Antibiotics are one possible treatment for blepharitis. They can sometimes help keep the area free of bacteria or treat an underlying condition.
Blepharitis causes your eyelids to become red and inflamed. You may experience irritation of the eye area and feel like something is stuck in your eye. Many people have flakes or crusts at the base of the eyelids that look like dandruff.
The primary treatment for blepharitis is keeping the eye area clean. But antibiotics may clear up an infection or treat an underlying condition like ocular rosacea that may be the root cause of your blepharitis.
Both topical and oral antibiotics are sometimes used for blepharitis.
Antibiotics come in two types: bactericidal, which kill bacteria, and bacteriostatic, which prevent them from growing. The antibiotics for blepharitis include oral tetracyclines like doxycycline and macrolides like erythromycin. These are bacteriostatic medications.
Since blepharitis has many different causes, the type of antibiotic depends on treatment goals.
Topical antibiotics are used to treat blepharitis of the outer eyelid (anterior blepharitis). They reduce symptoms and get rid of bacteria in the area.
Oral antibiotics are used to treat blepharitis of the inner eyelid (posterior blepharitis) caused by dysfunction of the eye’s oil glands (meibomian glands). They are also used for blepharitis associated with ocular rosacea.
Topical antibiotics are usually only taken for up to
The effectiveness of oral antibiotics for blepharitis is uncertain.
The authors said the evidence is very uncertain that oral doxycycline may improve clinical side effects of blepharitis and the medication may cause adverse effects.
Some people may need to take antibiotics long term in order to keep symptoms under control.
The many types of antibiotics for blepharitis can’t be used interchangeably. A doctor will prescribe an antibiotic that’s most appropriate given the nature of your symptoms and what’s causing them.
Oral antibiotics for blepharitis
Two primary classes of oral antibiotics are used in blepharitis treatment: tetracyclines and macrolides.
- Tetracyclines include antibiotics tetracycline, doxycycline, and minocycline.
- Macrolides include antibiotics erythromycin and azithromycin.
Tetracyclines are broad-spectrum antibiotics used to treat rosacea and various other conditions. Side effects include gastrointestinal distress and photosensitivity, among others.
Macrolides are antibiotics approved for use for many bacterial infections, including skin infections. The medications are generally safe but can cause gastrointestinal discomfort.
Ointment and other topical blepharitis antibiotics
Topical antibiotics are applied to the eye area. They’re typically in ointment or eye drop form and require a prescription.
- Bacitracin: The ophthalmic form of this antibiotic is for eye use only.
- Erythromycin: This is an antibiotic used for a wide range of bacterial infections.
- Neomycin, polymyxin, and bacitracin: This is a combination product of three antibiotics used to treat infections of the eye and eyelid.
Topical antibiotics are generally well tolerated, but each antibiotic comes with potential side effects. If you experience itching, burning, redness of the eye, eye pain, or swelling, call your doctor.
Antibiotics are usually available at pharmacies. A doctor can typically give you a prescription to take to the pharmacy or send it directly. Antibiotics that do not require a prescription may be held behind the pharmacy counter.
Can you get blepharitis antibiotics over the counter?
Most antibiotics require a prescription. A doctor may be able to prescribe the right oral or topical antibiotic for your blepharitis.
Some topical antibiotics are available over the counter, but it’s critical to ensure you use a safe and appropriate formulation for blepharitis.
For example, although bacitracin topical is available at most pharmacies without a prescription, it’s dangerous if you get it in your eyes. Bacitracin ophthalmic, which may be appropriate for blepharitis, requires a prescription.
Erythromycin requires a prescription. Oral antibiotics like tetracyclines also typically require a prescription.
Even if you obtain an over-the-counter antibiotic, it’s recommended to consult with a doctor or with a pharmacist before using the product. They can advise on how to use the product safely.
You can help improve blepharitis symptoms with home treatment. There are also medical treatments besides antibiotics that may help resolve or manage the condition.
Caring for your eyes at home can go a long way to reducing the frequency of blepharitis flare-ups. If you have an acute case of blepharitis, home treatment can support prescribed medications like antibiotics.
- Warm compress: Placed over the eyes for a few minutes, a warm compress can help the eye’s oil glands express. It also can make flakes softer and easier to remove.
- Eyelid scrub: Following a warm compress, a scrub of the eyelid can help remove bacteria and debris. Soak a cotton applicator in diluted baby shampoo and gently cleanse the eyelid margin.
- Warm water rinse: After the scrub, gently rinse the eye area with warm water.
- Eyelid massage: For people with blepharitis on the inner eyelid (posterior blepharitis), this can help express the meibomian glands.
- Artificial tears: Available over the counter, these eye drops can refresh and bring hydration to dry eyes caused by blepharitis.
- Dandruff shampoo: Dandruff shampoo can help reduce symptoms of blepharitis caused by dandruff.
- Natural supplements: Omega-3 fatty acids may help with eye health.
- Anti-inflammatory diet: Following anti-inflammatory diets like the Mediterranean diet may help reduce inflammation of the body, including inflammation that may lead to blepharitis.
Other medical treatment
Antibiotics may be the first medical treatment offered by a doctor, such as an ophthalmologist. They may explore with you other medications and new procedures to reduce blepharitis symptoms.
- Steroid eye drops: These are typically corticosteroids used to manage inflammation.
- Immune system medications: One option is cyclosporine A, sold as eye drops under the brand name Restasis.
- Antiviral medications: If blepharitis is the result of a herpes simplex virus infection, antiviral medications like acyclovir or valacyclovir may be prescribed.
- BlephEx (microblepharoexfoliation): This is a procedure performed in a clinic where a medical-grade sponge is applied to the eyelid to remove bacteria and toxins.
- Intense pulsed light (IPL): IPL is also an in-clinic procedure where infrared light is applied to the eyelids to treat oil gland blockages.
- LipiFlow (thermal pulsation): This clinic procedure uses a device that applies pressure and heat to the inner and outer eyelids to unclog oil glands.
- Thermal expression: This procedure uses heat and manual massage of the eyelids to improve oil gland function.
Topical ointments and oral antibiotics are two medical treatments for blepharitis. Oral antibiotics are generally prescribed for underlying conditions such as ocular rosacea or meibomian gland dysfunction.
Topical antibiotics are usually to control bacteria in the eyelid area. Some people take antibiotics for the long-term management of blepharitis.