The itching and inflammation of eczema can be aggravating at the best of times. When it affects the eyelids, it can be especially tough to deal with. Since eyelid skin is thin, sensitive and close to the eyes, symptoms may not only be magnified, but also more challenging to treat. The good news is that with a diagnosis and appropriate care, eyelid eczema can be controlled.
Types of eyelid eczema
Three types of eczema may occur on the eyelids: contact dermatitis, atopic dermatitis and seborrheic dermatitis.1-3 Research shows that contact dermatitis is most prevalent, followed by atopic and seborrheic dermatitis.1-4
Contact dermatitis on the eyelids
Contact dermatitis occurs when the skin reacts to allergens or irritants in the environment. These can include airborne substances like animal dander,2 personal care products such as cosmetics,2-4 metals2 or even topical medications.2,4 Pinpointing the allergen or irritant causing your skin to react is the key to treating this condition.
Research shows allergic contact dermatitis is more common than irritant contact dermatitis on the eyelids.1-3
The best way to diagnose contact dermatitis is to see an allergist or dermatologist. This can also help you identify the irritant or allergen at the root of the problem. Once you know which substances are causing a reaction, you can take steps to minimize or avoid contact with them. If your contact dermatitis is caused by personal care products, stop using them or choose hypoallergenic versions.
Airborne allergens can be more difficult to avoid. Morgan Maier, a dermatology physician assistant at Seattle Children’s Hospital in Washington, recommends washing your face or showering at the end of the day to minimize exposure to them.
“If it’s a pollen allergy, I recommend trying to keep the allergen out of your house,” said Maier. She advises patients with dust mite allergies to use mattress and pillow protectors.
Doctors may also recommend medication to control contact dermatitis, especially if the root cause has yet to be identified.
Atopic dermatitis on the eyelids
Atopic dermatitis is thought to be caused by a combination of genetic and environmental factors. Some common triggers are dry skin, irritants (e.g., laundry detergents or personal care products) and stress.
To treat atopic dermatitis on the eyelids, doctors may prescribe a medication. Keeping the skin moisturized and managing stress may also help prevent flares.
Seborrheic dermatitis on the eyelids
Seborrheic dermatitis can appear on the face, head, upper chest and back where there are oil-producing glands.
Like atopic dermatitis, seborrheic dermatitis is thought to be caused by genetic and environmental conditions. In some cases, it may be associated with an inflammatory reaction to a type of yeast (Malassezia) that grows naturally on the skin. Symptoms can be triggered by stress,5 cleaning agents, hormonal changes, cold weather, specific medicines and other conditions.
“As of now, we don’t have specific treatments for seborrheic dermatitis of the eyelids, and this can often present a challenge,” said Dr. Zelma Chiesa Fuxench, a dermatologist at the Hospital of the University of Pennsylvania and assistant professor of dermatology at the University of Pennsylvania.
She also explained that seborrheic dermatitis can look similar to atopic dermatitis on the eyelids, making diagnosis difficult.
In terms of treatment, Dr. Chiesa Fuxench said medications are frequently prescribed off-label for seborrheic dermatitis. This means they have been approved for a different condition.
