Eczema around the eyes: Types, causes, symptoms and treatment

Let's face it, in daily life, the health and vitality of our skin can play as much of a role in how we feel as the strength of our morning cup of coffee. So, skin problems like eczema around the eyes can cause mental irritation as well as skin irritation.

At Software, we're here to help you with your skin frustrations, so we're taking a deep dive into the phenomenon of eczema around the eyes. We'll examine how to prevent eczema flare-ups, treat eyelid eczema, and get an early diagnosis.

Eczema is more than just sensitive skin and while it can be uncomfortable, you don't have to tackle it alone.

What is eyelid eczema?

Eczema, or atopic dermatitis, as it's medically called, is an inflammatory skin condition found in all areas of the body and eyelid eczema affects the skin surrounding the eyes [1].

Eczema is the most common form of dermatitis, affecting around 2.4% of the global population [2]. So, if you struggle with eczema, you have plenty of company.

What types of eczema can you get around your eyes?

The skin around the eyes is particularly thin and exposed to the elements throughout the day. This means you may experience several types of eczema around the eyes.

Each form of eczema has unique triggers and characteristics, and it needs to be understood to be treated effectively.

Here are the most common types you'll come across:

1. Atopic eczema

Atopic eczema or atopic dermatitis is the most prevalent form of eczema, often presenting in childhood and continuing into adulthood. It's an inflammatory condition leading to dry, itchy skin with scaly patches. The biggest risk factors for atopic dermatitis include allergies, hay fever, or asthma in the past [3].

Food allergies, genetic hypersensitivity, harsh soaps, and hot water can all cause flare-ups of atopic dermatitis.

Atopic dermatitis can also make the eye area prone to bacterial infection, so it's important to receive the correct diagnosis from a board-certified dermatologist if you're experiencing eczema-like flare-ups around your eyes [4].

2. Contact dermatitis

If you have eczema-prone skin, environmental factors can play a role in developing eczema around the eyes. While atopic eczema is the most common form of dermatitis, allergic contact dermatitis is actually the most common form of eczema around the eyes [5].

Our eyes are exposed to the elements, and contact dermatitis or contact eczema can develop in response to allergic reactions, hay fever, dust mites, and inappropriate skincare and makeup.

3. Seborrhoeic dermatitis

Seborrhoeic dermatitis is characterised by scaly skin that is red and has a greasy look and feel. It is influenced by yeast on the skin and thrives on oilier areas of the body that produce sebum like, you guessed it, the eyes [6].

Seborrhoeic dermatitis affects 3-12% of the population and it is more common in men than women [7].

4. Asteatotic eczema

This is one of the less common forms of eyelid eczema and is typically found in other body areas, but it can still affect the eyes. Asteatotic eczema starts as dry skin, but as the skin becomes dryer, small cracks erupt leading to rapid moisture loss and dermatitis.

It is often found in older adults with less oil glands on their faces. It can also occur during dry winter, leading to cracked, scaly and itchy skin [8].

What causes eczema around the eyes?

The causes of eczema around the eyes are multifactorial, so it is important to receive the correct diagnosis before starting treatment. Conditions like contact dermatitis and asteatotic eczema are usually self-limiting. This means that they are unlikely to reoccur once the irritant is identified and removed.

The National Eczema Association advises that these conditions can be resolved with a short course of medicated creams [9].

Once the condition has resolved you can then focus on protecting yourself from future flare-ups.

Conditions like atopic dermatitis, on the other hand, are caused by underlying inflammatory conditions and genetic predispositions. They can also be a result of immune system issues linked to childhood illness.

These conditions are more likely to require longer-term treatment with medication and careful management.

How an expert can help

Your dermatologist may want to test you for allergies if you continually have skin reactions. This can involve a product "detox" in which you remove products from your routine, then add them back in to identify troublemakers.

A healthy diet and maintaining the eyelid skin barrier with topical creams will help prevent flare-ups for conditions like asteatotic eczema.

Diagnosis of atopic eczema simply means you can consider yourself to have eczema-prone skin. This is more likely to lead to severe eczema.

Fortunately, while several things irritate eczema-prone skin, they are quite well understood, making it a condition that can be well managed.

Symptoms of eye eczema

Swollen skin, dry and itchy skin, an inflamed area around the eyelid margins, scaly skin and a greasy finish to the skin can all indicate that you have eye eczema.

Does eye eczema go away on its own?

Eczema in infants and adolescents is not always lifelong and often self-resolves. However, at any age, eczema left untreated can have serious consequences.

The National Eczema Association warns that left untreated eczema can result in serious complications, permanent scarring and discoloured skin. In some instances, it can even result in hospitalisation [10].

So, it is important to treat eczema as soon as possible.

Potential complications

The American Academy of Dermatology also advises that for those who experience eczema around the eyes, it's important to watch for problems with the eye that can indicate eye diseases.

They note that because people who experience eczema around the eyes often experience discomfort, they can miss signs of more serious problems.

Conjunctivitis

These include allergic conjunctivitis, which can be identified by a pink or red colour to the eye (otherwise known as pink eye), weeping sores around the eye, and white or yellowish crust around the eyelid margins.

Inflamed cornea

You can also be at risk of an inflamed cornea. Watch for sensitivity to light, pain and discomfort, chronically itchy eyes, and persistent watering.

Left untreated long-term, this can cause permanent vision damage, so if eye problems last for more than a few days, make an appointment with a dermatologist [11].

Changes in the shape of the cornea

Consistent rubbing of the eye area can, over time, change the shape of the cornea [12]. The cornea is the outermost, clear layer of the eye that reflects light. The cornea is usually round, however frequent rubbing of the eyes caused by itchiness can cause it to bulge, exhibiting a more conical appearance.

If you're experiencing blurred vision, nearsightedness, or continually needing to change treatment for your contact lenses or glasses, you should have an ophthalmologist look closely at your eyes.

How to treat eczema around the eyes

While there isn't a "cure" for eczema, combining treatments and lifestyle adjustments can keep it well-controlled.

Diagnosing eczema is the first step, as is figuring out what kind of eczema you have. This may involve your dermatologist taking a skin biopsy (the slight ouch could save you many eczema flare-ups!).

Medications

Your dermatologist may recommend over-the-counter medications to keep your eczema controlled. Some treatments for eczema include topical calcineurin inhibitors, which block the production of a protein called calcineurin that contributes to inflammation with atopic eczema.

These come in two types: protopic ointment for moderate to severe eczema and elidel cream for mild to moderate eczema [13].

Skincare

Step 1: Avoid

First, exclude common triggers from your skincare regime. These include skincare products that contain essential oils and scented face creams. Common skincare ingredients like lanolin, urea, and retinoids are also not advised for people who experience skin problems around the eyes [14].

For sensitive skin, dermatologists advise avoiding overwashing your face, particularly the delicate eyelid area.

To keep skin moisturised, use lukewarm water and a gentle cleanser like Software's Salicylic Foaming Wash, followed by an unscented moisturiser on damp skin.

Step 2: Treat

Eczema around the eyes can benefit from a specific skincare strategy.

If you're having a severe flare-up, applying a thin layer of petroleum jelly can relieve itching and provide barrier protection.

Studies have found that daily use of a ceramide-dominant moisturiser and cleanser restored skin barrier function in adults with moderate eczema, so check the ingredients list on your skincare products [16].

Software's Ceramide Repair Balm is like a blanket of moisture and nourishment for your skin. It melts into the skin to replenish and protect the skin barrier, providing long-lasting hydration.

When to seek medical help

As soon as possible! It's ideal to consult with a dermatologist before embarking on your treatment journey.

This can help you tailor your treatment and ascertain whether you need medications or can manage your eczema with home remedies and skincare.

If you have contact eczema or eczema caused by an allergic reaction, simple steps like removing irritants can help without medication.

Eczema on the eyelids is certainly one of the more frustrating skin problems we encounter, but remember, it's a manageable condition.

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