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Blepharitis is an inflammation of the eyelash follicles, along the edge of the eyelid. The cause is overgrowth of the bacteria that is normally found on the skin.

Blepharitis is usually caused by seborrheic dermatitis or a bacterial infection, and sometimes it is a combination of both. Allergies and eyelash infestation with lice may also cause blepharitis, although these causes are less common.

This condition is characterized by excess oil production in the glands near the eyelid. Too much oil creates an environment where the normal bacteria found on the skin can overgrow. The eyelids appear red and irritated, with scales that cling to the base of the eyelashes.

Blepharitis may be connected to repeated styes and chalazia. Risk factors are seborrheic dermatitis of the face or scalp, rosacea, lice, and allergies.

• Eyelids have the following symptoms:
  • Crusty
  • Reddened
  • Swollen
  • Itching
  • Burning
• Blinking causes a granular sensation (like sand or dust in the eye)
• Loss of eyelashes may occur

An examination of the eyelids during an eye examination is usually enough to diagnose blepharitis.

The primary treatment is careful daily cleansing of the edges of the eyelids, to remove the skin oils that the bacteria feed on. Your health care provider might recommend using baby shampoo or special cleansers. Antibiotic ointments may also be helpful in controlling bacteria on the lids.

If seborrheic dermatitis or rosacea are causing the problem, seek treatment for those conditions.

The likely outcome is good with treatment. Continued attention to lid cleanliness may be required to prevent repeated problems. Continued treatment will typically make the eyes less red and more comfortable.

• Styes
• Chalazia
• Injury to the eye tissue (corneal ulcer) from irritation
• Inflammation of the surface of the eye (conjunctivitis)
• Loss of eyelashes
• Scarring of the eyelids

Call for an appointment with your health care provider if symptoms worsen or do not improve after careful cleansing of the eyelids for several days.

Cleaning eyelids carefully will help prevent blepharitis. If a specific skin condition is present, it should be treated.

Eyelid inflammation

Papier A, Tuttle DJ, Mahar TJ. Differential diagnosis of the swollen red eyelid. Am Fam Physician. 2007 Dec 15;76(12):1815-24.

Fay A. Diseases of the visual system. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, PA: Saunders Elsevier; 2007: sect XXVI, chap 449.

Olitsky SE, Hug D, Smith LP. Abnormalities of the Lids. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th Ed. Philadelphia, PA: Saunders Elsevier; 2007: chap 623.

Updated by: Linda Vorvick, MD, Seattle Site Coordinator, Maternal & Child Health Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.