Eczema (atopic dermatitis) is the catch phrase used to denote all skin problems with the characteristic flaky or scaly skin, inflammation, and general dryness of the skin. The skin that makes up the eyelid is thin (about 0.55mm). As a result, it is susceptible to antigens that can easily penetrate the skin and cause an inflammation.
According to the National Eczema Society, the types of eczema that can affect the eye area, including the eyelids are:
- Atopic eczema
- Allergic Contact Dermatitis
- Irritant contact dermatitis
Note that this problem can affect adults as well as children or babies. It tends to worsen during winter and can affect other parts such as your lips or around your mouth, ears and so on.
What triggers it – causes
There are certain risk factors that cause eczema on the eyelids. In most women, common causes of the condition are cosmetics containing irritants or allergens. Chemical components such as fragrances, preservatives, and surfactants can trigger irritant contact dermatitis.
Also, environmental factors such as harsh weather, harsh cosmetic products, over-exposure to water, or contact with other alkalis, detergents or solvents trigger the inflammation of the skin. About 76% of reported cases are as a result of the skin coming into contact with a harsh ingredient or harsh weather conditions (irritant or allergic contact dermatitis).
The only difference between allergic and irritant dermatitis is that allergic contact dermatitis is triggered when the skin comes into contact with a material known as an allergen. This is a material which your skin is allergic to.
Allergic contact dermatitis is also referred to as contact dermatitis. This condition is common among the elderly. It is triggered by topical antibiotics. Also, this condition is common in people whose skin function is impaired. For instance, patients with leg ulcers, or chronic irritant dermatitis.
There are various ways that contact eczema can be triggered. For example, rubbing the eyes using your hands can transfer airborne irritants such as animal hair or fiber from carpets thereby triggering the inflammation. Also, people who are sensitive to nickel may be affected when they apply nickel eyelid makeup.
Atopic dermatitis/atopic eczema is the most prevalent type of eczema. This form can also occur on the eyelids. The exact causes of atopic dermatitis are unknown. However, the condition is common among people with complications such as asthma, or Hay Fever. People who are genetically predisposed to developing hypersensitivity reactions connected to immunoglobin (Ig) are at high risk of developing atopic dermatitis.
Researchers argue that Atopic dermatitis may be due to genetics combined with other factors. When a substance occurring either inside or outside the body triggers the immune system, the skin overreacts leading to atopic eczema.
Allergic contact dermatitis can be superimposed on seborrhoeic or atopic dermatitis. Seborrhoeic eczema can also occur on the eyelids. This condition commonly occurs along the eyelid margins. The cause of seborrhoeic one remains unknown.
Lastly, it is important to note that there are other conditions that may cause eczema on the eyelids. They include:
- Dermatomyositis (a rare inflammatory disorder)
- Steroid rebound
- Allergy to corticosteroids
Treatment of eczema on the eyelids
The first step to treatment should be consulting an eye doctor to determine what may be causing eczema on the eyelids. In most instances, your health care practitioner may recommend emollients and mild topical steroids. Mild topical steroids (hydrocortisone) creams are recommended as they are ideal for the thin skin that makes up the eyelid. However, there are instances where a stronger steroid may be recommended.
Other medications that may be prescribed include Topical calcineurin inhibitors (TCIs) – tacrolimus (Protopic), or pimecrolimus (Elidel). On the downside, these medications have side effects and it is advisable to use them sparingly as prescribed by the doctor.
As a general rule, it is advisable to develop a simple facial skin procedure that incorporates the use of a moisturizer and gentle cleansers. Other simple practices that you can incorporate into your lifestyle include:
- Take shorter baths and avoid over-bathing.
- Opt for gentler soaps and avoid soaps that may over-dry the skin such as antiseptic soaps or deodorant soaps.
- Try a warm compress and apply a gentle moisturizer, petroleum jelly, or natural oils such as coconut oil.
- Be gentle when you dry your face. You can pat dry with a soft towel and later on apply a moisturizer.
- Avoid rubbing your eyelids especially with dirty/unwashed hands.
If you have atopic dermatitis, then you can opt for phototherapy. This technique involves controlled exposure to man-made UV light. Phototherapy is preferable if the eczema is chronic. Overall, the best way to avoid the condition is to maintain proper eyelid hygiene and to avoid irritants or allergens.
Because this skin condition can be stubborn to deal with, it is advisable to work closely with your healthcare practitioner so as to effectively bring it under control. There are people who struggle with eye eczema. However, there is hope out there for you, your friends, and family. Once you identify what triggers it, then you are well on your way to controlling the condition. Good luck. References:
- Donald Rudikoff, Steven R Cohen, Noah Scheinfeld. Atopic Dermatitis and Eczematous Disorders, CRC Press, 2014