Eyelid dermatitis: first understand it, and then treat it.

What is eyelid dermatitis?

Eyelid dermatitis is a sudden inflammatory reaction that appears in the form of redness, itching, wrinkling and desquamation of the upper and lower eyelids (more frequently the upper eyelids).

Who is affected by eyelid dermatitis?

Eyelid dermatitis appears in people suffering from Atopic Dermatitis, atopic conjunctivitis or other forms of atopy. It frequently occurs in concomitance with nickel allergy or reactiveness to pollens, house dust or animal dandruff.

What are the triggering causes of eyelid dermatitis?

The main triggering cause is repeated contact with water and soaps/cleansers/shampoos. Other triggering causes are make-up, a damp environment, change of season, and psycho-physical stress.

Why is water the main triggering cause?

Unlike the skin of the face, the skin of the eyelids does not have any sebaceous glands: i.e. the glands that produce sebum, which is the waxy, oily substance that waterproofs the skin. When the eyelids become wet, particularly in the presence of soaps/cleansers/shampoos, the water remains imprisoned in the skin in the form of humidity.

Why doesn’t the humidity evaporate and the skin dry?

When we sleep, our eyelids are distended but, during the day, they have one or more folds that hamper evaporation.

The arrows indicate the main folds that
form when our eyes are open:
these folds retain humidity.

The dampness of water mixed with traces of soap/cleanser/shampoo first irritates the folds, and then the whole eyelid.

What should be avoided when eyelid dermatitis appears

• Scratching
• Bathing your eyelids in search of relief
• Moisturising creams/emollients
• Make-up
• Popular remedies (aloes, arnica, etc.)
• Oils or ointments in general
• Creams with antihistamines
• Creams with antibiotics
• Creams with cortisone

Why should drugs be avoided?

Antihistamines are not indicated because eyelid dermatitis is not an urticarial reaction, and antibiotics are not indicated because it is not an infection. Furthermore, both may worsen eyelid dermatitis.
As in the case of atopic dermatitis, cortisone is not used because the dermatitis returns when it is discontinued (the rebound effect: see “Problems of cortisone” in the atopic dermatitis section of CutisCare), it causes early aging of the eyelids, and there is a danger of infection.

How can eyelid dermatitis be treated?

As soon as eyelid dermatitis appears, stop washing your eyelids because it is necessary to prevent them from coming into contact with water and soaps/cleansers/shampoos. Wash your hair with your head tilted backwards, and clean your face using cotton wool soaked in water or (better) a 0.1% solution of benzalkonium chloride (recommended: Disintyl 240 mL or similar, available in pharmacies). Scrupulously avoid cleaning your eyelids.

Why is it essential not to wet my eyelids?

The aim is to make sure that your eyelids become completely dry, as this will start the process of desquamation and lead to cell renewal. In this way, the dermatitis will heal spontaneously, usually in 15-20 days.

What can I do if the itching and swelling is intense?

In the case of intense itching and swelling, you can use Lenitive Cream with zinc oxide and magnesium silicate. The cream should be applied sparingly and massaged well in, preferably in the evening.

If I want to clean my eyelids without wetting them, what can I do?

If necessary, you can clean your eyelids without worsening the dermatitis using a Potassium Permanganate solution.
After preparing the solution, dampen a ball of cotton wool (which should then be squeezed to eliminate any excess moisture) and gently pass it over your eyelids.

How can I prevent eyelid dermatitis?

Eyelid dermatitis tends to recur, at least in predisposed subjects.
In order to prevent its occurrence and relapse, you should avoid aggressive cleansers (including so-called cleansing milks) when washing your face and/or removing make-up. Our advice is to use a non-foaming, lauryl sulphate-free cleansing cream such as Cleansing Cream.
After every wash, dry your eyelids carefully to remove all traces of dampness.