Several types of dermatitis can produce eczema around the eyes and on the eyelids. This causes discoloration, itching, and swelling.
Atopic, contact, and seborrheic dermatitis can all cause eczema in the eye area.
They can be a result of exposure to allergens or irritants. Additionally, some people have a genetic hypersensitivity to the environment, making them more likely to react to irritants.
Doctors recommend treating this with a simple skin care routine that avoids scented products. They may also prescribe medication creams, like low-concentration hydrocortisone or topical calcineurin inhibitors.
Read more to learn about the types of dermatitis causing eczema around the eyes, their causes and triggers, and treatment options.
The terms eczema and dermatitis are often used interchangeably to describe dry, itchy skin. Technically, eczema refers to atopic dermatitis, a common form of dermatitis.
The inflammation associated with dermatitis can affect any area of skin, including the eyelids and skin surrounding the eyes.
It occurs more often in the eye area in individuals who already have it on other parts of the body. Some of the common types of dermatitis affecting the eye area include atopic, contact, and seborrheic.
Atopic dermatitis is the main type of eczema. Although it is primarily a skin condition, asthma and hay fever may also occur.
It is more common in adults than children, and can be caused by genetics, environmental factors, or both.
Atopic dermatitis may
According to one research paper, the prevalence of eye complications in people with atopic dermatitis on or around the eyes ranges from
Contact dermatitis causes the skin to become inflamed and irritated. This is usually in response to something that triggers an allergy. It is more common in people with sensitive skin.
Unlike atopic dermatitis, it is not accompanied by other allergic reactions and only affects the skin.
It makes the eyelids red or discolored and scaly and can cause them to sting and burn. The condition ranges from mild to severe.
When contact dermatitis occurs on or around the eyes, it may affect the upper lid, lower lid, or both. If the condition persists, it can cause the eyelids to thicken.
Seborrhoeic dermatitis affects the face, ears, eyebrows, eyes, and scalp. It is often swollen and greasy with a white or yellowish crust.
When it affects the eye area, it often appears only on the margins of the eyelids, which are the edges of the eyes.
This form of dermatitis is more common in adults and affects
About 25–40% of people with atopic dermatitis have severe inflammation of the conjunctiva, which is the thin membrane on the inside of the eyelid.
In contact dermatitis, the eyelids are red or discolored, scaly, and possibly swollen.
Seborrheic dermatitis of the eye usually affects only the eyelid margins.
When dermatitis and/or eczema occurs in the eye area, it can cause various symptoms. These include:
- changes to skin color
- skin dryness
The different forms of dermatitis have different causes and triggers:
Atopic dermatitis is caused by a genetic hypersensitivity to the environment.
Triggers of flare-ups may include:
- climate, especially dry, cold air
- extreme temperature variations
- certain foods
- allergens, such as dust mites or pet dander
- certain clothing
Exposure to allergens or irritants causes contact dermatitis. This may be a result of direct, indirect, or airborne contact.
Direct contact triggers may include exposure to the following products:
- eye creams
- hair dyes
- eye drops
- medication ointments that a person applies to the eyelid
- personal care products, such as makeup removers
Indirect contact refers to contact through an individual’s own hands. When this happens, a person may touch their eyes after touching a triggering item. These can include:
- nail polish
- skin creams
- medicated creams
Airborne irritants may also trigger contact dermatitis. Examples of irritants include:
- home fragrances
- certain plants
- wood dust
- chemical sprays
Researchers believe seborrheic dermatitis is an inflammatory reaction to excess Malassezia yeast. This yeast normally lives on the skin’s surface. However, when there is too much of it, the immune system overreacts, resulting in skin problems.
Triggers of seborrheic dermatitis may include:
- harsh detergents, chemicals, and soaps
- cold, dry weather
- hormonal changes
- certain medications, such as lithium
When diagnosing eczema around the eyes, doctors examine a person’s skin. They will also ask about a person’s symptoms and medical history.
If they suspect a person has atopic dermatitis, they may decide to do a skin biopsy. This involves removing a small skin sample and sending it to a lab for testing. A doctor might also conduct a skin culture to see if the issue is bacterial or fungal.
A doctor suspecting contact dermatitis will conduct skin tests to determine if a person has allergies. They may also ask people about their occupations and hobbies to identify triggers.
Treatment will vary depending on the type of dermatitis a person has. For instance, a person with contact dermatitis may be told to identify and remove triggers from their daily routine.
According to the National Eczema Society, treatment usually involves skin care practices, mild topical steroid medications, and topical calcineurin inhibitors.
Experts recommend a simple skin care routine free of fragrances and irritants.
- washing the skin using a leave-on emollient and applying it as a moisturizer
- avoiding washing the face with soap
- avoiding greasy moisturizers on the face
- avoiding the use of scented face creams
- removing eye makeup with an emollient on a damp cotton pad
Emollients and mild topical steroids
A person applies topical creams and ointments directly to the skin.
Doctors generally advise using low concentration steroid ointments on the eyes. This is because the eyelid skin is very thin and delicate.
Some topical treatments are available over the counter, but others require a prescription.
A doctor may prescribe a moderate potency steroid for a severe eczema flare-up. However, they would only prescribe this for a short period of time, such as 5 days.
Topical calcineurin inhibitors
Topical calcineurin inhibitors (TCIs) are not a steroid, but they do help treat eyelid eczema. They require a prescription. Commonly prescribed TCIs include tacrolimus (Protopic) and pimecrolimus (Elidel).
Because they are not a steroid, they do not thin the eyelid skin. However, they do increase the skin’s sensitivity to sunlight, so people should take precautions when using them.
Various complications may accompany dermatitis around the eyes. They include:
Also called conjunctivitis, this is the inflammation of the thin tissue covering the white parts of the eyes.
- watery, itchy eye
- red or pink color of the eye
- sensitivity of the eyes to light
- sticky, wet, or dry, crusty eye
Keratitis is the medical term for an inflamed cornea.
- pain or discomfort
- sensitivity to light
- gritty feeling
- sensation of having something in the eye
- watery eye
Changes in cornea shape
Keratoconus is the term for changes in the shape of the cornea, the transparent covering of the iris and pupil. The cornea is normally round, but rubbing the eye can cause the cornea to bulge and become cone-shaped.
Symptoms and signs include:
- sensitivity to light, particularly during nighttime driving
- blurry vision
- the need of frequent changes in eyeglasses or contact lens prescription
Early diagnosis and treatment of keratoconus can minimize the potential vision loss.
Cataracts make the eye’s lens progressively more opaque, resulting in blurred vision. In people with atopic dermatitis, cataracts
Factors like eye rubbing and the severity of any lesions determine how quickly cataracts will develop.
Retinal detachment is a
The retina is a thin layer of tissue at the back of the eye. When it detaches, it pulls away from the blood vessels that support it.
This can lead to permanent vision loss.
Several types of dermatitis may cause eczema in the eye area. Common types include focal, contact, and seborrheic dermatitis.
Treatment may include the application of low concentrations of hydrocortisone ointment, which may be available over the counter or require a prescription. Doctors may also prescribe topical calcineurin inhibitors.
Getting an early diagnosis and treatment protects the eyes and prevents vision loss.