Is your dry and swollen eyelid skin caused by allergic contact dermatitis?
Allergic contact dermatitis on the eyelid is fairly common. That’s because eyelid skin is thin so it’s particularly sensitive to allergens. In my practice I see many people with this condition, and I also just had a conversation about it on the web.
Your eyelid skin is a ‘canary in the mine shaft’ when it comes to allergic and irritant reactions. It’s always fun for me to sleuth-out the cause – a sort of a Sherlock Holmes meets dermatology moment. My patients seem to like the detective adventure too since they're frustrated by their eyelid dermatitis and eager for help.
An allergic reaction on the eyelid is pretty dramatic. People usually describe their eyelids as wrinkled, swollen, red, itching, or burning. They’re also disturbed by the appearance because the rash is so striking and hard to hide. Most of the home remedies they've tried sting, and the problem gets steadily worse.
Here I discuss the causes of allergic contact dermatitis in the eyelid and how you can treat it effectively.
Allergic Contact Eyelid Dermatitis
What is allergic contact dermatitis on the eyelid?
Dermatitis is itchy inflammation of the outer layer of the skin (the epidermis and dermis). Allergic contact dermatitis is dermatitis caused by an allergen that’s come into contact with the skin. An allergen can be any number of substances that are harmless to those who aren’t allergic to it.
The usual cause of allergic contact dermatitis on the eyelid is nail polish and artificial nail components. Yes, nail polish and artificial nails. They contain chemicals (most notably formaldehyde and its relatives and glues) and when your lovely and enhanced fingernails touch your fragile eyelids, the chemicals can cause an allergic reaction - drats!
The skin of your fingers remains rash-free because it’s so thick that the chemicals don’t easily get through it. Your eyelid skin, on the other hand, is thin and readily absorbs the chemicals. If you’re allergic to formaldehyde, acrylates or other chemicals in nail cosmetics, you will get swollen eyelids and an allergic reaction.
Pro-tip: The rash from an allergen carried from your hands to your eyelids is usually worse on one eyelid because we touch our faces more with one hand than the other.
Why do I have a rash on my eyelid?
In North America nail polish and cosmetics are among the main causes of an allergic reaction on the eyelid. But if the cause isn’t nail polish it could be any number of allergens. The real detective work comes because of the seemingly unrelated allergen exposures that cause allergic eyelid reactions.
In fact, everything that you get on your hands can be carried to your eyelids. I've seen hand-to-eyelid dermatitis in musicians allergic to the metal on their musical instruments, gardeners allergic to specific plants, artists working with glues, paints and lacquers, cooks allergic to foods, hairdressers allergic to hair dye or perm solutions, and more.
Airborne droplets of any spray products bring allergens to your eyelids.
I’ve seen eyelid dermatitis due to air fresheners (sprays, plug-ins, potpourri, scented candles, etc.), spray perfumes, hair spray, spray household cleaners, etc. If you can smell something that means it’s in the air and can settle on your eyelids as a potential allergen.
Allergens include the fragrance itself, chemicals in products, and more. I've treated allergic eyelid dermatitis for so many years that I know how impossible it is to find truly hypoallergenic home cleaning products. That’s why I created my Natural Home Spray Cleaner, which is safe, non-toxic and ideal for those with sensitive skin.
Airborne pollen is another cause of eyelid dermatitis. This includes the usual pollens that cause some people to sneeze, indoor flower arrangements with flowers like chrysanthemums and others.
Other causes of eyelid dermatitis I’ve seen are wood burning smoke, inadvertently burned poison oak or ivy smoke, new carpet off-gassing, and sawdust.
Hand soaps and hand lotions
Chemicals are carried to your eyelids from your hands. This means that allergic contact dermatitis on the eyelid can be caused by the fragrances or ingredients in hand soaps and hand lotions.
I recommend that eyelid dermatitis patients use only hypoallergenic and fragrance-free hand cleansers and hand creams.
My recommended hand care products for people with eyelid allergic dermatitis include my:
All are free from the most common skin care allergens.
Chemicals washing over your eyelids from shampoos and conditioners bring allergens to your eyelid skin.
Hair care products are some of the most chemically complex hygiene products we have. The ingredients can be more than your delicate eyelids can handle.
These products are loaded with fragrances, preservatives, and foaming agents that can dry eyelid skin and cause allergic reactions. Fragrances are common allergens. Preservatives are also common allergens, especially the formaldehyde-releasing preservatives commonly found in hair care products, such as:
- Quaternium 15;
- Imidiazolidynil urea; and
- Methylchloroisothiazolinone and its relatives, among others.
It's best to completely wash these products off your skin before stepping out of the shower, just to be safe. If you suspect that your eyelid dermatitis may be due to your haircare products, the Vanicream Free and Clear Shampoo and Conditioner offer products free from the most common haircare allergens.
Products applied directly to eyelid skin
Allergens can be found in products you apply directly to your eyelid skin. Most commonly, these are your facial soaps or creams. Again, fragrances and preservatives in these products are often the cause. Metal from eyeglasses can cause eyelid dermatitis where the metal touches your skin. Topical antibiotic ointments that you may apply to heal the rash (such as neomycin and bacitracin) can also become allergens.
Interestingly, eye cosmetics are formulated carefully to minimize potential allergens. I rarely find them the culprit of allergic contact dermatitis on the eyelid. The one exception is metal sensitive patients who can have an allergic reaction to metal pigments in eye makeup.
Does a rash mean I have an allergic reaction on my eyelid?
A rash on the eyelid doesn’t always mean you’ve had an allergic reaction. It’s possible that the skin has broken down due to simple irritation without allergy.
For example, the ingredients in the best anti-aging or acne treatment products such as: tretinoin, glycolic acid, benzoyl peroxide, and salicylic acid can cause eye irritation.
Typically, with an irritant reaction on the eyelids, I see more skin redness and less scale, usually starting in the upper eyelid fold. The skin may split in the crease and it is more likely to burn than itch.
Eyelid dermatitis treatment
Start by finding the cause of allergic contact dermatitis
Treatment starts with identifying the cause of allergic contact dermatitis in the eyelid and avoiding it.
It's difficult to confirm the allergen that causes eyelid dermatitis because we usually carry out this type of allergy testing on the back skin. Eyelids are more sensitive than the back, or any other area of the body, so we can't usually recreate the same reaction. This means identifying the allergen relies on detective work.
Eyelid dermatitis is dramatic and frustrating. It's also fascinating because the cause is almost always such a surprise. Find the allergen, and you fix the problem.
Change your skincare routine
By making changes to your skincare routine, you can eliminate some of the most common eyelid allergen contacts and treat irritated skin.
I usually recommend that patients wash their face with only the most non-irritating hypoallergenic facial cleanser until their skin heals. Skin with a rash is more porous, and thus easily irritated - and irritated skin just won’t heal. My favorite ultra-hypoallergenic and non-irritating facial cleanser is Vanicream Cleansing Bar.
Dry, itchy skin needs to be moisturized effectively. The most hypoallergenic options include pure jojoba oil, shea butter, coconut oil or Vaseline.
Start healing eyelid dermatitis now with 4 key products:
- VaniCream Cleansing Bar
- Natural Face and Body Lotion
- Naturally Best Bar Soap, and
- Dry Skin Hand Cream.
This will help you to eliminate allergens on your hands that are carried to your eyelids.
How to reduce eyelid swelling from an allergic reaction
To reduce inflammation from a severe allergic reaction I may prescribe a short course of a non-halogenated, low potency, hypoallergenic cortisone ointment.
Cortisone treatment for allergic contact dermatitis on the eyelid must be supervised by a treating physician. That’s because cortisone topical medicines can be absorbed through the eyelid skin and damage the eyes.
The bottom line with allergic contact dermatitis of the eyelids:
This is a dramatic and frustrating rash often caused by allergens that are tricky to identify. But when you identify the allergen you will cure the dermatitis - it's worth the effort!
Author: Dr. Cynthia Bailey M.D. is a Board Certified dermatologist practicing dermatology since 1987. She has done well over 200,000 skin exams during her career and authors the longest running physician written skin health blog in the world.