Thursday, July 23, 2009

Eyelid dermatitis: skin of the eyelids seems to get itchy and flaky?

The thin and sensitive skin of the eyelids seems to get itchy and flaky at the slightest provocation. That's because eyelid skin is the thinnest and most sensitive skin of the entire body.

When eyelid dermatitis strikes, it is usually just a little red, flaky, itchy bother, but it can be more severe, with swelling and even splitting of the tender eyelid skin. When it strikes you, this post will help you decide why it happened and what you can do about it.
Anyone can develop eyelid dermatitis, but the problem is far more likely in individuals who:

  • Have seborrheic dermatitis
  • Have, or have a history of, asthma, hay fever, or allergic (atopic) eczema
  • Are occupationally exposed to irritating chemicals Have become allergic to cosmetic and skin-care products

No matter what the cause of eyelid dermatitis, it all looks pretty much the same, so you cannot rely on the appearance of eyelid dermatitis to help you much in determining the cause. The following is a discussion of the various causes of the problem. After reading it, you will have a better idea of what caused your eyelid dermatitis.

Seborrheic Dermatitis
If you have eyelid dermatitis and seborrheic dermatitis, seborrheic dermatitis is almost surely the cause of the eyelid dermatitis. Seborrheic dermatitis is manifested by flaking and itching of the scalp (dandruff), ears, brows, and cheeks at the sides of the nose. Since seborrheic dermatitis is the leading cause of eyelid dermatitis, it should be thoroughly understood by all who have eyelid dermatitis.

Seborrheic dermatitis may be the primary cause of eyelid dermatitis, or it may be a contributing cause. The tendency to seborrheic dermatitis may set the scene for irritation from cosmetic and skin-care products.

Allergies and Eczema
Individuals who have a tendency to, or history of, respiratory allergies such as asthma and hay fever, and of allergic or atopic eczema, are more prone to eyelid dermatitis.
Pollens and other airborne allergies seem to play a role in eyelid dermatitis in this group. Spring and fall (the high allergy seasons) are when most eyelid dermatitis shows up at the dermatologist's office.

The other factor in this allergic group is that they just seem to have more sensitive skin than normal, more apt to be irritated by, or allergic to, cosmetic and skin-care ingredients. Also, they have skin allergic to any other chemical substances that get on the lids.

Allergies and Sensitivities to Chemicals
At home or at work, there may be chemicals that can cause eyelid dermatitis. Eyelid skin is so thin and sensitive that it may react when no other skin area does. Chemicals that produce fumes may cause problems by being in the air at home or at work. Chemicals- that get on the hands are easily transferred to the eyelids by touching and rubbing.
At home, suspect any cleaning product, wax, and all hobby chemicals—glue, paint, solvents, and sawdust.
At the office, suspect any chemically treated paper and copying chemicals.
At the plant, suspect airborne fumes and any other solvents or chemicals with which you are working.
Contact lens wearers should suspect the preservative (usually thimersol-merthiolate) in any of the lens solutions.

Allergies and Sensitivities to Cosmetic and Skin'Care Products
This topic is discussed last on the list of things that may cause eyelid dermatitis, even though it is usually the first cause that comes to mind. Many dermatologists feel that sensitivity to cosmetic and skin-care products is not the most common cause of eyelid dermatitis.

But cosmetic and skin-care products do certainly sometimes cause the problem, either by being the primary culprit—irritating healthy eyelid skin—or just by further aggravating eyelid skin that is already affected by seborrheic dermatitis or atopic (allergic) eczema.
The following products may come into contact with eyelid skin and cause eyelid dermatitis:
  • Soap and other cleansing products Eye makeup remover Moisturizers
  • Special "eye-line" products
  • Special cosmetic products like Eye Fix
  • Foundation
  • Concealer or cover stick Eye shadow of various types Eye liner Mascara
And a few other things you may not think about:
  • Shampoo Conditioner Hair spray Bath soap
  • Perfume—it drifts everywhere
  • Nail cosmetics—from back-handed stroking of the lids
And all these products contain multiple ingredients—just look at those labels. Is it any wonder that it may sometimes be so difficult to determine the specific sensitivity that caused the eyelid dermatitis?

Eyelid skin may react to products that do not bother other facial skin areas. It is very important to remember about the extreme thinness and sensitivity of eyelid skin when trying to sort out this problem.

Almost any product that contacts eyelid skin may cause the problem. Irritation occurs and allergies develop from "new" products in your skin-care and cosmetic routine, or even from products you have used for a long while. These "old" products may have changed ingredients, or your skin may just have become more sensitive.

It usually takes a while—two weeks or more—to develop a true allergy to a new skin-care product. It only takes a day or two to react (develop dermatitis) to a product or ingredient to which you are already allergic.

By taking some logical steps, you may be able to find out on your own what is causing your eyelid dermatitis. Here's how:
1. Be sure you have previous posts and have looked at your face, ears, and scalp for signs of that problem.
2. Rule out the possibility that a non-eye product is causing the problem. Be very careful to avoid eyelid contact with hair spray, shampoos and conditioners, nail enamel, and fancy or scented bath soaps.
3. Simplify eyelid care and cosmetics. Stop using things that are not absolutely necessary, and use the simplest products.
For example, for removing eye makeup use a little baby shampoo and water (a new product, Occusoft Lid Scrub, is now available for this special purpose); use plain mineral oil first if you need to. Use simple eyelid moisturizers (if you moisturize). Try just a tiny bit of petrolatum (Vaseline). And that's all—simplify!
4. Change eye makeup products. One good change is from "waterproof" cosmetics to ones that are not, or vice versa. Change to hypoallergenic, unscented, fragrance-free products for all your facial cosmetic needs. Change from your present brand of eye cosmetics to another.
5. Discard any old eye makeup products—mascara, shadows, liners, crayons. After a few months, the preservatives in these products break down, and these makeups can become contaminated by microorganisms that can cause dermatitis or an eye infection.
Microbes, as has been mentioned, are always present on the human body and can be transferred to eye/makeup via an applicator, fingers, or saliva. Unfortunately, you may not know your product is contaminated until it is too late. Three ways to protect yourself:
  • Don't buy preservative-free products. (Of course, if you are allergic to a particular preservative, don't buy that product.)
  • Before you apply any eye product, sniff it. If it smells "off" or spoiled, don't apply it.
  • Date your makeup. Note the day and month of purchase on the label, or write it on a self-adhesive label or a strip of masking tape and stick it on the product. The maximum shelf life of eye products is six months.

Usually these maneuvers will, sooner or later, give you an answer to the question of what caused your eyelid dermatitis, or at least get you into an eye-care program that does not cause you problems.

The use test on the previous page is a way you can test yourself for an eye product sensitivity.
Allergy testing of a more detailed kind can be done by dermatologists and allergists. Experience has shown, however, that this is a difficult and often impracticable approach, since there are so many product ingredients and often they are not available as individual chemicals for testing.

For a simple and not so severe problem you can successfully treat yourself. The treatment is the same no matter what the cause of your eyelid dermatitis. Those individuals who experience a more severe problem, or for whom simple home treatments are not effective within ten days, should definitely consult a dermatologist.

Apply .5 percent hydrocortisone products. They are available over the counter—no prescription required. Apply the hydrocortisone at least twice daily. Four times is better.

Apply the hydrocortisone very sparingly. Use so little that it does not get into the eyes and is not apparent on the skin (or no more than barely apparent).

Use the ointment form of hydrocortisone. The ointment form is of petrolatum (Vaseline) consistency and is not creamy. The cream forms are fine but may themselves contain ingredients that can irritate sensitive eyelid skin. Ask your pharmacist for help here if you need it.

The safety, for use on eyelids, of nonprescription-strength hydrocortisone products may be of concern to you. Though the information in the package cautions against using these products around the eyes, they really are quite safe for limited use there, if you are very careful. Limit use of the product to ten days. If you are not cleared up by then, consult your dermatologist.
Try not to get any cortisone products in your eyes. If you do, wash it out immediately. If irritation develops, see a doctor. Do not use any "cortisone" products (prescription or over-the-counter) on the eyelids regularly over a prolonged period. Serious injury to the eyes can occur. If seborrheic dermatitis is the cause of your eyelid problem, be sure you are working to control the seborrheic dermatitis. Controlling seborrheic dermatitis of the scalp and elsewhere on the face is a big help in clearing up seborrheic dermatitis of the eyelids.


Anonymous said...

Excellent article! Thanks for your help! I have been dealing with this for about 2 months n now I know how to proceed with care.

Anonymous said...

I found out that soy was causing my eyelid dermatitis-- it is much better now although soy is in almost every prepared food!