Following a regular eyelid care regimen can help you manage and treat blepharitis. Prescription treatments are also available for more complex forms of the condition.

Blepharitis is inflammation of the eyelids. It often causes crusts or flakes that look like dandruff on the eyelashes.

There are two types of blepharitis. Anterior blepharitis happens at the base of the eyelash, on the outside of the eyelid. Posterior blepharitis occurs on the eyelid’s inner edges where it comes into contact with the eyeball.

Blepharitis may be acute or chronic. Acute blepharitis is often caused by a bacterial or viral infection. Chronic blepharitis is more common and has various possible causes. Often, the condition is linked to dysfunction of the meibomian glands, which are oil glands that help the eyes make tears.

The condition causes itchiness, redness, and irritation of the eyelid and eye area.

Even if blepharitis is well managed, it often comes back. The goal is to keep the eyes free of crusts and irritation and to treat any underlying causes.

Since blepharitis often comes back even after symptoms improve, it’s important to follow a regular eyelid care regimen. This helps manage the condition.

Warm compress

A warm compress placed over the eyelids for 5 to 10 minutes can help loosen crusts. It also helps keep the meibomian glands from becoming clogged, which can prevent the healthy flow of oil.

Using a warm compress instead of a cold one helps soften the oil glands’ contents so they express more easily.

Be sure to use a clean compress for each eye.

Eyelid massage

After loosening the crusts, you can gently massage the eyelid with the compress for about 30 seconds. This helps express the meibomian glands.

Focus on the lower part of the eyelid near the base of the eyelashes.

Warm water rinse

Rinse the eye and eyelid area with warm water after the compress treatment and eyelid massage. This should remove any remaining debris.

To keep the eye area as clean as possible, it’s a good idea to use plain water to rinse the eye. You may also want to use a new, clean cloth instead of reusing the warm compress.

OTC products can also help manage blepharitis symptoms. These are items that you may use in addition to an eyelid hygiene routine.

Artificial tears

Eye drops, sometimes called artificial tears, can help reduce symptoms of dry eye, redness, and swelling. If they prove ineffective, a doctor may be able to prescribe another treatment to help reduce these symptoms.

Baby shampoo

If you have dandruff, you’re more likely to have blepharitis. Dandruff causes flakes of skin on the scalp and face. Using a baby shampoo on your scalp may also reduce blepharitis symptoms.

Using a dandruff shampoo may, in some cases, irritate your scalp further.

Natural supplements

Consuming omega-3 fatty acids, a component of fish oil, may help reduce dry eye, a common symptom of blepharitis. A 2019 review of 17 clinical trials found that omega-3 supplementation worked better than placebo in reducing dry eye symptoms.

Only take supplements from reputable sellers and be sure to follow the directions on the packaging.

An optometrist or ophthalmologist may be able to prescribe medications for blepharitis or recommend more advanced treatments for the condition.

Antibiotics

A doctor may prescribe antibiotics if blepharitis is the result of a bacterial infection. Some antibiotics for blepharitis include:

  • ointment applied to the lid margin, such as bacitracin and erythromycin
  • oral medications, such as tetracyclines and macrolides, which are antibiotics
  • antibiotic eye drops

The course of antibiotics may take a few weeks, and you’ll need to take the entire series.

Steroid blepharitis eye drops

If you continue to experience redness, irritation, and swelling even after starting an eyelid cleansing routine, a doctor may prescribe steroid eye drops. Steroids for managing eye inflammation are usually only for short-term use.

Immune system medications

Some medications that work on the immune system may help improve some of the symptoms of blepharitis. Topical cyclosporine A, sold under the brand name Restasis, is an anti-inflammatory and may help with dry eye symptoms. However, research doesn’t show that cyclosporine helps with blepharitis specifically.

Microblepharoexfoliation

The experimental treatment BlephEx (microblepharoexfoliation) may offer results to people with blepharitis due to a Demodex mite infestation. BlephEx removes debris from the meibomian glands. A 2020 clinical trial with 46 participants couldn’t offer conclusions about the clinical effectiveness of the treatment.

Intense pulsed light (IPL)

A treatment that has shown some promise in improving meibomian gland function is IPL. This involves the application of light to the skin that may reduce inflammation and increase flow of the oil glands.

A 2017 study of 40 people found that IPL improved symptoms of dry eye disease in people with meibomian gland dysfunction.

A possible side effect of IPL is hypopigmentation, or skin lightening, which is more common in people with darker skin tones. For this reason, a doctor may not recommend the procedure for you.

Thermal pulsation

Thermal pulsation therapy involves a device called LipiFlow. The device applies heat to the outside and inside of the eyelids. It helps keep the glands open and expresses them.

Thermal expression

MiBoFlo is a new treatment still under study. It applies heat therapy to the outside of the eyelids. In a 2022 randomized controlled trial involving 54 people, MiBoFlo improved meibomian gland function as measured by gland secretion.

Treating the underlying cause

If you have acute blepharitis that’s the result of an infection, clearing up the infection with prescription medications can significantly reduce or eliminate symptoms.

Some conditions may also put someone at greater risk for having blepharitis, such as:

Treating these conditions in addition to thoroughly cleansing your eyelids may reduce blepharitis symptoms.

Symptoms of blepharitis include:

  • itchy or watery eyes
  • burning or stinging eyes
  • red or swollen eyes
  • foamy tears
  • light sensitivity
  • crusty eyelids or eyelashes

Some people with blepharitis only experience itching and irritation. A doctor can determine if your eye irritation is from blepharitis or another condition, such as:

If daily cleansing of the eyelids doesn’t get rid of blepharitis, you may want to see a doctor. They can help determine if your symptoms are the result of another condition. Also, they can diagnose a potential infection or another cause that requires prescription treatment.

Blepharitis is typically a chronic condition. Regularly cleansing your eyelids can help you manage symptoms like crusts, inflammation, and irritation.

Prescription treatments are sometimes required if the condition is the result of an infection. Newer therapies such as thermal expression are still under study but hold great promise for people with blepharitis.