Q: I often get red, itchy, swollen eyelids. What can I do to relieve this?
A: This sounds like blepharitis, though if symptoms last more than two weeks or are particularly bothersome, you should see an eye doctor for evaluation. If it is blepharitis, you may also experience crusting around the eyelashes, excessive tearing of the eyes, and a burning sensation.
Blepharitis can affect the front of the eyelid, where the eyelashes are attached. The two most common causes of this are bacteria and seborrheic dermatitis (like scalp dandruff but on the eyelids). It can also affect the inner eyelid when the oil (meibomian) glands located around the base of the lashes become clogged and accumulate debris. Blepharitis is also frequently associated with acne rosacea (which causes red and inflamed skin) and dry eye syndrome. Some people develop hordeola (painful lumps near or on the edge of the eyelid, commonly known as styes) in conjunction with blepharitis.
Though blepharitis can clear up on its own, it often becomes a chronic condition that requires daily care for life. However, while it may be uncomfortable, it rarely has serious medical consequences and is not contagious.
Home treatment involves keeping the lids clean and free of crusts. Using a clean washcloth, place compresses soaked in warm water over your eyes for several minutes, several times a day, to loosen the crusts. Then lightly scrub the eyelids using a mixture of water and a few drops of baby shampoo placed on a cloth or cotton swab. Commercial eyelid scrubs are also available. Follow with a lid massage, using either a washcloth or a clean fingertip: Gently massage your lids using circular motions to clear the oil accumulated in the glands.
Don’t wear eye makeup or contact lenses until the symptoms clear. If scalp dandruff is present, a dandruff shampoo for the hair is recommended as well to prevent the debris from falling into the eyes and causing a further reaction and clogging of the glands.
If self-care measures don’t help enough, your doctor may prescribe antibiotics or steroid eye drops. Topical antibiotic ointments can be applied on the eyelid edges for a few weeks. Oral antibiotics may be needed for more difficult-to-manage cases, such as in people with rosacea.
Also see Pinkeye Problems.
Originally published August 1, updated January 9, 2017.