Eczema of the eyelid is usually limited to this area, but it can also appear on the face and hands. This very troublesome eczema is most often caused by repeated contact with irritating or allergenic products, found in cosmetics, but not only. To find out more, Doctissimo interviewed Dr. Brigitte Millepied, dermatologist and allergist at the Bordeaux University Hospital and member of the French Society of Dermatology (SFD), who tells us about the symptoms and treatment of eyelid eczema, as well as the different measures that can be taken to prevent its occurrence.
What is eyelid eczema? Eyelid eczema is a localized eczema, but it can spread to the face and hands. Mostly women are affected. “This is mainly due to the frequent exposure to irritants and allergy-causing products that are applied directly to the eyelids, such as those found in cosmetics,” explains Dr. Brigitte Millepied.
In most cases, eyelid eczema is a contact dermatitis, that is, it occurs after regular contact of the eyelids with irritants or allergens. From a pathophysiological point of view, contact dermatitis corresponds to delayed hypersensitivity. “Although the skin is relatively impermeable, molecules can pass through it. This is especially true in atopic skin, where the skin barrier is disturbed,” explains the specialist. Upon contact with an irritant or allergen, the Langerhans cells in the epidermis present the allergen to lymphocytes that are naturally present in the skin. Everything travels to the afferent ganglia, which activates cytokines and triggers inflammation, which is what causes the symptoms of eczema. And dermatologists warn: “We become allergic to things to which we are frequently exposed. To the same ingredients in the same products or different products with which we come into regular contact.” As soon as the skin is no longer exposed to radiation, the skin symptoms will disappear.
Causes of eyelid eczema
Makeup (mascara, eyeshadow, eyeliner, etc.), makeup remover, eye cream, anti-wrinkle cream, shampoo, shower gel, etc. Cosmetics are often the cause of eyelid eczema. They contain preservatives and fragrances that can cause allergies.
Eyelid eczema can also occur through indirect contact. This is when the trigger is placed on the eyelid with a finger. This is called “hand eczema”. “Nails and all related products, whether varnishes based on resins obtained from formaldehyde, cyanoacrylates for artificial nails or methacrylates for molded nails, are the cause of numerous eyelid eczema cases in young women. And we are witnessing the start of an epidemic of much more dangerous eye diseases, eczema and keratitis, due to the fashion for artificial eyelashes, which require the application of glue,” warns Dr. Millepied.
Finally, if irritants are carried in the air and land on the eyelids, they can cause the so-called “airborne eczema”, which is the case, for example, in people who are allergic to perfumes. ” They are so volatile that their molecules settle on the eyelids and remain in the folds under the eyelids. Among other substances, the most notable are the highly sensitizing preservatives isothiazolinones (especially methylisothiazolinone). “These substances have been banned in cosmetics since 2017, but not in water-based paints, in which more than 90% of them are found,” the expert regrets.
hat are the symptoms of eyelid eczema?Eyelid eczema first manifests itself as redness and then itching. Inflammation, which characterizes the underlying mechanism of eyelid eczema, can lead to eyelid edema and swelling. Unlike other areas, eyelid eczema is very rarely acute, says Dr. Millipede. “It’s similar to dry eczema, which forms fine scales. It rarely develops blisters.”
How is eyelid eczema diagnosed?
As with other eczemas, the diagnosis of eyelid eczema relies primarily on careful questioning of the patient to look for potentially irritating pathogens that may be causing the problem. Laboratory tests can help assess the severity of the disease. “Then we carry out the actual diagnosis. h. A test patch containing at least 30 different allergens is applied to the back. If after 48 hours one or more allergens causes symptoms and the patient seeks medical attention, the diagnosis of eyelid eczema is confirmed,” explains the skin allergist.
Treatment of eyelid eczema
The main treatment for eyelid eczema is to avoid contact with the causative allergen or irritant. “But in the meantime, we can reassure the patient that if the tests carried out jointly by the patient and the specialist do not identify the cause and prescribe a topical corticosteroid to be used until the symptoms disappear.” To avoid that, we can suggest a maintenance therapy. This will also be based on corticosteroids, to be used once or twice a week in the form of a cream, supplemented with a hypoallergenic emollient on the other days. “In case these treatments fail or a longer treatment is required, the use of a tacrolimus-based cream may be preferable,” suggests Dr. Milpee previously.
How to prevent eyelid eczema?
Having eyelid eczema does not mean you have to stop wearing eye make-up, ban nail polish or avoid perfume. Eczema flare-ups aside, it is entirely possible to maintain these beauty habits if you choose your beauty products carefully.
Dr. Brigitte Millepied recommends choosing a hypoallergenic make-up range that does not contain substances known to be irritating and/or allergy-inducing. The same applies to facial care such as eye creams, day creams, night creams and other serums. It is also advisable to regularly clean your makeup tools, especially the brushes you use when applying eyeshadow. Avoid waterproof mascaras that are difficult to remove and avoid rubbing your irritated eyelids. It is recommended to remove eye makeup by gently applying it with your fingertips or with an oil or makeup remover dabbed on cotton. Finish this routine by applying a warm water compress to your eyelids, as it has a soothing and decongestant effect on the skin.
To color your nails, experts emphasize that you should choose varnishes that do not contain formaldehyde resins and above all not succumb to the trend of artificial or shaped nails.
As for wall paints, we try to look for those that do not contain isothiazolinones or leave their use to those who are not sensitive.