Your eyelids are important little flaps of skin, small but mighty, with the crucial job of spreading moisturizing tears across your eyes with each blink (and, you know, generally protecting your jelly-soft eyeballs). You probably don’t think about them often unless they act up somehow. If your eyelids suddenly become dry and itchy, for example, you might think about them a lot.
Several things can cause inflamed, irritated eyelids, including eczema, which might sound surprising. You may be familiar with the fact that eczema is a condition that can cause dry, itchy skin, a rash, and other symptoms, but you also probably wouldn’t think it could bloom on your freaking eyelids. Unfortunately, no part of your skin is eczema-immune. Here’s what to do if your eczema decides your eyelids are the perfect place to show up.
Let’s back up a second and cover some eczema basics, like what exactly it is and why it happens.
Atopic dermatitis, which is what people usually mean when they say “eczema,” is a chronic condition that happens due to a problem with your skin’s protective barrier, the Mayo Clinic says. If you have atopic dermatitis, your top layer of skin doesn’t retain adequate moisture or protect you as well as it should against things like irritants and allergens.
People with atopic dermatitis generally experience symptoms like very dry and itchy skin, red, brown, or gray skin patches, raised, weeping bumps, and thick, cracked, or scaly skin. They may also have raw, sensitive, swollen skin due to scratching-induced irritation.
If you have atopic dermatitis, your skin can seem totally fine sometimes, and then during a flare, remind you just how frustrating this health condition can be at full force. Triggers like sweat, stress, harsh soaps and detergents, dust, and pollen can cause flares, although it’s possible for eczema to rear its head for no apparent reason as well, the Mayo Clinic says.
Luckily, it’s possible to treat eyelid eczema, but you have to make sure you know what you’re dealing with first.
There are other reasons you might wind up with a rash on your eyelids, like contact dermatitis, Gary Goldenberg, M.D., assistant clinical professor of dermatology at the Icahn School of Medicine at Mount Sinai Hospital, tells SELF. That’s when something that comes into contact with the skin on or around your eyelids causes an allergic reaction, the Mayo Clinic explains. Knowing exactly what’s actually causing the rash on your eyelids will help you treat it as best as possible.
If you do have atopic dermatitis on your eyelids, you’ll want to do your best to avoid your triggers. This can range from pretty easy to completely ludicrous, depending on what specifically incites your eczema. If you can’t steer clear of your triggers, or if doing so isn’t enough to calm your eyelid eczema, you may need some extra help.
To treat atopic dermatitis, experts will often recommend topical corticosteroids to battle inflammation, the Mayo Clinic says, but these can be too strong on your delicate eyelid skin. If your doctor decides a corticosteroid cream is the best treatment for your case of eczema, they’ll likely only prescribe it for a short period of time because it can cause thinning of your eyelids and the skin around your eyes, Cynthia Bailey, M.D., a diplomate of the American Board of Dermatology and president and CEO of Advanced Skin Care and Dermatology Inc., tells SELF. “This treatment needs to be supervised by a physician,” Dr. Bailey says.
There are also non-steroidal creams that work by tamping down on your overactive immune system or suppressing inflammation. Doctors are often more comfortable using those for people who need long-term help treating their eyelid eczema, Jonathan I. Silverberg, M.D., Ph.D., M.P.H., an eczema researcher and dermatologist at Northwestern Memorial Hospital, tells SELF, since they’re not known to thin out your eyelid skin.
Beyond that, experts often recommend that you go all in on moisturizing when you have atopic dermatitis. The same applies when you have it on your eyelids, Dr. Silverberg says—you just want to make sure that you use the gentlest options so you don’t irritate your eyelid skin further. Look for products labeled “sensitive,” “fragrance-free,” and any other buzzwords indicating the product is simple and solely meant to moisturize, not slough off your skin or make your face smell like a Hawaiian waterfall. It’s also smart to look for eye creams specifically, since they’re formulated with that area in mind.
As you treat your eyelid eczema, keep in mind that it can cause some other eye issues for you, too, and look out for the symptoms.
The more severe your eyelid eczema, the more likely it is that you might experience other eye problems, the American Academy of Dermatology (AAD) says. The organization specifically highlights three eye conditions that people with eyelid eczema should have on their radar: pink eye, keratitis, and keratoconus.
Pink eye, also called conjunctivitis, happens when your conjunctiva (the thin, clear tissue lining your eyelids and the whites of your eyes) becomes inflamed. Pink eye can cause bloodshot eyes, itching, tearing, a gritty feeling, and crustiness, the Mayo Clinic says.
Keratitis is an inflammation of your cornea (the clear, protective outer layer of your eye) that may cause eye pain, sensitivity to light, redness, a feeling that something is in your eye, excessive tearing or other discharge, and blurry vision, among other symptoms.
Finally, keratoconus is when your cornea changes from its usual round shape into a bulging cone shape instead, creating blurry or otherwise distorted vision, sensitivity to light and glare, needing to change your eyewear prescription too frequently, and cloudy vision, according to the Mayo Clinic.
It’s hard to say exactly why people with eyelid eczema are at a higher risk for these eye conditions. One potential reason: People with eczema may be more susceptible to the kind of pink eye that’s linked with allergies (allergic conjunctivitis) due to something known as the “atopic march.” The atopic march is a progression of allergic diseases a person can have throughout their life, starting with eczema as a child and eventually dealing with issues like food allergies, hay fever, and asthma, per the American Academy of Allergy Asthma & Immunology. “The concept of the atopic march is that having an impaired skin barrier in eczema allows allergens to cross the skin, prime the immune system, and set off systemic allergies, including allergic conjunctivitis,” Dr. Silverberg says.
These issues could also be tied to using those too-harsh medications that thin out your skin, Dr. Silverberg says. Scratching and rubbing that extra-thin skin can create tiny tears or irritate your eyes, making you more vulnerable to infection and inflammation that may present as pink eye or keratitis. That rubbing can also change the shape of your cornea, leading to keratoconus, the AAD says.
It’s in no way guaranteed that you’ll wind up with a bunch of interconnected eye issues just because you have eyelid eczema, but making sure you treat it—and your delicate lids—properly can lower your risk. If you’re not sure where to start, talk to your doctor for help so that together, you can put a lid on your eczema.