Skin Conditions Around the Eyes

There are a number of conditions that affect the skin around the eyes. Find out what they are, and how they can be treated.

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Eyelid Contact Dermatitis 

Eyelid cosmetics and cleansers can cause an irritant or allergic reaction in patients sensitive to them, triggering itching, burning and redness together with blistering and scaliness. If an allergy is suspected, a patch test can be done to confirm this and to ascertain the cosmetic or chemical responsible. Avoidance of the cosmetic will cure the condition.

Eye drops, contact lens and medicaments may also cause eyelid contact dermatitis. If you have eyelid dermatitis you should consult your doctor. Eyelid dermatitis treatment may involve creams and you may be referred to a dermatologist for an allergy test if necessary.



Atopic Dermatitis 

Atopic dermatitis is a genetic skin disorder and often affects the eyelids. The skin may be red and scaly, and oozing and itching is common.

Sometimes the eye lining and eyelids are also affected, resulting in a sore eye. There is watery eye discharge and patients may find their eyes sensitive to light. If the eyelid or eye itself is affected, your doctor will prescribe some eye drops and creams. Many patients are also allergic to house dust, which can aggravate eye inflammation.

 

Bacterial Skin Infection (Impetigo or Conjunctivitis) 

Like the skin elsewhere, the eyelids can be infected by bacteria. The eyes will show a thick, sticky, yellow discharge and the eyelids may be red with yellow crusts. Impetigo is most commonly seen in children. Good hygiene and antibiotics are needed to clear bacterial infection.

 

Xanthelasma 

These are flat to slightly raised yellowish plaques on the upper and lower eyelids. They are associated with high blood cholesterol or triglycerides level in about 20 percent of people with this condition. Sometimes there will be a family history of similar problems. The xanthelasma can be excised surgically or by laser or chemical treatment. Such lesions may recur. Patients with high cholesterol or triglyceride should have their lipid level controlled before surgery.

 

Syringoma 

These are tiny, harmless skin-coloured growths on the eyelids, which may run in families. Syringoma are enlarged, underdeveloped sweat glands that usually appear during adolescence and adulthood. Most people choose to leave these skin growths alone, but they can be removed surgically by laser or excision for cosmetic reasons.

 

Skin Tags 

Skin tags are small, harmless skin-coloured outgrowths of skin that can be seen around the eyes and the eyelids. Similar outgrowths are often also seen on the neck and chest. Treatment is not necessary but they can be easily removed surgically for cosmetic reasons. 
  

Milia 

These are small white or yellowish-white skin growths often seen on the eyelids or temple and are caused by obstructed sweat ducts. They are very small and resemble millet seeds. They can be removed surgically for cosmetic reasons.

 

Dark Rings around the Eyes 

Darkened pigmentation of the eyelids is common in many dark-skinned people. In many cases, the darkening seems to vary with stress or lack of sleep. There is no effective treatment for the condition, which may be inherited or constitutional, but the condition is benign and is not a sign of illness. 

Naevus of Ota 

This is a birthmark that occurs at birth or shortly after birth as a patch of blue-black discolouration on the cheek, temple and eyelids and on the white of the eye. Usually, one side of the face is affected although occasionally discolouration appears on both sides of the face. The pigmentation can be reduced by pigment laser surgery. Patients will require multiple treatments at two- to three-monthly intervals. Only the pigmentation on the skin can be treated.

 

Strawberry Naevus 

These are vascular birthmarks (birthmarks in the veins). They can appear as a large, red, soft growth on the eyelids. The growth will continue to enlarge and grow as the baby grows older but the growth will slowly regress spontaneously when the child is three to four years old. If the vascular growths are small, they can be left alone to await spontaneous regression. If large and encroaching on the eyelid, vision may be affected and the child should then receive treatment. Treatment options include oral medication, injections and laser surgery.

 

Port-wine Stain 

These are also vascular birthmarks, which appear as flat, red patches on the eyelids and the cheek at birth. The vascular birthmarks increase in thickness and small blebs (irregular bulges) of blood vessels may be seen. Unlike strawberry naevus, port-wine stains do not disappear spontaneously as the child grows older and treatment is necessary. Most port-wine stains respond to vascular laser. Patients will need multiple laser treatments at three-monthly intervals to achieve optimal results.



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