Eczema around the eyes can be challenging to treat because of the sensitive tissue in this area. The skin around the eyes is thinner and more fragile than the skin of other areas of the body. With severe eczema around the eyes, eyelid swelling and involvement of the eye itself may affect your vision. Treatment focuses on keeping the involved area soft and moist, reducing skin inflammation and avoiding exposure to irritants. Your doctor may recommend different treatment options based on the severity of your eczema.
Your doctor will likely recommend frequent use of a moisturizer, also known as an emollient. A moisturizer reduces skin dryness and helps alleviate itchiness. By keep your skin soft, a moisturizer also reduces the likelihood of developing breaks in the skin. Ointments are the most effective moisturizers, although their greasiness can be a drawback. Your doctor may recommend a cream or lotion for daytime use and an ointment for use at night. Moisturizers used for eczema differ from cosmetic moisturizers in that they do not contain any perfume, sunscreen or anti-aging ingredients. Only use moisturizers recommended by your doctor.
Medicines to Reduce Inflammation
Your doctor may recommend medication to reduce the underlying inflammation causing eczema around your eyes. A steroid ointment or cream, such as hydrocortisone, is often the first choice. If your eyelids are involved, your doctor may prescribe steroid eye drops as well. Although steroid medicines are usually effective, side effects can occur with long-term use. If side effects are a concern or your eczema does not improve, your doctor may recommend another type of anti-inflammatory medication for your skin, such as pimecrolimus (Elidel) or tacrolimus (Protopic). These medicines are not approved for children younger than age 2. Your doctor may recommend other prescription creams, ointments, oral medications or eye drops to control your eczema.
Phototherapy -- which involves short bursts of exposure to a medical form of ultraviolet light -- can be useful if your eczema does not clear with another type of treatment. Your eyes are protected during phototherapy sessions to treat the skin that surrounds them. Skin affected by eczema is prone to infection due to bacterial overgrowth and breaks in the skin caused by scratching or dryness. Your doctor will prescribe an antibiotic if you develop a skin infection.
Measures to Reduce Skin Irritation
Skin affected by eczema is easily irritated, which can make your symptoms worse. The American Academy of Dermatology recommends limited use of a nonsoap skin cleanser, which is less drying to your skin than soap. These cleansers are hypoallergenic, fragrance-free and have a pH close to that of your skin. Avoiding other potential irritants, such as makeup, may also be helpful. If you have allergies, your doctor will talk with you about how to limit your exposure to substances that may aggravate your eczema -- such as pollen, dust mites and animal dander. Applying a cool compress to the skin around your eyes may help temporarily reduce itchiness.
Because eczema around your eyes can potentially affect your vision, it's important to work closely with your doctor to control your condition. Depending on the severity of your eczema and the extent to which your eyelids are involved, your doctor may recommend you visit an eye specialist. Contact your doctor right away if you experience any change in your vision. If you have allergies in addition to eczema, working with an allergist may also be helpful.
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- Diseases of the Eye and Skin: A Color Atlas; H. Bruce Ostler, et al.