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Eczema on the Eyelids: Do Creams Work? (Treatment Guide)

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Genetics and environment combine to produce the redness, itching, and swelling we call eczema. It can happen anywhere on the body, including the eyelids. When it strikes there, the swelling can be so severe that it can be hard for you to see clearly.

There are many eyelid dermatitis creams that can help, including steroid versions and innovative immunosuppressants like tacrolimus. Over-the-counter creams like Eucerin can also help to keep moisture within your skin, so a breakout is less likely.

No matter what method you use, talk with your doctor. Disclose what you are using and how you use it. Sometimes, the ingredients in eyelid dermatitis creams (even if they are made for people with sensitive skin) can make eczema worse.

If medications do not help, your eczema may have a different cause. Skin creams, airborne allergens, and other irritants can cause localized versions of eyelid eczema. You will need a different form of treatment for those issues.

What Causes Eczema?

man covering eye in pain

Some medical conditions have a clear cause. If you are exposed to the chickenpox virus, for example, you are likely to come down with the condition yourself. Eczema is different. This condition comes about through the intersection of two factors.

Your eczema develops due to the intertwining of:

  • National Jewish Health says people with family members who have food allergies, asthma, hay fever, and similar conditions are more likely to have eczema. The exact gene has not been identified, but this is a condition that tends to run in families.
  • Irritants tend to start the cycle of itching and pain, says the National Eczema Association. Common triggers include cigarette smoke, perfumes, soaps, formaldehyde, and antibacterial ointments.

An eczema outbreak can happen anywhere on your body that is covered with skin. But the issue is especially common on hands, backs of knees, and feet.

It’s also very common for eczema to strike the eyelids. You can have eczema here and nowhere else on your body. If it strikes your eyelids and the swelling is severe, you may struggle to see clearly. If you are unable to open your eyes fully, seeing the world is not easy.

Who Is Prone to Eczema?

The primary predisposing factor for the skin condition is genetics. If one of your relatives, such as a parent, had eczema, you’re more likely to deal with the condition than others who don’t have a family history of it.

Eczema can show up at any age, regardless of gender. The vulnerability of children and adults varies based on the type of eczema.

Some adults with atopic eczema (caused by sensitivity to allergens) start experiencing symptoms as kids (as young as 5 years old). In other cases, swelling, red rashes and itching may erupt periodically as from childhood before disappearing for several years.

Young children without a family history of eczema don’t usually get contact dermatitis, although they aren’t immune to it. This type of eczema generally affects adults and teenagers.

Also, people that have had asthma or hay fever (or a family history of these conditions) are prone to eczema. The same is true for individuals with pre-existing skin inflammation.

Signs You Have Eczema on Your Eyes

When you have eyelid eczema, you’ll experience several symptoms and areas of discomfort, some of which will keep getting worse until you start managing the condition. A reddish rash on the eyelids can get itchy and uncomfortable.

You’ll experience such discomfort on the affected skin area, which can be on both eyes’ upper and lower eyelids. The condition doesn’t have to affect all eyelids, however.

Some patients will have the itchy, reddish rushes only on the upper or lower eyelids.

Because the itching is usually persistent and chronic, you’ll keep feeling the urge to scratch, which can eventually cause the eyelid skin to become thicker and leathery. From the constant scratching and rubbing, there will be scaling on the skin.

Some long, narrow cracks will present themselves, and the lashes may begin to crust with time. A burning sensation and pain can accompany these issues.

If you also experience these symptoms and discomforts on other parts of the body like the face or neck, you most probably have eczema.

Creams That Can Help

There is no cure for eczema. You can’t walk into your doctor’s office and get a pill or a shot that stops your body from reacting to triggers.

The goal of treatment is to soothe outbreaks when they appear. Typically, that involves stopping the itch cycle. When you do not dig at your skin, you do not continue to damage the delicate tissue. Healing is easier.

Your doctor may suggest:

  • Immune-suppressing creams. Products with tacrolimus can stop swelling and itching, and researchers say these creams are slightly more effective than those that contain steroids. The products work by stopping your immune system from producing substances that spark eczema outbreaks, experts say, and they are usually applied twice per day.
  • Steroid creams. These products stop your immune system from producing swelling, itching substances. They are used twice per day, and they are effective in reducing eczema symptoms.
    Doctors warn that this is a short-term therapy for eyelid eczema, as the products can thin your tissues and raise pressure within your eye. Once you’ve improved, you will stop using this medication.
  • Moisturizers. Eczema is itchy, and as you scratch, you can push bacteria into your skin. Stopping the itch cycle is key, and lotions can help. Products like Eucerin, Cetaphil, and Aquaphor are thick, and they can trap moisture within your tissues.

Your eyelids are not solid barriers, and products you pop on your lids can slide into your eyes. It’s crucial that you talk with your doctor before putting anything on your eyes.

For example, doctors point out that over-the-counter steroids seem like a custom-made solution for eyelid eczema. But the products you see in the store can be much stronger than those a doctor would recommend for your eye. If you use them, you can adjust the size and efficacy of tissues within the eye. That can cause tears to build up and pressure to rise. The result is a painful eye from glaucoma.

Before you put anything on your eyelid, visit your doctor. If you are planning to use something you bought in a store, bring the product with you for a discussion.

Eyelid dermatitis cream creams should also go on your eyelids in a thin layer, not as a thick blob that can run into your eyes. You might need help from a friend to apply the products if you are struggling to see properly. Your doctor may also have tips to help you put the products on the right way.

What Else Could It Be?

man rubbing eyes

When you are dealing with eyelid eczema, you will visit the doctor often. Together, you will determine whether your skin is improving or degrading, and you will work on a treatment plan that can help you feel better. Sometimes, you will need to change course.

Typically, medicated creams bring relief within about three weeks, and when they do, you stop using them. Then, you will talk to your doctor if the issue comes back. If it does, something else might be triggering your outbreaks.

The American Academy of Ophthalmology points out that skin creams and moisturizers often trigger eczema. They can contain:

  • Perfumes
  • Chemicals
  • Preservatives

If you’ve switched to an over-the-counter cream to prevent the next outbreak, that solution could be causing your current misery.

You may also be triggered by something in your environment. Researchers say up to 74 percent of cases of eyelid eczema are caused by contact dermatitis, and for some patients, it can take up to seven years to get the right diagnosis.

Your doctor can suggest allergen testing. The results can help you pinpoint the issues that spark your symptoms, and you could be surprised by what you find out. Patients have been diagnosed with sensitivities to nail polish remover, for example, but only their eyelids (not their nails) swelled with exposure.

Work with your doctor and be persistent as you search for your trigger. Once you find it, you will have the information you need to protect yourself against further outbreaks.

When one appears, head right back to your doctor and ask for advice. It could be that you’ve developed a sensitivity to a new trigger, or you’ve had a hidden exposure you weren’t aware of. A course of treatment could be just what you need to feel comfortable once more.

Is Eyelid Eczema Contagious?

While many skin conditions are contagious, eyelid eczema is not. This means you can’t contract the condition through contact with someone who has it.

It also means you can’t spread the skin disorder to others.

References

  1. What Causes Eczema? (July 2015). National Jewish Health.
  2. Eczema Causes and Triggers. National Eczema Association.
  3. Tacrolimus Ointment vs. Steroid Ointment for Eyelid Dermatitis in Patients With Atopic Keratoconjunctivitis. (July 2007). Eye.
  4. Tacrolimus Topical. (February 2016). U.S. National Library of Medicine.
  5. Tacrolimus Ointment Compared to Steroid Ointment for Eyelid Dermatitis in Patients with Atopic Keratoconjunctivitis. (May 2006). Investigative Ophthalmology and Visual Science.
  6. Safe Periocular Steroid Use for Eyelid Dermatitis. (November 2011). Clinical Advisor.
  7. How to Manage Eczema on the Face. (September 2019). WebMD.
  8. Dr. Frank Bures: Use Care if Applying Cortisone on Eyelids. (August 2013). Winona Daily News.
  9. How Do You Medically Treat Eyelid Eczema? (February 2014). American Academy of Ophthalmology.
  10. Solving the Mystery of the Itchy Eyelid. (November 2006). Review of Ophthalmology.

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