From the Guidelines
The best treatment for itchy periorbital erythema typically involves a combination of warm compresses, artificial tears, and eyelid cleansing, as these methods have been shown to significantly improve symptoms in patients with blepharitis 1. The treatment approach should be tailored to the individual patient's needs and may involve a trial-and-error approach to find the most effective combination of treatments.
- Warm compresses can be applied to the eyelids for several minutes to soften adherent scurf and scales or discharge and/or warm the meibomian secretions, with sustained warmth achieved by using hot tap water on a clean washcloth, over-the-counter heat pack, or homemade bean/rice bag that can be heated in the microwave 1.
- Artificial tears can be used to help lubricate the eyes and reduce irritation, and eyelid cleansing can be accomplished by brief, gentle massage of the eyelids, with eye cleaners with hypochlorous acid at 0.01% having a strong antimicrobial effect 1.
- Topical perfluorohexyloctane, antibiotics, antiparasitic medication, and topical anti-inflammatory agents may also be helpful in some cases, but their use should be guided by the severity of the symptoms and the patient's response to treatment 1. It's essential to instruct patients to avoid using compresses that are too hot, as this can burn the skin, and to perform eyelid cleansing safely, taking into account the patient's manual dexterity and ability to perform the task without causing injury to the corneal epithelium 1.
- A schedule of regularly performed eyelid cleansing, daily or several times weekly, can help blunt the symptoms of chronic blepharitis, and once- or twice-daily warm compresses and massage can be generally adequate 1.
- Expression of the meibomian glands may be particularly helpful in cases of meibomian gland dysfunction (MGD), but it must be performed with care to avoid mechanically induced irritation 1.
From the Research
Best Treatment for Itchy Periorbital Erythema
The best treatment for itchy periorbital erythema depends on the underlying cause of the condition. According to the studies, the following are some of the possible treatments:
- Topical corticosteroids, such as triamcinolone cream, are commonly used to treat periorbital dermatitis 2
- Calcineurin inhibitors, such as tacrolimus, are effective in treating atopic eczema and may also be used to treat periorbital eczematous lesions 3, 4
- Identifying and avoiding allergens and irritants, such as fragrances, preservatives, and certain cosmetics, is crucial in treating allergic contact dermatitis 3, 5
- Symptomatic treatment with topical steroids or antihistamines may be used to manage erythema multiforme 6
- Emollients and soap-free cleansers may be used as maintenance therapy for atopic dermatitis 4
Causes of Periorbital Erythema
The causes of periorbital erythema include:
- Allergic contact dermatitis 3, 5
- Atopic eczema 3, 5, 4
- Airborne contact dermatitis 3, 5
- Irritant contact dermatitis 3, 5
- Periorbital rosacea 3, 5
- Allergic conjunctivitis 3, 5
- Psoriasis 3, 5
- Erythema multiforme 6
Risk Factors
The following are some of the risk factors for periorbital dermatitis: