Periorbital dermatitis can be a source of discomfort and frustration, affecting the delicate skin around the eyes. Understanding the causes, symptoms, and available treatments can help you manage this condition and maintain healthy skin. This blog post will provide valuable insights on periorbital dermatitis and practical advice on preventing and managing this skin condition.
Table of contents
Key Takeaways
- Periorbital Dermatitis is a skin condition caused by allergic or irritant reactions to certain substances and physical factors.
- Risk factors include female gender, atopic skin diathesis and age over 40. Common triggers are cosmetics, airborne allergens and occupational exposure.
- Treatment options involve topical medications, oral therapies & lifestyle changes such as avoiding triggers & following a gentle skincare routine for prevention strategies.
Understanding Periorbital Dermatitis
Periorbital dermatitis, also known as eyelid dermatitis or periocular dermatitis, is an inflammatory skin condition that affects the eyelids and the area surrounding the eyes, often caused by irritant contact dermatitis. It is estimated that 15-20% of individuals will experience contact dermatitis at some point, with cases involving the skin affected around the eyelids being quite common. In some instances, perioral dermatitis, periorificial dermatitis, or seborrheic dermatitis, a similar condition affecting the area around the mouth and other facial orifices, can also be present.
The two primary types of periorbital dermatitis are allergic contact dermatitis and irritant contact dermatitis.
Allergic Contact Dermatitis
Allergic contact dermatitis is a type of periorbital dermatitis caused by an allergic reaction to substances such as cosmetics, skincare products, or environmental allergens, including airborne contact dermatitis triggers. Common allergens include preservatives in eye drops, and ingredients found in cosmetics, shampoos, conditioners, lotions, and laundry detergents. Ingredients commonly found in eye makeup and perfumes, such as resins, solvents, volatile oils, preservatives, and pigments, can be potential allergens that cause allergic contact dermatitis in the eye area. Irritant contact dermatitis makes it crucial to differentiate between the two types of contact dermatitis when diagnosing and treating the condition. Topical medications, oral therapies, and lifestyle modifications may be employed as treatment options for allergic contact dermatitis.
Avoiding all potential allergens might be daunting, but it’s crucial to recognize and eliminate the substances causing a reaction. A patch test – applying a new product to the neck or forearm for 5-7 days before facial application – can aid in determining potential reactions.
Irritant Contact Dermatitis
Irritant contact dermatitis (ICD) is another form of periorbital dermatitis, caused by direct irritation from harsh chemicals, pollutants, or physical factors. The most prevalent substances and physical factors known to cause ICD in the periorbital area are dust, cosmetics, soaps, detergents, bleach, chemicals, temperature extremes, and humidity extremes.
The customary clinical presentation of irritant contact dermatitis in the periorbital area may include erythema with papules and vesicles. Vesicles may advance to exudation and crusting, with prolonged exposure resulting in lichenification. Differentiating between irritant and allergic contact dermatitis is crucial for proper treatment, as irritant contact dermatitis involves direct chemical damage to the skin, while allergic contact dermatitis is an immune-mediated response to an allergen.
Risk Factors and Common Triggers
Female gender, atopic skin diathesis, and age over 40 are the risk factors for periorbital dermatitis, which is a form of atopic dermatitis. Recognizing common triggers like cosmetic products, airborne allergens, and occupational exposure is key in managing and preventing periorbital dermatitis effectively.
Cosmetic Products
Cosmetic products, particularly fragranced skincare products and topical steroids have been linked to periorbital dermatitis. One study in Japan discovered that 4.8% of patients with periorbital dermatitis were attributed to cosmetics. Another study noted that common periorbital allergic contact dermatitis elicitors were leave-on cosmetic products such as face cream and eye shadow.
To reduce the dermatitis risk associated with cosmetic products, consider using hypoallergenic products designed for sensitive skin. Performing a patch test before using new products can help identify potential allergens and irritants.
Airborne Allergens
Airborne allergens, such as pollen, dust mites, animal hair, and latex, can trigger periorbital dermatitis in susceptible individuals. Exposure to these allergens can lead to redness, itching, swelling, and a rash in the periorbital area as the skin reacts to the allergen.
Maintaining a clean living environment, using air purifiers, and limiting exposure to known allergens can mitigate periorbital dermatitis risk caused by airborne allergens. Frequent laundering of bath and bed linens can further reduce allergen exposure.
Occupational Exposure
Occupational exposure to irritants, such as chemicals, plants, or other allergens, can lead to periorbital dermatitis. Common irritants include:
- Shellac
- Benzalkonium chloride
- Acrylates
- Surfactants
- Sodium lauryl sulfate
- Formaldehyde
- Lanolin
- Fragrances
These irritants can be found in cosmetic products, nail polishes, hair dyes, and certain airborne contact allergens, some of which may contain plant or animal proteins.
Implementing safety measures like wearing protective gear and adhering to chemical handling and storage guidelines can prevent dermatitis caused by occupational exposure. Keeping the workspace clean also minimizes exposure to irritants and allergens.
Symptoms and Clinical Presentation
Periorbital dermatitis typically presents with the following symptoms around the eye area:
- Redness
- Scaling
- Swelling
- Itching
The location, laterality, and distribution of redness may indicate the offending agent in allergic contact dermatitis (ACD) or irritant contact dermatitis (ICD). Patients with ICD often report a “burning” sensation, while ACD is more often accompanied by itching.
Experiencing symptoms of periorbital dermatitis warrants consulting a healthcare professional for an accurate diagnosis and treatment plan. Prompt intervention can control symptoms, lessen discomfort, and avert potential complications.
Diagnosis and Differential Diagnoses
Diagnosis of periorbital dermatitis is primarily based on clinical examination and patient history. A skin biopsy may be considered when the diagnosis is atypical. Patch testing and the repeated open application test (ROAT) can also be useful in determining the specific cause of periorbital dermatitis, especially when an allergic reaction is suspected.
Differential diagnoses for periorbital dermatitis encompass other skin conditions, allergies, and infections. Differentiating between periorbital dermatitis and other conditions is vital for appropriate treatment and management.
Treatment Options
Treatment for periorbital dermatitis typically involves topical medications, oral therapies, and lifestyle changes to avoid triggers and manage symptoms. The specific treatment plan will depend on the severity and underlying cause of the dermatitis.
Topical Medications
Mild cases of periorbital dermatitis can often be treated with topical corticosteroids or calcineurin inhibitors. Nonetheless, caution is needed with topical corticosteroids, as long-term treatment can cause side effects like skin atrophy, adrenal suppression, and steroid sensitization.
Calcineurin inhibitors, such as pimecrolimus and tacrolimus, are effective and well-tolerated in treating periorbital dermatitis. These medications work by modulating the immune system and reducing inflammation in the affected area. Prescription steroid sprays are another option for treating dermatitis, but calcineurin inhibitors offer a different approach.
Oral Therapies
Oral medications such as antibiotics or anti-inflammatory drugs may be prescribed for moderate to severe cases of periorbital dermatitis. Commonly prescribed oral antibiotics include doxycycline, minocycline, and macrolide antibiotics such as azithromycin, erythromycin, and clarithromycin. Oral anti-inflammatory drugs, including tetracyclines, doxycycline, and minocycline, can help reduce inflammation in the affected area.
Being mindful of oral medication side effects is important. These may include:
- Nausea
- Vomiting
- Diarrhea
- Rectal or vaginal itching
- Dry mouth
Oral therapies usually take effect within several weeks to months after treatment initiation.
Lifestyle Changes
Lifestyle modifications can aid in managing periorbital dermatitis symptoms and preventing flare-ups. Here are some tips to help:
- Recognize and avoid triggers like cosmetics, fragrances, and airborne allergens.
- Follow a gentle skincare routine using hypoallergenic products.
- Avoid thick or heavy products that may suffocate the skin.
Implementing these changes can help prevent periorbital dermatitis and manage its symptoms.
Dietary modifications, stress management, and avoiding over-the-counter steroid creams can also play a role in managing periorbital dermatitis symptoms. Individuals can reduce the frequency and severity of periorbital dermatitis flare-ups by making these changes.
Prevention Strategies
Preventing periorbital dermatitis entails recognizing and avoiding triggers, using hypoallergenic products, and keeping a healthy skincare routine. This includes avoiding certain cosmetics, fragrances, and other reaction-causing products, and performing patch tests before using new products.
Additionally, maintaining a clean living environment, using air purifiers, and avoiding exposure to known allergens can help prevent periorbital dermatitis caused by airborne allergens. By implementing these prevention strategies, individuals can reduce their risk of developing periorbital dermatitis and maintain healthy, comfortable skin around the eyes.
Summary
In conclusion, periorbital dermatitis is a complex skin condition that can cause discomfort and frustration for those affected. Understanding the causes, symptoms, and available treatment options can empower individuals to manage this condition effectively and maintain healthy skin. Through proper diagnosis, treatment, and preventive measures, individuals can reduce the frequency and severity of periorbital dermatitis flare-ups and enjoy improved skin health.
Frequently Asked Questions
How do you treat periorbital dermatitis?
Treatment of periorbital dermatitis typically includes a combination of antibiotics, topical corticosteroids, immunosuppressive creams and ointments, topical ivermectin, and/or oral antibiotics. Short-term use of topical corticosteroids may also be recommended for mild cases.
How do you treat periorbital seborrheic dermatitis?
Treatment for periorbital seborrheic dermatitis involves topical calcineurin inhibitors such as pimecrolimus and tacrolimus, which are effective for this condition.
What is the cause of perioral dermatitis?
Perioral dermatitis is commonly caused by topical and oral steroids and certain cosmetics creams, make-up, and sunscreens.
What are the main types of periorbital dermatitis?
The main types of periorbital dermatitis are allergic contact dermatitis and irritant contact dermatitis.
What are some common triggers for periorbital dermatitis?
Common triggers for periorbital dermatitis include cosmetic products, airborne allergens, and occupational exposure to irritants.
Reference
- Veraldi, S., Angileri, L., & Barbareschi, M. (2015). Periorbital dermatitis: a clinical and etiopathogenic study. Journal of Dermatological Treatment, 26(1), 64-67. https://doi.org/10.3109/09546634.2013.848258
- Lipozencic, J., & Wolf, R. (2007). Periorbital dermatitis – more than just an allergic reaction. Clinics in Dermatology, 25(1), 113-119. https://doi.org/10.1016/j.clindermatol.2006.05.008
- Wollenberg, A., & Zoch, C. (2014). Periorbital dermatitis – a recalcitrant disease: causes and differential diagnoses. British Journal of Dermatology, 171(5), 969-977. https://doi.org/10.1111/bjd.13214
- Guin, J. D. (2002). Eyelid dermatitis: experience in 203 cases. Journal of the American Academy of Dermatology, 47(5), 755-765. https://doi.org/10.1067/mjd.2002.122755
- Zirwas, M. J., & Molenda, M. A. (2009). Dietary nickel as a cause of systemic contact dermatitis. Journal of Clinical and Aesthetic Dermatology, 2(6), 39-43. PMID: 20729941.
- Jacob, S. E., & Steele, T. (2006). Practical aspects of eyelid dermatitis. Dermatologic Therapy, 19(5), 289-298. https://doi.org/10.1111/j.1529-8019.2006.00087.x
- Fowler, J. F., Fowler, L. M., & Hunter, J. E. (2011). Allergic contact dermatitis to cosmetics. Dermatologic Clinics, 29(1), 43-48. https://doi.org/10.1016/j.det.2010.08.012
- Zug, K. A., Warshaw, E. M., Fowler, J. F., Maibach, H. I., Belsito, D. L., Pratt, M. D., … & Taylor, J. S. (2009). Patch-test results of the North American Contact Dermatitis Group 2005-2006. Dermatitis, 20(3), 149-160. https://doi.org/10.2310/6620.2009.08097
- Goossens, A. (2003). Contact-allergic reactions to cosmetics. Journal of Allergy and Clinical Immunology, 112(5), 951-962. https://doi.org/10.1016/j.jaci.2003.09.007
- Thyssen, J. P., Linneberg, A., Menné, T., & Johansen, J. D. (2007). The epidemiology of contact allergy in the general population—prevalence and main findings. Contact Dermatitis, 57(5), 287-299. https://doi.org/10.1111/j.1600-0536.2007.01220.x
Author
Dr. M. Ronan Conlon started his career in the field of ophthalmology at the same time as the development of refractive eye surgery in Canada. In 1996, he brought laser technology to Canada from Germany, which allowed him to perform laser eye surgery before it was available in the United States. With the establishment of the Conlon Eye Institute, Dr. Conlon has performed more than 40,000 refractive procedures and has advanced his expertise in LASIK and refractive cataract surgery.
The information on this page should not be used in place of information provided by a doctor or specialist. To learn more, read our Privacy Policy and Editorial Policy pages.
