Seborrheic dermatitis is a nasty skin condition that affects up to 42% of babies under 3 months of age but usually clears up completely in early childhood. Its incidence goes down drastically with age, to the max of 1-3% among adults and teens. Seborrheic dermatitis of the eyelids is even rarer, but it’s an extremely uncomfortable condition that can cause a lot of suffering to the patient. It deals a great blow to the self-esteem, increases the risk of depression. With the right care it can be brought under control and most or all symptoms eliminated for long periods of time, however it is regarded as incurable by many doctors. To prevent a future problems that this, seemingly mild, disease can lead to, one needs to have it diagnosed and managed using the best available treatments.
Seborrheic Dermatitis of the Eyelids: Definition and Symptoms
The correct term for seborrheic dermatitis of the eyelid is seborrheic blepharitis, though medical literature uses both terms. Information on blepharitis describes this condition as eyelid inflammation and states that seborrheic blepharitis is one of several types blepharitis. It occurs when the Glands of Zeis (the type of sebaceous glands responsible for ‘oiling’ your eyelashes) get inflamed.
This condition sometimes referred to as ‘eyelash dandruff’. That makes sense because it looks the same and dandruff is another type of seborrheic dermatitis. However, the definition of dandruff clearly states that it’s a condition affecting the sebaceous glands of the scalp. Therefore, to think of seborrheic blepharitis as ‘dandruff’ may lead to not treating it with the seriousness it deserves until too late
Main symptoms of this condition are:
- Crusting on the eyelashes (hence why the problem is likened to dandruff)
- Inflamed, red, and swollen eyelids
- Excessive oil production by the Glands of Zeis (leads to eyelash crusting)
Seborrheic Dermatitis of the Eyelids: Causes
Despite the fact that seborrheic dermatitis has been known for centuries, the exact causes of the condition are unknown. It’s currently believed that it occurs because of a combination of genetic and environmental factors. Yet, it’s unclear which genes are responsible. It is, however, a fact that you have a higher chance of developing this condition if you have a family history of it.
Some studies also indicate that seborrheic dermatitis is connected to neurodegenerative disorders, like Parkinson’s, as well as mood disorders, like depression. Other research indicates a fungal nature of the condition. Malassezia yeast, in particular, is believed to be a cause.
One interesting fact is that this condition is not a result of poor hygiene, as it was believed to be. It’s more closely associated with stress than lack of regular washing. However, the latter certainly doesn’t help the treatment.
What Is the Treatment for Seborrheic Dermatitis of the Eyelids?
The bad news is that there is no cure for seborrheic dermatitis at all. The good news, however, is that the condition can be treated and managed to the point, where it won’t be uncomfortable. In fact, some patients can go years without any outbreaks. However, those can be triggered by stress and immunity problems.
The treatment of seborrheic dermatitis of the eyelids has some unique challenges that complicate the process greatly. Because the affected area is close to the cornea, which is extremely sensitive, the majority of ‘harsh but effective’ topical solutions are impossible to use.
The standard treatment for seborrheic dermatitis includes:
- Specialized shampoos and washes
- Anti-fungal medications (both creams and pills)
Because of the proximity to the eyeballs, you’ll have to avoid all ointments that contain:
- Volatile oils and fragrances
- Sulfur preparations
- Alkaline solutions
- Antibiotics and anti-fungal solutions (unless specifically prescribed)
- Tar (especially coal tar)
This excludes about 90% of topical treatments, and you have to be extremely careful with those that you do choose to use. Bear in mind that irritation caused by any of them can do a great irreparable damage to the eye.
Therefore, the main focus of eyelid seborrheic dermatitis treatment is medications taken by mouth. You’ll usually get prescribed a combination of anti-fungal, anti-androgen, and antihistamine pills.