It’s that time of year… The temps drop, the heat is on high, and chances are your skin may very well be acting up. 

You go to get ready and notice of all things your eyelids are dry, red, burning, and peeling. Um, seriously? You don’t have time for this!

We feel you. Any issue on your skin can be stressful but especially when it’s on your face! But rest assured, you’re not alone. 

Eyelid dermatitis (ED) is super common and we’re here to help you figure it out.

So strap in, grab a cup of coffee, and let’s chat all things ED.

How to know if you have eyelid dermatitis

So, you think you may have ED, but how do you know? ED is a rash that occurs on and around the eyelid skin.

It commonly occurs during the cooler months. 

If you have ED, you may notice a red, scaly rash on or around your eyelids that burns whenever any product is applied to that area. 

Severe cases can involve skin cracking and bleeding.

Some symptoms you may experience if you have ED are:

  • Scaling
  • Redness, or erythema (red eyelid)
  • Peeling
  • Burning on the lid and around eyelid margins
  • Stinging
  • Irritation
  • Swelling, or edema
  • Itching, or pruritus
  • Thick skin, or lichenification
  • Vesicles

If you’re experiencing these symptoms on or around the skin of your eyelids, you may have ED. 

So, why are you getting this annoying rash?! Let’s dig into that.

Why am I getting this

The most common cause of ED is often allergic contact dermatitis (ACD) or irritant contact dermatitis. 

But what does that mean?

ACD occurs when you get a rash because you had exposure to a product on your skin or eyes that you have an allergy to.

Irritant contact dermatitis occurs when you get a rash because you had exposure to a product on your skin or eyes that acted as an irritant to your skin.

Some underlying conditions may increase your chances of experiencing ED. 

If you have a history of eczema, or atopic dermatitis, asthma, or hay fever, you may be at an increased risk of getting ED.

One of the most annoying things about ED is that it can be very difficult to figure out what exactly is causing the rash. 

You may not realize it, but most of us come in contact with a prevalence of products to the skin around our eyes, or even in our eyes, daily and any of these could be the culprit. 

Common causes of eyelid dermatitis

Possible triggers of ED include direct contact with:

  • Cosmetics such as mascara, eye liner, eye shadow, primer, foundation, concealer, powder
  • Skincare products such as scented moisturizers, eye creams, eye masks, serums, lotions, sunscreen, or other skin treatments
  • Fragrances or preservatives in products
  • Nickel from products such as eyelash curlers or jewelry
  • Shampoo, body wash, soap, makeup remover, or face cleanser
  • Laundry detergents, fabric softeners, or fragrance boosters
  • Hair dye or artificial nails like shellac nails
  • Eye drops or contact lens solution
  • Airborne allergens
  • Ointments that contain neomycin

If you think it may be an allergy-causing your ED and you can’t seem to figure out which product is causing your possible eyelid contact dermatitis, you have options!

If it was possibly an allergen…

So you’re thinking the trigger of your contact dermatitis may be an allergen? 

It’s probably a good idea to undergo allergy testing to see what ingredients you are allergic to that may be causing your ACD.

Dermatitis can also be caused by food allergens, so it’s important to get tested to see if you have any underlying food allergies. 

Here are a couple of tests you can expect to undergo to uncover any relevant allergens you may have:

Patch testing

Patch testing may be performed if you are experiencing symptoms of an allergen coming in contact with your skin that is causing an ACD. 

An organization called the North American Contact Dermatitis Group made up of providers from the United States and Canada, created a test where 80 of the most common allergens of the skin are applied to stickers and then placed on your back. 

Once the test is complete, your provider will give you an extensive list of products and ingredients you need to avoid to prevent a reaction. 

Most dermatology offices and allergy offices offer patch testing to patients who are experiencing allergic contact dermatitis so if you think you may need testing, call your dermatologist or allergist!

Skin prick tests

Skin prick tests may be performed to test for environmental allergens such as dust mites, pollen, or pet dander. 

While such allergens may trigger underlying atopic dermatitis or eczema, skin prick tests are not typically used to test for conditions that are only affecting the skin.

Again, if you think it may be an allergen causing your eyelid contact dermatitis, make an appointment with your dermatology provider to discuss your options for eyelid ACD.

Now let’s talk about how to give your lids some relief if you think you may have ACD of the eyelids.

Otherwise, here are some remedies

Think you may have ED or eyelid eczema? Let’s dig into some possible solutions to stop the scratch!

Barrier repair

If you are having an eyelid eczema flare, there is likely an issue with your natural skin barrier. 

This is why you experience itching, or pruritus, or burning whenever you apply a product to your eyelids.

To help repair your skin barrier, you can incorporate personal care products such as fragrance-free ointments, emollients, or thick cream. 

Apply these products multiple times per day to help repair your natural skin barrier.

Hydrocortisone

Swelling, or edema, itching, or pruritus, and inflammation are all common signs and symptoms of eyelid eczema, whether triggered by irritant contact dermatitis or ACD. 

Hydrocortisone is a topical steroid that is available over the counter at certain strengths. 

Steroid creams and steroid ointments can help fight inflammation in the skin which can be helpful when dealing with pesky atopic eczema of the eyelids. 

Topical corticosteroids come in many different strengths so be sure to consult with a dermatologist to be sure the one you have is safe to use on your lids.

Make sure to be on alert for sneaky ingredients in your personal care products that may actually worsen your itchy skin around the eyelids. 

Avoid ingredients such as fragrances, formaldehyde, propylene glycol, methacrylates, cobalt, balsam of peru, cocamidopropyl betaine, and resin. 

When seeking out treatment of itchy red eyelids, reach for products that say they are unscented, fragrance-free, or for sensitive skin, to decrease the chances of experiencing increased erythema, or redness, burning, or irritation.

Want to go a more natural route? We feel you! 

Let’s take a look at some natural options to soothe those delicate lids of yours.

Natural treatments help, too

If you want to go the more natural route, we have good news! 

There are several natural remedy options for your ED. 

Let’s take a peek at a few.

Aloe vera

You mean what my mom lathered me up with after getting a sunburn as a kid? Yep! Aloe vera is often used for several different skin conditions, including eczema or atopic dermatitis. 

Aloe vera has properties that fight inflammation and increases moisture of the skin which are both pertinent ways to combat eyelid eczema. 

When you are picking out an aloe vera to try, be sure to choose one that is fragrance-free to avoid any further irritation.

Oatmeal

Yep, it’s not just for breakfast anymore. 

Colloidal oats, or oats ground up in a special way, are what we typically go for when using oats to help with atopic dermatitis or eczema. 

When the oats are prepared this way, they act as an emollient for the skin and studies show they can help add moisture to the skin, soften the skin, decrease inflammation of the skin, and help with pruritus, or itching, of the skin. 

Alllll good things when it comes to dealing with dermatitis.

Honey

I know, I know, we sound crazy. But hear us out! Historically, honey has often been used for its antibacterial and inflammation-fighting properties. 

Now don’t necessarily go grab the little bear-shaped honey from the grocery store and start rubbing it on your affected areas. 

Reach for manuka honey, which is commonly used for its healing properties.

Cool compresses

Cool compresses can help decrease annoying symptoms of ED such as itchy skin, swelling, and burning. 

Grab a clean towel, run under cool water, and place it over your closed eyes to provide some temporary relief. 

Be sure to apply an ointment, emollient, or thick cream after you’re done!

As always, be sure to test any new products on a non-affected area such as the underside of your forearm to avoid further irritation or any undesired reactions on your face!

If your over the counter options or natural remedies just aren’t cutting it, it’s probably time to meet with a skin pro.

Consider meeting with a skin pro

So, you’ve tried all the things and you’re still not seeing improvement? Or the rash is worsening instead of getting better? 

Yikes! 

It’s time to make an appointment to have an evaluation with your dermatology provider. 

Here’s what you can expect.

Typically eyelid dermatitis is a clinical diagnosis, meaning it can be made with physical examination alone and often without further testing. 

When performing a physical examination of your skin, your dermatology provider will be able to tell if you are experiencing eyelid dermatitis or if you are experiencing another skin condition within the differential diagnosis of ED such as:

  • Seborrheic dermatitis
  • Blepharitis 
  • Contact urticaria 
  • Atopic keratoconjunctivitis 
  • Systemic contact dermatitis 
  • Rosacea

If the condition seems to be affecting the actual eye, your derm will likely refer you to an ophthalmologist for a physical examination and further evaluation.

If your derm provider diagnoses you with ED, they will likely discuss the importance of repairing your skin barrier with ointments, emollients, or thick creams to help restore the natural state of your lids.

They will also probably discuss the importance of restriction of skincare products that may be triggering a contact dermatitis such as nickel, fragrances, or other potentially relevant allergens that could be a contact allergy.

The next step in your treatment plan? Probably a topical steroid. 

Topical steroid

Prescription-strength topical steroids can be risky in areas of thin skin, such as the eyelids. 

If used incorrectly, steroid ointments and steroid creams can cause skin atrophy, or thinning of the skin, telangiectasia growth, or the appearance of new tiny blood vessels, or even a special type of acne lesions called steroid-induced acne.

That being said, your derm will likely choose a low-potency topical steroid for you to use for a short period of time when you have outbreaks.

Anti-inflammatory creams

With cases of eyelid dermatitis, your dermatology may prescribe a different family of anti-inflammatory creams called topical calcineurin inhibitors. 

Topical calcineurin inhibitors include tacrolimus and pimecrolimus, or Elidel. 

Tacrolimus ointment and pimecrolimus are both often used for the treatment of contact dermatitis, eczema, or dermatitis on the face since they lack some of the side effects of steroid ointments and creams. 

Tacrolimus ointment, or Protopic, and pimecrolimus, or Elidel, are commonly used calcineurin inhibitors that your derm may decide to incorporate into your treatment plan.

Other tests

If you are experiencing recurrent breakouts of eyelid dermatitis, as mentioned above your derm may decide to order a patch test for you to rule out allergic contact dermatitis, or ACD. 

Patch testing can help guide you when deciding which personal care products you need to cut out in hopes of avoiding future ACD flares.

As always, when in doubt, make an appointment with your derm provider to make sure you are on the right track to restoring your healthy skin!

In-brief

You want to know what’s exciting about eyelid dermatitis? 

There is hope! 

Since SO many people struggle with this common skin condition, there is a ton of research on the best treatment options to get your skin back to its glowing self.

Let’s wrap it up with the key takeaways we want to send you off with!

If you have ED, you may notice a red, scaly rash on or around your eyelids that burns whenever any product is applied to that area.

The root of ED is often allergic contact dermatitis or irritant contact dermatitis.

Possible triggers of ED include direct contact with cosmetics, skincare products, fragrances or preservatives in products, nickel, shampoo, soap, laundry detergents, hair dye, artificial nails, and eye drops.

If you think your eyelid dermatitis may be stemming from an allergy, it’s probably a good idea to see your derm and undergo allergy testing to see what ingredients you are allergic to that may be causing your allergic reaction.

Over the counter remedies for eyelid dermatitis include ointments, emollients, creams to repair the skin barrier and increase the moisture of the eyelids, and hydrocortisone to fight inflammation.

If you want to go the more natural route, consider trying aloe vera, colloidal oatmeal, manuka honey, or cool compresses.

If you aren’t having any luck with over the counter or natural treatment options, it’s time to make an appointment with your dermatology provider. 

They will likely perform an examination of your skin and prescribe medications such as topical steroids like desonide, or calcineurin inhibitors such as tacrolimus, or Protopic, or Elidel.

We hope you feel encouraged knowing that:

A. If you think you have eyelid dermatitis, you’re not alone, and

B. There are several different treatment options, so have hope!

“Eyelid Contact Dermatitis.” Eyelid Contact Dermatitis | DermNet NZ, dermnetnz.org/topics/eyelid-contact-dermatitis/.

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