triggers of eyelid allergic contact dermatitis are:

• Skincare products
• Sunblock
• False eyelashes
• Nickel and gold
• Hair dye
• Eyelash curler
• Antibiotics
• Pollen
• Poison ivy

Airborne eyelid eczema

Airborne eyelid eczema is seen with the exposure of any irritant particle that is suspended in the atmosphere. Yep, your job could be irritating your eyelids! 

Atopic Dermatitis

Atopic dermatitis or eczema on eyelids appears when your immune system considers a certain substance dangerous for your skin and as a reaction releases certain T-cells to fight against it. This reaction causes itching, swelling, and redness on eyelids.

Atopic dermatitis is a chronic skin condition which means it can come and go throughout one’s lifetime in the form of eczema flare-ups.

Causes

The exact cause is not known but atopic eczema is believed to be caused by a combination of factors such as genetics, the immune system, and environmental factors. People who have a family health history of asthma, hay fever, eczema, and allergies are more likely to develop it.

Seborrheic Dermatitis

Seborrheic dermatitis is a chronic condition that is often present in different parts of the body. Seborrheic dermatitis is considered a severe form of dandruff that causes itching, flaking, and scaling on different parts of the body. 

It manifests as a yellow, thick, greasy scale on infants’ skin and is known as cradle cap. It can cause redness and scale in the groin or armpits or on the sides of the nose and it can also cause scale and redness on the eyelids and eyebrows.

Causes

Seborrheic dermatitis is believed to be caused by a combination of factors such as overactive sebaceous glands and an overabundance of Malassezia yeast. When sebaceous glands start producing excess sebum it leads to an overabundance of food for the Malassezia yeast. Yep, yeast likes to feast.

When the yeast and sebum combine together they create a byproduct that leads to inflammation, irritation, and redness on the skin.

Diagnosing Eyelid Eczema

If you are unable to identify what might be causing your dermatitis and which type it is then it is best to consult a doctor. They will be able to accurately diagnose your condition and provide you with a treatment plan according to it. 

The doctor will first physically examine your symptoms and inquire about your and your family’s health history related to

• Hay fever
• Atopic dermatitis
• Asthma
• Allergies 

If the dermatologist suspects that you are experiencing allergy then they may prescribe more tests to determine what you are allergic to, such as

• Patch test
• Skin prick test
• Radioallergosorbent test
• Intradermal allergy test

Other Complications Associated With Eyelid Dermatitis

Intense itching, scratching, and rubbing of the eyes can lead to other complications such as:

• Skin infection
• Neurodermatitis
• Eye infection
• Sleep disturbance
• Depression
• Conjunctivitis
• Keratoconus 

What Is The Treatment For Eyelid Dermatitis?

The best strategy to avoid eyelid eczema is by following a proper skincare routine that includes:

Eczema Shampoo

Cleaning the affected area with an eczema shampoo and body wash daily. This will help soothe the irritated skin. An eczema shampoo that is free from harsh chemicals like parabens, sulfates, fragrances, and artificial dyes is best for eczema-prone dry skin.

Try Best Shampoo for Eczema it is especially formulated for dry, irritated, itchy, eczema-prone skin and is safe to be used by all ages.

Eczema Cream 

Applying an eczema cream at least twice daily can help soothe itching and dryness on the eyelid. The best eyelid eczema cream is the one that avoids common irritants like the preservative parabens that can irritate broken skin and also does not contain added scents and dyes. 

Regular and gentle application can help moisturize the skin of the eyelids and help maintain the protective skin barrier. Try Happy Cappy Eczema Eye Cream, it helps restore the skin’s protective barrier and soothes itching and dryness associated with eczema.

Don’t Scratch

We know that eyelid eczema can be very itchy and you might feel the urge yo scratch your eyelid. But try to avoid scratching the affected area as it can can lead to future complications like skin infection, eye infection, and even loss of vision.

Choose The Right Products

Be extra attentive while choosing your skincare products if you are experiencing eyelid dermatitis. Use products that are free from harsh chemicals like fragrances, paraben, sulfate, dyes, and gluten. 

Choose products that have a low pH level as these will help ease your symptoms.

Limit The Use Of Makeup

There are chances that the makeup you are using might be causing dermatitis on eyelids. If you limit the use of makeup, or change your products and ditch all that expired makeup then there are chances your eyelid dermatitis gets better.

If your condition still doesn’t get better it is best to consult a doctor, who may prescribe the use of a topical non-steroidal prescription anti-inflammatory (like crisaborole, pimecrolimus, or tacrolimus)  to manage the symptoms.

How long Does Eyelid Dermatitis Lasts?

It depends on the severity of the condition and what might be causing your eczema. With proper care and treatment eyelid irritant contact dermatitis may take 2 to 3 days to get better and allergic contact dermatitis takes a few days to get better.

References

1. Guin JD. Eyelid dermatitis: experience in 203 cases. J Am Acad Dermatol. 2002 Nov;47(5):755-65. doi: 10.1067/mjd.2002.122736. PMID: 12399770.
2. Amin KA, Belsito DV. The etiology of eyelid dermatitis: a 10-year retrospective analysis. Contact Dermatitis. 2006 Nov;55(5):280-5. doi: 10.1111/j.1600-0536.2006.00927.x. PMID: 17026693.
3. Jurakić Tončić R, Balić A, Pavičić B, Žužul K, Petković M, Bartolić L, Ljubojević Hadžavdić S. Occupational Airborne Contact Dermatitis Caused by Omeprazole. Acta Dermatovenerol Croat. 2019 Sep;27(3):188-189. PMID: 31542064.

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