“Stop itching your eyes!” We know, but for someone with eyelid dermatitis, this can be hard to stop. Eyelid dermatitis can be extremely uncomfortable and at times a challenge to diagnose. However, the most common cause of eyelid dermatitis is allergic contact dermatitis (ACD) and it is reversible upon stopping contact with the responsible product or substance. 1
Eyelid ACD is a condition that can cause itching, tearing, redness, discharge, and even drooping of the eyelids. It is caused when the skin comes into contact with something that you are allergic to. ACD of the eyelid can occur on one eye or both eyes.
Eyelids can be extremely sensitive because the skin is so thin, allowing for easy penetration of contact allergens. It is important to note eyelid ACD can occur from direct or indirect contact with an allergen, which can complicate diagnosis. Most people touch their faces & rub their eyes multiple times a day without even realizing it. The rash could be coming from something not directly applied to the eyelids. People with a gold allergy can develop eyelid ACD from wearing gold jewelry at places distant from their eyelids.2 In addition, products applied to the hair, face, scalp, and fingernails can also cause reactions.
Common Culprits of Allergic Contact Eyelid Dermatitis
- Topical medications
- Acrylic nails
A recent study found metals in cosmetics and the preservatives phenylenediamine (PPD) and thiomersal to be common allergens in patients with eyelid dermatitis. Nickel, cobalt and chromium are metals often found in eye shadow, eyeliner, and mascara.4 Another recent study, reported an increase in eyelid ACD in people wearing acrylic nails, indicating that nail products should also be considered when treating eyelid dermatitis.5 In addition to products, rubbing and touching were also reported to be significant contributing factors.
If you cannot identify the triggers, you should visit a dermatologist. A dermatologist can help narrow down the search, accurately diagnose you, and come up with a treatment plan.
Patch Testing: Narrowing Down the Search
Patch testing is done at a dermatologist's office and can be used to see if a substance is causing ACD. To perform a patch test, allergens, along with a positive and negative control, are applied to patches that are placed on your skin on the forearm or upper back typically for 48 hours. Upon return to the doctor’s office, the patches will be removed, and your skin will be evaluated for reaction. It is important to note that patch tests are not always accurate, however they are a good starting point to obtain a list of things to avoid in trying to manage your ACD symptoms. 6
Reading ingredient labels can be confusing and time-consuming. SkinSAFE is an excellent resource for people with dermatitis.
If you have a list of allergens, you can email firstname.lastname@example.org and someone from the SkinSAFE team will generate a personal allergy code (PAC). Once this is entered into your account, you have the option to exclude products that contain your specific allergens.
How can the EyelidSafe badge help?
EyelidSAFE is the stamp of approval used by SkinSAFE. (skinsafeproducts.com) For someone who has not had patch testing done at the dermatologists' office, this is a great place to start to get uncomfortable eyelid dermatitis under control. EyelidSAFE excludes common allergens that can cause eyelid irritation.
If a product is rated as EyelidSAFE, the product is free of:
- Common fragrances,
- Soap & glue ingredients,
- Soaps related to Cocamidopropyl betaine, and
- Glue/adhesives like shellac or acrylate monomers.
4) Oh JE, Lee HJ, Choi YW, Choi HY, Byun JY. Metal allergy in eyelid dermatitis and the evaluation of metal contents in eye shadows. J Eur Acad Dermatol Venereol. 2016;30(9):1518–1521. doi:10.1111/jdv.13646.
5) Moreira J, Gonçalves R, Coelho P, Maio T. Eyelid Dermatitis Caused by Allergic Contact to Acrylates in Artificial Nails. Dermatol Reports. 2017;9(1):7198. Published 2017 May 29. doi:10.4081/dr.2017.7198.