The skin of the eyelids is very thin (just 0.05 mm) and represents, together with the lips, the most delicate and vulnerable area of our face.
Despite this, the eyelids play a very important protective function: they protect the eyes from mechanical trauma, from sunlight, air, and from potentially harmful external chemical and physical agents.
If we try to force our eyes to stay open without blinking as happens naturally, we will begin to feel a burning sensation in our eyes due to dehydration resulting from prolonged contact with air.
In addition, the eyelids also play a vital aesthetic function: they contribute to the shape of our eyes and the beauty of our gaze.
Various types of make-up products are used to enhance the eyes and accentuate the gaze even more.
Finally, the appearance of the periocular region and of the eyelids is also influenced by the degree of skin ageing (ptosis or eyelid drooping) and by overall health (e.g. bags and dark circles).
The skin of the eyelids contains sebaceous glands at the eyelashes and a few small and widespread sebaceous glands that contribute to the formation of the fatty part of the tear film which protects and hydrates the eyeball.
There are also sweat glands which, with their secretion, externally hydrate the eyelid skin.The crease of the upper eyelid with an open eye helps to keep the skin hydrated.
The skin of the eyelids is, however, very sensitive and can become irritated, with the appearance of the so-called eyelid dermatitis, an inflammatory reaction that most frequently affects the upper eyelid.
Eyelid dermatitis is a very common problem.
It appears in mild cases with:
- pruritus (itching)
- desquamation (flaking skin)
In severe cases, also with:
- intense pruritus
- vesicles and crusts
- lacrimation (tear production)
Very often it affects children but is also found in adolescents and adults.
The term dermatitis is a generic term that indicates an inflammatory state of the skin triggered by a number of causes.
One of the most frequent is irritation from external agents.This is referred to as irritant contact dermatitis.
Irritant contact dermatitis of the eyelids
Inflammation of the eyelid skin occurs due to contact with a physical or chemical agent.
The most common cause is normal cleansing of the face and hair due to contact with water, cleansers and shampoos.The skin of the face may not be affected, but that of the eyelids, as we have seen, is much more sensitive and delicate, therefore, the calcareous water or surfactants in cleansers can first cause dryness followed by irritation, redness and burning.For the same reason, chlorine in swimming pools can also dry and irritate.
Dry, windy and cold climates, the change of season, and psychophysical stress (with excessive rubbing of the eyes) can also favour its onset.
Of course, the use of creams or make-up can also cause irritant contact dermatitis of the eyelids, but this is less common.
Sometimes the act of applying (excessive rubbing or massaging) the cosmetic can lead to irritation.
People who suffer from Atopic Dermatitis (ezcema), the so-called atopic subjects, are more affected by eyelid dermatitis as they have more sensitive skin and are more vulnerable to external agents.Cold winter weather is often enough to produce annoying irritation.
Atopic subjects have a genetic predisposition to respiratory and food allergies, therefore they also suffer at the same time from allergic conjunctivitis to pollen, household dust or animal dandruff or dander that leads to lacrimation and further irritation of the eyelid area.
Allergic contact dermatitis of the eyelids
It is caused by an allergic reaction to chemicals with which the skin of the eyelids comes into contact.
Allergic contact dermatitis is caused by chemical substances capable of crossing the epidermis, even if it is intact, and of stimulating an immune response by the lymphocytes of the dermis.
It represents 5-10% of cases of reactions to the use of cosmetics: it is often caused by an allergy to nickel (contained in mascara, eyeshadows, eyeliner, pencils), to preservatives and perfumes, to preservatives present in eye drops and liquids for contact lenses, and to resins in nail polish.
The allergic reaction does not appear immediately, but is delayed, occurring even a few days after the use of a product, often making it more difficult to identify the cause.
The main symptom is pruritus, usually very intense, accompanied by redness and formation of vesicles that quickly cover themselves with crusts.
In the event of eyelid dermatitis, it is necessary to contact a specialist dermatologist for an accurate diagnosis and to establish the specific cause and, if necessary, to identify the substance responsible for the allergy by means of patch tests.
To prevent irritant eyelid dermatitis:
- remove eye make-up with very gentle cleansing creams that contain no foaming agents
- dry the eyelids completely, without rubbing, to remove all traces of moisture
- avoid applying retinoid or fruit acid based stimulating creams near the periocular region
In all cases of eyelid dermatitis it is advisable to follow some precautions:
- absolutely avoid rubbing or wetting the eyelids to relieve the burning or itching sensation
- stop applying cosmetics on the face and eyes (creams, eyeshadow, pencils, mascara and eye-liner) to avoid having to use make-up removers or cleansers
- avoid applying cosmetics based on natural ingredients that may be irritating or, worse, allergenic
- avoid swimming pools and saunas
- avoid contact with shampoo
- contact a dermatologist for diagnosis and treatment
Finally, it is vital to take care of periocular hygiene and use safe, high-quality cosmetics that are certified hypoallergenic and nickel free on the eyes and eyelids.