This is a series focused on facial eczema, with the privilege of having Dr Lynn Chiam, of of Children & Adult Skin Hair Laser Clinic, to help explain further the type of facial rashes, its treatment options and daily facial care. Dr Lynn is a consultant dermatologist who subspecializes in paediatric skin conditions at Mount Elizabeth Novena Specialist Medical Centre, Singapore. Apart from paediatric dermatology, her other subspecialty interests include adult pigmentary conditions and laser dermatology. More on Dr Lynn can be found here.
What can I apply to treat the rashes on my eyelids?
For the past four posts, we’ve explored the various types of rashes that can occur on one’s face and various treatment options. This week’s focus is on the eyelids – a particularly tricky part of the face because the eyelid skin is very thin and steroids can be absorbed more readily, leading to problems such as cataract and glaucoma. Dr Lynn’s advice on treatment options include:
1. Do consult a doctor if you have rashes around the eyelid. It is important to determine what is causing the rash. Common causes include eczema and contact dermatitis secondary to eye make-up. In general, mild to mid potency steroids can be applied to the face. It should be applied twice a day and for not longer than 1-2 weeks. A mid potency steroid can be used initially then tailing down to a low potency steroid once the rash is better. Alternatively, a steroid-spring cream such as Tacrolimus or Pimicrolimus can used . In a minority of patients,Tacrolimus can cause a stinging sensation. At night, apply the cream just before you go to sleep. To prevent the steroid from dripping into the eyes, you can use a cream or ointment based steroid rather than a lotion based one which is more ‘watery’. Allow 20-30 minutes after application of the cream to the eyelids before doing activities that may cause sweating.
2. Clean the eyelid area, with lukewarm water, including cleaning the ‘mascara’ area of the eyelid. Avoid using water that is too hot. Use a gentle soap and do not rub this area excessively. Avoid using products with ingredients you’re allergic to. A patch test can be taken at the dermatologist, and ingredients that you’re tested sensitive to should be avoided for your face and eyelids as well.
3. Moisturize the eyelid, taking care again to use products that you are not allergic or sensitive to. If you feel that the moisturizing lotion you are using is too “watery“ and runs into your eyes, you can change the moisturizer to a cream or ointment form which is thicker.
4. For those who are using makeup, it is important to wash your brushes and change them regularly. Do not use make-up past their expiry dates as bacteria will accumulate in make-up which can irritate and infect your skin. Avoid mascara and choose products from large cosmetics and skincare companies that clinically test their products. Also avoid products that are shimmery or glitters as these contain metal particles, mica, which can irritate the skin.
A final note is to avoid rubbing the eyes, as this can lead to neurodermatitis, a thickening (lichenification) of the eyelids due to prolonged scratching. The appearance of the eyelids will be darker and in some instance, lead to skin folds on the eyelid.