The eyelids are among the most delicate skin on the body.  They are often symptomatic before other areas of skin.  Rashes may appear rather suddenly accompanied by redness, itching, scaling and peeling, and causing much concern.  A myriad of creams and lotions may be applied without relief.  In fact, they may seem to worsen the condition.

The eyelid skin is sensitive and prone to allergic reaction.  This includes traditional allergic reactions to environmental agents (dusts, molds, pollens) and contact dermatitis.  Allergic eye reactions often appear in the spring when the flowers and grasses are in bloom, and here in the Coachella Valley during the fall reseeding season.  Those afflicted may wake up feeling swollen with ocular irritation. The natural reaction is to rub our eyes which can further irritate the skin.

The allergens in the air are constantly circulating during these times and it is difficult to find relief.  If home remedies are sought, one may consider artificial tears to help relieve discomfort and non-scented emollient products applied to the affected skin.  When using topical skin care products be sure to avoid close contact with the eyelid margins (where the lashes are located) as products may cause additional irritation to the eyes themselves. Over-the-counter oral allergy medications often help with the systemic allergic symptoms (sneezing, runny nose) as well as ocular itching.

But some cases call for more directed therapy to the eyes and eyelid region.  If you find yourself using artificial tears multiple times a day without relief, or your eyelid skin is not improving, prescription therapy may be needed.  Prescription eye drops often bring relief and may be discontinued when the allergen season subsides.  For eyelid irritation, an ophthalmic ointment with a steroid ingredient may be needed to alleviate symptoms.  Additionally, some allergy sufferers find that showering and washing their hair before bed helps to lessen symptoms.  Bathing removes an abundance of allergens that have microscopically settled on our skin and hair throughout the day.   

Another common ophthalmic complaint is eyelid irritation without generalized allergy symptoms.

Contact dermatitis may appear gradually or more suddenly.  It may be sporadic at first, and then become more constant.   One may notice redness and scaling of the lids, as well as intense itching.  It is important to look for the causative agent.  Changes in soaps, lotions, detergents, make up, skin care products, bedding or clothing material may be the source.  Nail polish is also a rare cause, especially if one is prone to touching their eyes frequently.

Another factor to consider is the development of a contact allergy after prolonged use of a specific product.  The best way to determine the offending agent is to eliminate one product at a time every few days.  Prescription relief is available while the condition is very symptomatic.  Through the process of elimination the cause is often determined.

While allergic reactions in and around the eyes may cause alarming symptoms and findings, they are often quick to resolve once the causes have been pinpointed and treated.  The good news is that these allergic flares are usually not long lasting and many options are available to provide relief.

Dr. Hui is the founder of The Eyelid Institute in Palm Desert. She is an oculoplastic surgeon and has a special interest in helping patients with eyelid, lacrimal and orbital conditions. Dr. Hui can be reached at (760) 610.2677.

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