First of all, eyelid dermatitis may result from coming into contact with allergens or irritants found in personal care products or your environment. Eyelids have the thinnest skin on the body which makes it easier for allergens to penetrate the skin. Additionally, because of their exposed location on the body, eyelids are subject to significant cosmetic and environmental exposure, including frequent contact with allergens carried by your hands and then transferred to your eyelids.
I’ll first explain what you need to do to get your eyelid dermatitis under control, and then I’ll explain why. Don’t worry, we can solve this and get you back to being you!
Step 1. Avoid all potential exposures to chemicals that you may be allergic to. This can sometimes be the most difficult part of treatment for perioral dermatitis, but the good thing is, we know the chemicals that most people are allergic to when they get eyelid dermatitis so we can avoid those first. If it works, your problem is solved and you can introduce products back in ONE AT A TIME—-but you will never reintroduce any products that we know are problematic. Here are the three categories of what you need to avoid in step one:
- Stop using all of your current personal care products (makeup, cleansers, lotions, makeup remover, artificial lashes, shampoo, conditioner–anything that is applied to your face or gets washed over your face) OR that could be transferred to your face by your hands (i.e. a hand soap, dish soap, hand cream, scented laundry soap etc.,.).
- Remove any nail polish or artificial nails.
- Stop wearing any metal jewelry on your hands and wrists until we get your rash cleared up and long term if it becomes clear that one of the metals found in your jewelry is a problem.
Step 2. Treat the rash around your eyes until it is gone.
If the problem is more severe, you can get a prescription product to treat this by doing a telehealth appointment at rx.cherylleemd.com or you can use our Eczema Experts Hydrocortisone Barrier Cream. Use this once or twice daily until the rash is resolved–it usually only takes a few days or up to two weeks at the most. Very, very rarely, the use of steroids near the eye can trigger glaucoma, so please stop using this product if you experience blurring of vision or changes of vision and contact an ophthalmologist if this happens–this is extremely rare, and though most dermatologists have never actually seen this happen, it is something you should know about.
Step 3. Avoid products that contain the chemicals you are allergic to long term. I will discuss what chemicals you should avoid in general and in what kinds of products they are found so you know how to avoid them.
Step 4. Finally, we’ll discuss what products you CAN use long term.
Chemicals to Avoid:
There are seven classes of chemicals that most commonly cause eyelid dermatitis; metals, preservatives, topical antibiotics, fragrances, acrylates, shellac, and surfactants. We will review each of these chemical classes below, followed by additional classes of chemicals that cause eyelid dermatitis, but less commonly. The first seven classes of chemicals should be avoided entirely as part of your treatment regimen. If you do so, and then continue to have eyelid dermatitis, then you should consider getting patch tested. If you already have been patch tested, then also avoid the chemicals listed as numbers 8 to 12 below:
- Metals such as Nickel, Cobalt, Gold and Chrome
Nickel is the number one most common contact allergen in the world and can be found in make-up products (eye shadow and mascara), eyewear (sunglasses and prescription glasses) and eyelash curlers. Due to the transfer of tiny amounts of substance from the hands, nickel from rings on your fingers, metal coins or clothing fasteners, buttons and snaps may also cause eyelid dermatitis (through rubbing or touching the eyelids with your hands!). Modified cobalt (such as cyanocobalamin and amine cobalt salt) can occasionally be found in both cosmetics, household goods and vitamins. Gold exposure comes from wearing jewelry on the hands or ears, and may be made worse by using mineral-based sunscreen or cosmetics at the same time. Eye shadow, mascara, foundations, moisturizers, and eye masks are among the cosmetics that have been found to contain gold. Chromium oxide green, a version of Chromium, which is used to give many makeup products their green hue, is also an identified eyelid allergen. Numerous household products, such as glues, leather goods, and polishes, also contain potassium dichromate/chromium.
- Preservatives that are found in personal care products: Methychlorisothiazolinone/Methylisothiazolinone (MCI/MI), Formaldehyde releasers, Benzalkonium chloride and Thimerosal are preservative systems that can commonly cause eyelid dermatitis.
- Methychlorisothiazolinone/Methylisothiazolinone (MCI/MI) is a preservative that is often found in hand soap, body wash, shampoos and conditioners. It is a very common allergen.
- Benzalkonium chloride is a preservative found in skincare products, prescription and over-the-counter eye preparations or drops, hand sanitizers, deodorants, detergents, shampoos, and liquid soaps and may cause eyelid dermatitis.
- Formaldehyde releasers are common allergens found in many liquid personal care products including soaps, shampoos, body wash and conditioners. Examples of allergenic formaldehyde releasers include 2-bromo-2-nitropropane-1,3-diol (Bronopol), diazolidinyl urea (Germall® II), DMDM, imidazolidinyl urea, DMDM hydantoin (Glydant®) (Germall I), tris-nitromethane (Tris Nitro) and quaternium-15. The most common of these preservatives is quaternium-15.
- Thimerosal is a mercury-based preservative known for inhibiting bacterial growth in ophthalmic solutions and sometimes in eye makeup, is a problematic contact allergen. Vaccines, eye drops, and contact lens cleaning products no longer frequently contain it.
- Topical antibiotics
Triple antibiotics such as Neosporin® include neomycin and bacitracin. These two antibiotics are extremely allergenic–some of the most allergenic chemicals on earth. Please avoid using them. If you have a cut, scrape or burn, you can safely use this product instead: Double Action Boo Boo & Bum Balm.
- Fragrances Chemicals found in fragrances are of the most common allergens and are found in most. personal care products including shampoo, conditioner, lotion, makeup, lip products, sunscreen, laundry soap and hand soap…the list is extensive! Here are some of the most common chemicals that are found in fragrances that cause problems. Please note that essential oils ALSO contain these chemicals and may be part of your problem. In addition, personal care products that tout plant-based extracts and oils almost always have one or more of these chemicals in them:
- Limonene: Limonene is a terpene commonly found in citrus fruits and is often used in fragrances and other personal care products. It is a known skin sensitizer and can cause allergic contact dermatitis.
- Linalool: Linalool is a terpene alcohol found in many essential oils, including lavender and bergamot. It is a known skin sensitizer and can cause allergic contact dermatitis.
- Geraniol: Geraniol is a terpene alcohol commonly found in rose oil and other essential oils. It is a known skin sensitizer and can cause allergic contact dermatitis.
- Eugenol: Eugenol is a phenol found in many essential oils, including clove oil and cinnamon oil. It is a known skin sensitizer and can cause allergic contact dermatitis.
- Hydroxycitronellal: Hydroxycitronellal is a fragrance chemical that is commonly used in perfumes and other personal care products. It is a known skin sensitizer and can cause allergic contact dermatitis.
- Isoeugenol: Isoeugenol is a fragrance chemical commonly used in perfumes and other personal care products. It is a known skin sensitizer and can cause allergic contact dermatitis.
- Cinnamaldehyde is a major component of cinnamon and is commonly used in fragrances, flavorings, and other products. It is a known skin sensitizer and can cause allergic contact dermatitis.
- Acrylates in artificial nails and artificial eyelash glue
Nail polish, artificial nails and gel nails are known to contribute to eyelid dermatitis and contain hydroxyethyl methacrylate and other acrylates. The dermatitis is often triggered due to allergen transfer to the eyelid from your hands–so I recommend you remove any nail polish, gel nails or artificial nails if you use them. I know this is hard to do, but you can do it! 🙁
Artificial eyelash glue and adhesives are also very allergenic. The chemical found in eyelash glue is called cyanoacrylate. There are no eyelash glues that do not contain this that I know of so, if you wear artificial lashes, I’d recommend maybe trying the magnetic ones.
- Shellac
Lipstick, adhesive tooth whitening strips, and mascara are examples of products that contain shellac or shellac wax (used as a tackifier in eye makeup products). Shellac is also a common allergen that causes eyelid dermatitis.
- Surfactants
Shampoo, conditioners, hand soaps and other soaps contain surfactants that can also cause eyelid dermatitis. The surfactants that most commonly cause eyelid dermatitis include the following: Sodium lauryl sulfate (SLS), sodium laureth sulfate (SLES), cocamidopropyl betaine (CAPB), ammonium laureth sulfate (ALES), ammonium lauryl sulfate (ALS), olefin sulfonate (OS), sodium lauroyl sarcosinate (SLSO), and disodium laureth sulfosuccinate (DLES). A less common, but still significantly allergenic surfactant is called decyl glucoside.
For this reason, I recommend that you discontinue the use of your shampoo and conditioner, hand soaps if it contains any of the above chemicals and 99.9% of shampoos/soaps do. You can safely use the TrueCider Shampoo and Body Wash and Conditioner in the vast majority of cases.
The following chemicals are less frequently a problem, but can indeed be problematic to some people. if you have fully eliminated the seven categories of chemicals above, and still have a problem, then eliminate the following as well:
- Paraphenylenediamine
Paraphenylenediamine, a chemical allergen, is present in hair dye (PPD). Additionally, it can be found in cosmetics, henna tattoos, inks, film for cameras, black rubber, oils, and gasoline. You may use walnut based hair dyes as an alternative. Just make sure they don’t contain this chemical.
- Epoxy Resins
Epoxy resins are found in glues and adhesives. Glues that have two parts and which must cure are usually an epoxy resin. Uncured epoxy resin is very allergenic. Cures epoxy usually has some component of the uncured chemicals and can be allergenic.
- Airborne contact dermatitis
Exposure to antigen or irritant particles suspended in the air can lead to airborne contact dermatitis of the eyelids. We call this type of allergen and aeroallergen. When you have airborne contact dermatitis on the eyelids, it is usually also present elsewhere–especially under the chin and on the upper front part of the neck. This can sometimes help you to differentiate if you have an aeroallergen or a contact allergen that is causing your problem. These include pesticides, medications, industrial and agricultural dusts, wood allergens, plant antigens, plastics, rubber, glues, and metals. One of the most common causes of airborne contact dermatitis of the eyelids is exposure to plants in the Compositae family, such as parthenium, ragweed, asters, sunflowers, chrysanthemums, and artichokes.
- Protein contact dermatitis
Allergic Contact Dermatitis caused by sensitization to plant or animal proteins is known as protein contact dermatitis (PCD). These include items such as food, pollen, fur, and latex (think rubber gloves, bandaids and stretchy fabrics or materials).
- Irritant Contact dermatitis
Irritant contact dermatitis is a type of skin inflammation caused by contact with substances and/or environmental factors that harm the skin, causing the skin barrier to be damaged. It occurs when chemical or physical agents cause more damage to the skin’s surface than the skin can repair. Irritants remove oils and natural moisturizing factors from the skin’s outer layer, allowing chemical irritants to pass through the skin barrier and cause inflammation. Among the irritants known to cause or exacerbate eyelid dermatitis are soaps, preservatives, and fragrances. Wet work, detergents, solvents, acids, alkalis, adhesives, and metalworking fluids are examples of occupational irritants. Of note, the use of topical retinoids (like retin-a and retinol) and benzoyl peroxide can also cause an irritant reaction to eyelid skin even when not applied directly to the eyelids.
My goal is for you to be able to understand all of these potential chemicals that commonly cause eyelid dermatitis so you can safely avoid them while still enjoying your life with a nice skincare regimen.
Okay so what can you safely use in the nearterm and in the long term:
Haircare: Please use the TrueCider Shampoo/Body Wash and Conditioner.
Facial Products: You can safely use the TrueCider Cleanser, followed by the TrueCider serum and the TrueLipids lotion OR cream for deeper moisture. You can also safely use the TrueLipids lip balm.
Body: Use the TrueLipids Lotion, cream or ointment depending on how much moisture you need. The lotion is the lightest, but has very high levels of the most effective age prevention molecules around. The Ceramide+ cream is a very deep moisturizer and can be used as an eye cream and night cream (but let’s get you all cleared up first!). The Ceramide+ Cream also contains all the anti-aging greats as the lotion–niacinamide, ceramides, other skin barrier lipids, polyhydroxy acids and glycyrrhetinic acid–all really great age-fighting ingredients so you don’t have to miss out on luxurious skincare even though it doesn’t contain all the toxic/allergenic junk! If you need really deep moisturization–like really dry legs, elbows, knees and feet–use the TrueLipids ointment as needed.
As your daily facial routine, I recommend using the TrueCider Cleanser followed by serum and TrueLipids lotion twice a day.
Hand soap: I recommend you use the TrueCider body wash for your hand soap–keep some by the sink and it is also a good idea to get a smaller travel size container that you can put it in and keep it with you for when you need it.
Makeup: This is the tricky/difficult part. Unless you are clearly allergic to nail products or haircare products or to soaps, then you are in the zone where it is likely one of the ingredients of your eyeliner, mascara or eyeshadow….and unfortunately, chances are that all makeups have at least one of the common allergens.