Learn Some Common Causes of Irritating Eyelid Rashes

Identifying and Treating Allergic or Autoimmune Causes

Eyelid Rash
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Eyelid rashes are a common problem, especially in women, caused by everything from an allergic reaction to an autoimmune disease. The skin over the eyelids is extremely delicate and especially vulnerable to rashes and localized infections. The condition can be further exacerbated by cosmetics or facial cleansers used to remove makeup.

There a number of conditions that can cause an eyelid rash:

Contact Dermatitis

Contact dermatitis is a form of eczema that occurs when the body reacts abnormally to a substance placed on the skin. It is common in women who apply makeup to their eyes, many of which contain allergens such as formaldehyde or quaternium-15.

Eye makeup with a green or blue color often contains nickel or cobalt, which are also common allergy triggers. Even certain applicators, such as those used for mascara, may contain nickel.

And, it's not just makeup causing the problems. Certain chemicals used in shampoo, conditioners, hair dye, hairsprays, and other hair products can seep onto the skin and trigger a reaction. In fact, anything you touch can be transferred to the eyelids if you scratch or rub your eyes, including detergents, perfumes, metals, or food allergens.

Contact dermatitis can affect the upper and/or lower lids on one or both sides of the face. The rash will usually be itchy, often with a dull burning sensation.

The rash itself will be red and scaly and may cause the skin to become thick and leathery (referred to as lichenification).

Atopic Dermatitis

Atopic dermatitis is a type of allergic skin reaction associated with asthma, hay fever (allergic rhinitis), and chronic dermatitis. Common allergens include tree pollens, mold spores, dust mites, and pet dander.

While atopic dermatitis most often affects the flexural surfaces of the body (including the skin creases under the arms or behind the knees), it can sometimes develop on the eyelids alone. Persons with atopic dermatitis of the eyelids will usually have had the condition since childhood and may also have a long history of allergy or hay fever.

Itchiness (pruritus) will typically accompany the red, scaly rash and will often be described as maddening. Due to the relentless scratching and rubbing, the skin of the eyelids will often look raw or visibly abraded. There may even be visible hair loss from the eyelashes or eyebrows.

In addition to asthma and hay fever, food allergies are a common cause of atopic dermatitis of the face, lips, and eyes.

Other Causes

Seborrheic dermatitis, commonly associated with dandruff, mostly affects the scalp but can also cause dry, flaky patches on other oily parts of the body (such as the face, upper back, and chest). The cause is not entirely known, but it is believed to be the result of either a fungus, called Malassezia, found in skin oil or an autoimmune disorder.

Other autoimmune diseases such as dermatomyositis and systemic lupus erythematosus can also cause an eyelid rash.

These outbreaks can be differentiated from an allergy by their accompanying symptoms, such as weight loss, fever, fatigue, night sweats, muscle aches, and joint pains.

Treating Dermatitis

Contact or atopic dermatitis are both commonly treated with topical creams or ointments.

Typically speaking, topical steroids are avoided as they can cause the irreversible thinning of the eyelid skin. Moreover, accidental eye exposure can increase the risk of glaucoma or cataracts. A low potency, over-the-counter hydrocortisone cream, such as Cortaid, may be used but only be used under the supervision of a doctor and for no longer than 10 days.

Two non-steroidal eczema creams, known as Elidel and Protopic, ‚Äčare safe on the eyelids and can be applied twice daily until the rash is fully resolved.

Severe cases may require a low-dose, oral corticosteroid, such a prednisone, prescribed for no longer than one to three weeks to help relieve symptoms.

Source:

Chisolm, S.; Couch, S.; and Custer, P. "Etiology and Management of Allergic Eyelid Dermatitis." Ophthal Plastic Recon Sur. 2017; 33(4):48-250. DOI: 10.1097/IOP.0000000000000723.