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Eyelid contact dermatitis

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What is eyelid contact? dermatitis?

Contact dermatitis of the eyelid is a inflammatory reaction involving the skin of the eyelid caused by contact with a trigger substance. It may be due to allergy (allergic contact dermatitis) or irritation (irritating contact dermatitis). Eyelid dermatitis is also called eyelid. eczema.

The upper, lower, or both eyelids on one or both sides can be affected by contact dermatitis. The patient may report itching, stinging or burning, and the caps are red and scaly. They can swell. With the persistence of dermatitis, the eyelids thicken with the increase of marks on the skin (lichenification) The margins of the eyelids may be affected (blepharitis). The appearance is similar, whatever the cause.

The thin skin of the eyelids is particularly sensitive to irritants and Allergens and therefore it is prone to develop contact dermatitis. Contact with the same trigger may not lead to a eruption in other areas of the skin.

Eyelid contact dermatitis

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Mild chronic dermatitis of the eyelid

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Chronic severe dermatitis of the eyelid

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Severe acute dermatitis of the eyelid

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Irritant contact dermatitis of the eyelids

How does irritant contact dermatitis of the eyelids occur?

Irritant contact dermatitis is an innate inflammatory reaction due to injury to the skin. Unlike allergic contact dermatitis, it does not involve specific diseases. antibodies (immunoglobulins) or specific immune cells (memory T cells )

What triggers irritant contact dermatitis of the eyelids?

Irritant contact dermatitis can be triggered by contact with irritants and / or physical triggers.

Irritants that can cause irritant contact dermatitis of the eyelids include:

  • Soaps and detergents
  • Acids and alkalis
  • Chemicals like chlorine under goggles used when swimming
  • Dust particles
  • Hydrophobic substances (composed of molecules that repel water, i.e. drying agents)
  • Cosmetics like eyeliner, eyeshadow, mascara, and sunscreen.

These substances can touch the eyelids directly or transfer from the fingers (which may not be affected by dermatitis).

Physical triggers that can cause irritant contact dermatitis include:

  • Extreme temperatures (hot or cold)
  • Humidity extreme (dry or wet)
  • Mechanical (rubbing or scratching)

Who gets irritant contact dermatitis of the eyelids?

Irritant contact dermatitis can occur in anyone. However, it is more common in people with sensitive skin. People with a history of atopic eczema, asthma and hay fever (“atopy“) They are more prone to irritant contact dermatitis than people without this history.

Any pre-existing inflammation of the skin can compromise the skin's waterproof “barrier” and make it more vulnerable to irritant contact dermatitis. The barrier function may also be faulty for genetic reasons.

How is the diagnosis of irritant contact dermatitis of the eyelids made?

The diagnosis of irritant contact dermatitis of the eyelids is made by identifying its characteristics.

  • An itchy rash that affects one or both eyelids, which can occur intermittently or continuously
  • Suspicion that it has been caused or aggravated by contact with an irritant (see the list above).
  • Often pre-existing sensitive skin or atopic eczema
  • Patch Tests for suspected contact allergens are negative

It can be difficult to identify the precise cause.

Allergic contact dermatitis of the eyelid

How does allergic contact dermatitis occur with the eyelids?

Allergic contact dermatitis is caused by an immune reaction to the trigger; this is known as the allergen. Often this is a substance that the patient has been exposed to many times before without problems. The rash usually occurs one to several days after contact with the allergen. This can make it difficult to identify the cause of the dermatitis. Allergic contact dermatitis involves a type of delay hypersensitivity reaction (also called type IV hypersensitivity) and involves immune memory cells.

What triggers allergic eyelid contact dermatitis?

Contact dermatitis of the eyelids follows direct contact with an allergen.

Allergy to cosmetics may be due to contact with allergens in:

  • Emollients and moisturizers
  • Eye creams
  • Solar filters
  • Makeup
  • Cleaners
  • Fragrances and essential oils.

  • Jewelry containing nickel and gold.

Other potential allergens are in:

  • Eyelash curlers or tweezers (nickel)
  • False eyelashes (components or more frequently, adhesives)
  • Eye drops (preservatives and antiseptics)
  • Contact lenses solution
  • Rubber goggles

  • Glasses frames

Contact dermatitis with the eyelids can also occur after indirect contact with an allergen, due to the transfer of small amounts of substance from the hands (rubbing or touching the eyelids). These allergens can include:

  • Nickel from metal coins or clothing zippers

  • Fragrances
  • Nail cosmetics (varnishes and hairpieces nail)

  • Hair dye, i.e. allergy to paraphenylenediamine

Contact dermatitis with the eyelids is sometimes triggered by airborne allergens, such as dust Pinch and plant pollen. Compound allergy is an example of an airborne allergen that causes eyelid dermatitis.

Who gets allergic contact dermatitis of the eyelids?

Allergic contact dermatitis of the eyelids can occur in anyone. It is no more likely in people with known sensitive skin or atopic eczema than in people who have not previously had skin problems.

Contact allergy usually develops after repeated previous contact with the allergen, so it is not necessarily a new substance that has triggered the allergy.

How is the diagnosis of allergic contact dermatitis with the eyelids made?

The diagnosis of allergic contact dermatitis of the eyelids is made by identifying its characteristics.

  • An itchy rash that affects one or both eyelids.
  • This is more likely to occur intermittently at intervals of days to years.
  • Suspicion that it has been caused or aggravated by contact with an allergen (see the list above).
  • Patch tests for one or more suspected contact allergens are positive

Knowing the details of all the substances that the skin may have been exposed to in skin care, hobbies, and work are an important part of the screening work required to find the cause of an eyelid dermatitis. Patch tests should be organized to establish or confirm the triggering allergen.

What is the treatment for contact dermatitis of the eyelids?

It is important to avoid contact with known or potential irritants and allergens to ensure that the skin is healthy and can form an impermeable barrier.

  • Avoid rubbing and scratching.
  • Just touch the eyelids with clean, rinsed hands.
  • Wash the eyelids under running water or use a cream Cleanser designed for sensitive skin.
  • Avoid all contact with allergens detected by patch tests; this is necessary throughout life.
  • Avoid eyelid cosmetics while dermatitis is active.
  • Wear wrap-around goggles if exposed to cold, wind, dust particles, etc. Glasses can also make it easier to stop scratching and rubbing your eyelids.

Short mild courses current corticosteroids (i.e. 1% hydrocortisone cream or ointment) or calcineurin inhibitors (pimecrolimus 1% cream) may be needed to treat active inflammation. Severe contact dermatitis of the eyelids is usually treated with a short course of oral corticosteroids.

Eyelid dermatitis can be followed by post-inflammatory pigmentation, one of the causes of dark circles under the eyes.