From the Guidelines
Desonide topical should be used with extreme caution on eyelids due to potential risks of increased intraocular pressure, glaucoma, and cataracts, as reported in guidelines of care for the management of psoriasis and psoriatic arthritis 1. When considering the use of desonide on eyelids, it's crucial to weigh the benefits against the potential risks, especially given the thin skin of the eyelids which may lead to greater absorption of the medication.
- Key considerations include:
- The potency of the corticosteroid: Desonide is considered a low-potency topical corticosteroid, which might reduce some risks associated with stronger steroids.
- Duration of use: Limiting the treatment duration to 1-2 weeks can help minimize the risk of side effects, as prolonged use around the eyes is more likely to cause complications 1.
- Application method: Applying a thin layer to the affected area, avoiding the eyes, and following the healthcare provider's instructions are essential to reduce risks.
- Potential side effects to watch for include:
- Increased intraocular pressure
- Glaucoma
- Cataracts
- Thinning of the eyelid skin Given these considerations, it is recommended to use desonide on eyelids only under strict medical supervision and with careful monitoring for any signs of adverse effects, as the risks associated with its use around the eyes, as noted in the guidelines 1, can have significant implications for morbidity, mortality, and quality of life.
From the FDA Drug Label
Desonide Ointment, 0. 05% should not be used in the eyes. FOR EXTERNAL USE ONLY. Avoid contact with the eyes.
Desonide topical is not okay for eyelids. It should not be used in the eyes and is for external use only, with instructions to avoid contact with the eyes 2.
From the Research
Safety of Desonide on Eyelids
- Desonide is a topical corticosteroid used to treat various skin conditions, including dermatitis and eczema.
- The safety of desonide on eyelids is a concern due to the delicate skin in this area.
- According to a study on the complications of topical hydrocortisone 3, long-term application of topical corticosteroids on the eyelids can lead to atrophy and telangiectasia.
- However, desonide is considered a mild to mid-potent topical corticosteroid, and its safety profile is generally good, with most reported adverse events being mild and local in nature 4.
- A study on the efficacy and safety of desonide 0.05% lotion for the short-term treatment of facial atopic or seborrhoeic dermatitis found that it was well-tolerated and effective, with a high level of patient acceptability 5.
- While there is no direct evidence on the safety of desonide specifically on eyelids, the available data suggest that it may be a suitable option for short-term use, but caution and intermittent therapy are recommended, especially in susceptible individuals and vulnerable areas like the eyelids 3, 6.
- Alternative treatments, such as topical tacrolimus, may also be considered for atopic eyelid disease, especially in patients with open-angle glaucoma or those who are steroid responders 7.