How Blepharitis Is Treated

Blepharitis is a common skin condition that makes your eyelids red, irritated, itchy, and swollen. Also known as eyelid inflammation, it is usually treated with home remedies. However, in more stubborn cases, prescription medication may be needed.

This article discusses the symptoms, causes, and treatment of blepharitis. You'll also learn about home remedies, over-the-counter (OTC) treatments, and prescription medications that treat chronic eyelid inflammation.

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Blepharitis Symptoms

Common symptoms of blepharitis include:

• Burning, stinging, or watery eyes
• Dandruff-like flakes on eyelids and eyelashes
• Dry eyes
• Eyelid swelling or thickening
• Feeling like there is something in your eye
• Red, irritated eyelids
• Tears that are foamy or have bubbles in them
• Waking up with crusty eyelids or eyelashes

In some cases, symptoms may clear up only to return a few weeks later. This is known as chronic blepharitis and can be difficult to treat.

What Causes Blepharitis

Blepharitis can be caused by an infection, parasite, or skin condition.

Infection

A bacterial infection can cause blepharitis. It is normal to have some bacteria on the skin at all times. However, too much bacteria can be a problem.

When there is an overgrowth of bacteria at the base of the eyelashes, dandruff-like flakes can form and irritate eyelid skin.

Skin Conditions

Certain dermatological conditions can cause blepharitis. These include:

• A type of eczema known as seborrheic dermatitis
• Acne rosacea, a condition that causes the skin on the face to become red and irritated
• Contact dermatitis, a condition where the skin becomes irritated and inflamed due to direct contact with a chemical irritant or allergen

Eyelash Mites

An eyelash mite called Demodex is a common cause of blepharitis in older adults.

These parasites are commonly found on eyelashes and do not normally cause a problem.

Sometimes, however, the mites can build up at the base of the eyelashes. This can irritate the skin around the rim of the eyelashes, causing redness, irritation, and flakes.

Poor Hygiene

Bacteria live and breed on skin. And if the eyelids are not washed often enough, the bacteria can multiply. This leads to an overgrowth of bacteria that can irritate eyelid skin.

To keep bacteria levels low, it is important to wash with soap and water regularly.

Poor hygiene is a common cause of blepharitis in children and teens.

Home Remedies

Blepharitis is usually treated with home remedies. In some cases, prescription medications may be needed.

Eye Compresses

The first treatment for blepharitis is placing a warm compress on the affected eyelid several times a day.

To make an eye compress, wet a washcloth or paper towel with warm water. Hold it on your eyelid for a few minutes or until the compress cools to room temperature.

You can also use a warm teabag as an eye compress. Allow the teabag to cool after steeping so that it is warm but not hot.

According to the American Academy of Ophthalmology, a teabag compress does not have any additional benefits over warm water. However, its shape may make it easier to use.

Eyelid Scrub

To keep bacteria levels low, it is important to scrub your eyelids with a gentle cleanser and water.

Baby shampoo is commonly recommended because it is gentle and does not sting eyes. You can also use a specially formulated eyelid wash.

To scrub your eyelids, put a drop of cleanser on a warm washcloth and bring it to a lather. Close your eyes and gently scrub the eyelid using a horizontal back and forth motion. Then, rinse with cool water.

Do this twice a day after applying a warm compress for best results. This can help clear up mild blepharitis.

Over-the-Counter Treatments

Medicated eyelid washes that treat blepharitis are available over the counter. These cleansers can help clear up chronic blepharitis and prevent further eyelid inflammation.

Avenova

Avenova is an eyelid wash that contains hypochlorous acid 0.01%. Clinical studies show hypochlorous acid treats the bacteria that cause blepharitis.

To apply, spray Avenova on a cotton ball or cotton round. Then, wipe it in a horizontal motion across your upper and lower lashes three times. Repeat with a fresh cotton pad on the other eye. Use twice a day.

Cliradex

Cliradex is a medicated wipe that contains Melaleuca alternifolia, a form of tea tree oil that treats blepharitis. Research shows a compound in tea tree oil known as 4-Terpineol is what helps ease blepharitis symptoms.

To treat blepharitis, wipe eyelids and lashes with Cliradex wipes twice a day for 10 days. If symptoms do not clear up, continue to use Cliradex wipes once a day for another 10 days.

Cliradex is safe for everyday use and also works to remove eye makeup.

Blephadex

Blephadex is a medicated wipe that treats blepharitis caused by eyelash mites. The wipes contain a gentle eyelid cleanser, tea tree oil, and coconut oil.

According to research, tea tree oil can reduce Demodex mites and help clear up blepharitis. In addition, tea tree and coconut oils have anti-microbial properties, meaning they kill microorganisms like bacteria, viruses, and fungus.

Coconut oil also has powerful anti-inflammatory and pain-killing properties that help to relieve blepharitis symptoms.

Prescriptions

If at-home care does not relieve blepharitis symptoms, see an eye doctor (ophthalmologist).

They can prescribe medicine that treats the causes and symptoms of blepharitis.

Antibiotics

Antibiotics are used to treat blepharitis caused by bacterial overgrowth. Depending on the severity of the infection, your healthcare provider may prescribe a topical antibiotic applied to the skin or an oral antibiotic taken by mouth.

Topical antibiotic ointments used to treat blepharitis include:

• Erythromycin ophthalmic
• Bacitracin ophthalmic

If topical treatments do not fully clear up the infection, your healthcare provider may prescribe an oral antibiotic such as tetracycline or doxycycline.

Steroids

In some cases, corticosteroids are used to control eyelid inflammation and irritation.

Prescription steroids used to treat blepharitis can be delivered in eye drops, topical ointments, or oral medicine.

Combination Treatment

Blepharitis is often treated with a combination of antibiotics and corticosteroids. Research shows combination treatments can be more effective than antibiotics or steroids alone.

The prescription medication Blephamide combines an antibiotic (sulfacetamide sodium) with a corticosteroid (prednisolone acetate).

Blephamide comes in eye drops and as a topical ointment.

Eyelash Mite Treatment

When eyelash mites cause blepharitis, your healthcare provider may prescribe a medication that kills parasites.

Stromectol (ivermectin) is an oral drug that is used to kill Demodex eyelash mites. The medication is taken in two doses one week apart.

Xdemvy (lotilaner) is an eye drop used twice daily in each eye for 6 weeks to treat Demodex blepharitis.

Summary

Home treatments for blepharitis include applying warm compresses and scrubbing the eyelid with baby shampoo. Medicated eyelid washes that treat blepharitis, sold over the counter, can also help treat mild cases.

If at-home treatments are unable to calm the irritation and inflammation, see an eye doctor. You may need prescription eye drops, topical ointments, or oral antibiotics and steroids.