Eczema on your eyelid is called eyelid dermatitis. It usually happens because something touched your eyelid skin that you are allergic to or that was too harsh and irritating for your thin, eyelid skin.
Dermatologist Explains Exactly What to Do About Eyelid Eczema
Allergens and irritants come into contact with the eyelid skin in some surprising ways:
- As airborne droplets (think hair spray, perfume or home cleaners) or pollen that rain down on your skin;
- Carried up by your hands to the eyelid skin (think hand creams or other things your thick, hand skin has gotten into without any problem). Everyone rubs their eyes unconsciously during the day. It’s true, and the most common cause of eyelid dermatitis is nail polish carried up from the hands.
- Applied products (think acne medicines and anti-aging products); and
- Products that wash over your skin (think shampoo and cream rinse or facial cleansers).
How common is it for eczema to show up on a person's eyelid?
Eyelid dermatitis is really common. Over my years of dermatology practice, I would see at least one or two patients every week with it. It’s a confusing and frustrating skin problem for people because the cause is usually unexpected, like nail polish, hand cream or even a saxophone!
How is eyelid eczema diagnosed?
Eyelid dermatitis/eczema is diagnosed by physical exam. Skin on the upper or lower eyelid (that means skin within the confines of the round bony ridge that surround the eye) is rough textured, swollen and feels itchy or burns.
Skin may look more wrinkled, too. One or both eyes may be involved depending on how the allergen or irritant contacts the skin. The rash may involve only the fold of the upper eyelid (often indicating that something irritating concentrated in the fold such as acne medicines) or involve mostly the non-folded skin near the nose (often indicating an allergen carried up from the hands when it is worse on one side).
Any area of skin within this bony ridge around your eyes can be involved.
How does eczema on the eyelids look different from blepharitis?
Blepharitis is a swelling and redness of the lash line. The glands around your lashes become inflamed from conditions such as rosacea and seborrheic dermatitis. Usually, both sides are involved, and upper and lower lash lines are, too.
How is eyelid eczema treated?
The most important treatment is to figure out what caused the rash. That involves thinking about how the allergen or irritant got to your eyes.
Usually, a day or two after contact, the rash starts. Then, it slowly builds up if you don’t figure out the cause. To help sleuth out the cause, I remove some of the possible culprits; I have patients use only hypoallergenic shampoo, face wash and moisturizers.VaniCream Cleansing Bar and moisturize their entire skin with my hypoallergenic Natural Face, Hand and Body Lotion. This typically allows the eyelid skin to heal. We then wait and watch, trying to figure out what activity and exposure seems to trigger the rash.
What medicines do doctors prescribe to treat eyelid eczema?
To calm the eczema, I often prescribe a very very mild cortisone cream for a limited time. It must be in a totally-hypoallergenic base that does not sting skin or contain allergens such as anti-itch ingredients like diphenhydramine or "caines" (like benzocaine).
Cortisone cream applied around the eye can be dangerous; it can cause thinning of the cornea, cataracts and skin thinning - so this treatment needs to be supervised by a physician.
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