Overview

If your eyelids often get itchy, swollen, or irritated, you may have one or more forms of eyelid dermatitis, a very common condition. The two types of eyelid dermatitis are atopic (allergic) contact dermatitis and irritant contact dermatitis.

Keep reading to learn more about these conditions and how you can manage and prevent eyelid dermatitis.

Symptoms

Symptoms of eyelid dermatitis can occur in one or both eyes. Your symptoms may be chronic or they may only happen occasionally. They may also include the eyelids alone or the surrounding area.

Symptoms may include:

  • itching
  • swelling
  • pain or burning sensation
  • red rash or scaly, irritated skin
  • thickened, creased skin

Causes

The skin on your eyelids is very thin. It contains many blood vessels, and little fat. This composition makes them susceptible to irritation and prone to allergic reactions.

Eyelid dermatitis has many causes, and it may be challenging to figure out what is causing your symptoms.

In people with atopic contact dermatitis, symptoms can result from an allergy. Symptoms occur when your immune system produces antibodies as a reaction to a substance you’re allergic to. These antibodies are called immunoglobulin E (IgE). The antibodies create a chemical reaction in the cells, which causes allergic symptoms, such as redness and itching.

Irritant contact dermatitis occurs when the area around your eyelids comes into contact with an irritating substance. You don’t need to be allergic to the substance. For example, makeup or eye cream may cause irritant contact dermatitis even if you aren’t allergic to any of the ingredients.

Many substances that cause allergic contact dermatitis also cause irritant contact dermatitis. The difference between the two conditions is determined by your immune system’s reaction.

No matter what type of eyelid dermatitis you have, the result can be itchy and uncomfortable. Both types can be treated with medication or lifestyle changes.

Learn more: What causes itchy eyebrows? »

Keeping a daily journal may help you uncover an allergen or sensitivity that might be playing a role in causing your eyelid dermatitis.

Write down the products you use each day and look for clues in the ingredient lists. These products should include personal care products that you use on your face, hair, and body, like soap, lotion, and shampoo. You should also note items you use around the house, such as cleansers, since you may be transmitting irritants to your eyelids with your hands.

For some people, dust, or even the weather, may cause symptoms of eyelid dermatitis.

Causes of atopic contact dermatitisCauses of irritant contact dermatitis
foods you’re allergic tovery hot or cold temperatures
pollenextreme humidity or very dry air
latexrubbing or scratching the eyes
rubberinsect bites
plasticchemicals, including chlorine and bleach
contact lens solutionrubbing alcohol
personal care products, including eye makeup, moisturizer, cleanser, nail polish, hand cream, hair dye, or shampooindustrial solvents
metals, such as nickel, which might be found in tweezers, scissors, and jewelryairborne contaminants, such as dust particles
medications, such as corticosteroids and antibioticswood particles
preservatives in various products, including eye dropsnew carpeting, furniture, and mattresses that may shed chemicals and cause a reaction known as off-gassing.
dust mites
pet dander
perfume

Diagnosis

If your symptoms are clearly associated with a specific product, such as mascara, eliminating the product should also eliminate your symptoms. If you cannot identify what is causing the condition, seeing a doctor, such as an allergist or dermatologist, can help.

Your doctor will review your symptoms and ask you questions that may help uncover potential triggers. You’ll also be asked about allergic reactions you’ve had, and your history of:

  • atopic eczema
  • hay fever
  • asthma
  • other skin conditions

If your doctor suspects you have an allergy, one or more tests may be done to determine what you’re allergic to. Some of these require needles, or lancets, but cause minimal pain. The tests include:

Patch test

This test is typically done on the arm or back. Your doctor will choose around 25 to 30 potential allergens to test for. Tiny amounts of each allergen will be placed on your skin and covered with hypoallergenic tape, forming a patch. You’ll wear the patch for two days, after which time your doctor will examine the area to see if you’ve had an allergic reaction.

Intradermal allergy test

Unlike the patch test, this test provides results in under 30 minutes. Tiny needles are used to inject small amounts of potential allergens right under the surface of the skin, usually on the arm. Your doctor can test for multiple substances at one time. Each area is observed for an allergic reaction, such as redness, swelling, or hives.

Skin prick (scratch) test

This test also provides fast results and can be used to test up to 40 substances at one time. A tiny amount of various allergen extracts is gently inserted directly beneath the skin using a cutting tool, called a lancet. In addition to the allergens, histamine is inserted to verify the accuracy of the test.

Histamine should cause an allergic reaction in everyone. If it doesn’t cause one in you, then the entire test is considered invalid. Glycerin, or saline, is also inserted. These substances shouldn’t cause an allergic reaction. If they do, then your doctor may determine that instead of allergies, you have highly sensitive skin and are experiencing irritation, not allergic reaction.

Radioallergosorbent test

This is a blood test that detects specific IgE antibodies. It may help your doctor pinpoint the substances you’re allergic to.

Treatment

If a trigger for your symptoms can be identified, eliminating it will be your first, and best, line of defense. If a food trigger is found, removing it from your diet will be important.

Your doctor may prescribe use of a short-term topical or oral corticosteroid, which will reduce inflammation, swelling, and itching. If you decide to try an over-the-counter topical treatment, make sure to check the ingredient list first. Some of these products include preservatives and other ingredients you might be allergic to. Avoid any that have:

  • added fragrance
  • formaldehyde
  • lanolin
  • parabens

It’s also important to keep your eyelids clean. Also avoid touching your skin, scratching, or rubbing your eyes, and don’t use makeup or scented cleansers during this time. Even hypoallergenic cosmetics should be avoided until your symptoms improve.

If you work in a very dusty or contaminated environment, wearing wraparound goggles may help eliminate irritation to your eyelids.

There are a number of at-home treatments you can try. You’ll likely need to use a trial-and-error approach. Don’t continue with a treatment that doesn’t provide relief or that seems to make your symptoms worse. Some people find that taking oral sulfur supplements, or probiotics help to alleviate their symptoms.

Topical applications you might wish to try include:

  • cold washcloth compresses dipped in milk or water
  • cucumber slices
  • salve made from plain oatmeal and honey that you apply to the skin
  • aloe vera gel

Outlook

Both atopic and contact dermatitis can be successfully treated and eliminated. Determining what’s causing your symptoms can help to reduce your chances of a recurrence.

There are many irritants and allergens in the environment, so it’s not always possible to figure out what is causing your symptoms. If you have skin that irritates easily, you may also become sensitive to substances you once were able to tolerate. Using personal care products and cleaners made from all-natural ingredients may help.

You should also try to keep your eyelids and hands clean, which may help to prevent, or reduce, future recurrences. Also, keep your hands away from your eyes and continue to keep a daily diary of the things you eat and the products you use to look for patterns in any flare-ups.

Finally, it’s important to talk to your doctor if your eyelids are irritated. The sooner you seek help, the sooner you can begin treatment and find relief.