6 Causes of a Rash on Your Eyelid and How to Treat It

Rashes on your eyelid are usually caused by contact dermatitis from environmental irritants or allergens, but they can also warn of more serious conditions like cellulitis or autoimmune diseases. If your rash persists despite home care, or if other symptoms arise, it’s crucial to consult a healthcare provider for proper diagnosis and treatment.

1. Contact Dermatitis

Contact dermatitis on your eyelids happens when exposed to irritants or allergens. These can be chemicals, substances, or certain activities.

Contact dermatitis-triggered eyelid rashes are often due to allergens like:

• Pollen
• Dust mites
• Poison ivy, poison oak, or sumac
• Other plants (e.g., tomato plants, chrysanthemums)
• Topical antibiotics
• Certain metals (e.g., nickel, gold) 
• Preservatives (in eyedrops, contact solutions) 
• Rubber
• Dyes
• Food

Everyday irritants beyond allergens include:

• Hair products, like shampoos and conditioners
• Soaps and detergents
• Chlorine
• Dust

Metals, preservatives, and dyes in cosmetics, especially eye makeup, can irritate your eyelids.

Physical irritation, such as eye rubbing or exposure to extreme weather, can cause rashes.

Appearance

Contact dermatitis causes an inflammatory response to the irritant or allergen. The rash can affect the upper lid, lower lid, or both. It can occur on one or both eyelids.

The rash appears red, scaly, and often swollen. It may itch, burn, or sting. Over time, the skin can become thick and leathery (lichenification). In severe cases, the affected area may become extremely red and swollen.

2. Atopic Dermatitis

Atopic dermatitis develops when a genetic alteration affects the immune system. As a result, the immune system becomes overactive, causing inflammation that damages the skin’s protective barrier.

Though the condition usually develops in young infants, it can appear at any age and is a chronic condition that lasts throughout adulthood.

The intensely itchy, inflammatory rash often occurs in people with asthma and hay fever. The rash comes and goes, with flare-ups caused by:

• Dry skin
• Irritants like soap and laundry detergent
• Stress

Atopic dermatitis can develop anywhere on the body, including skin folds, neck, knees, elbows, wrists, face, eyelids, and the skin around your eyes.

Appearance

The National Eczema Association reports that 85% of people with atopic dermatitis struggle with severe daily itching (pruritus).

The rash typically causes small, raised bumps that may ooze and then form a crust. The skin may be dry, red, scaly, and swollen. The skin under the rash may darken.

If you scratch the rash, it may bleed and lead to thick, hard skin. Excessive rubbing may cause eyelashes and eyebrows to fall out.

3. Seborrheic Dermatitis

Seborrheic dermatitis causes the skin to become flaky and inflamed. It is most common on the scalp but can also affect any body area with oil-producing glands.

Numerous oil glands (meibomian glands) are located along the edge of your eyelids. These glands produce the oil that’s essential for tears. However, they can also lead to an eyelid rash in the form of seborrheic dermatitis.

Seborrheic dermatitis is thought to be caused by a combination of genetic and environmental factors. The trigger is an inflammatory reaction to excess Malassezia yeast, which thrives near oil glands. This organism normally lives on the skin’s surface but when it overgrows, a fungal infection develops.

Like other types of eczema responsible for eyelid rashes, seborrheic dermatitis flares up in response to triggers. A few of the most common triggers include stress, hormonal changes, detergents, and cold weather.

Appearance

The rash caused by seborrheic dermatitis is different from contact and atopic dermatitis. You may develop:

• Flaking skin (which causes severe dandruff on the scalp)
• Patches of greasy skin covered in white or yellow scales
• Dark red or brown rash
• Burning or itchiness

4. Blepharitis

Blepharitis refers to inflamed eyelids. This condition has three causes:

• An overgrowth of bacteria on your eyelids, leading to dandruff-like flakes
• An overgrowth of tiny mites (Demodex) living in the eyelash follicle
• Clogged oil glands caused by meibomian gland dysfunction

Appearance

This condition makes your eyelids red, swollen, irritated, and itchy. Though it doesn’t cause a classic rash, it often results in crusty white flakes on the red swollen skin, which looks like a rash.  

Blepharitis can also affect your eyes and vision, causing itching, watering, and sensitivity to light.

5. Cellulitis

Like blepharitis, cellulitis doesn’t cause a typical rash on your eyelids. However, it’s a common bacterial skin infection that can affect your eyes. Without prompt treatment, it can spread quickly and cause severe complications.

The infection may or may not start in your eyes. It can begin in the sinuses, an insect bite, or skin wound and spread to the eyelids.

Preseptal cellulitis only develops in the eyelid but can spread and cause orbital cellulitis. Orbital cellulitis, an infection in the eye socket, may affect the optic nerve, causing blindness. It can also spread into the brain.

Appearance

Cellulitis causes redness, swelling, and pain in the eyelid. The swelling may only affect the eyelid or involve the tissues around the eye. Other symptoms include difficulty moving the eye, blurry or double vision, or a bulging eye. The infection may cause a fever and fatigue.

6. Autoimmune Causes

Several autoimmune diseases can cause swelling, discoloration, and an eyelid rash, including:

• Sjogren’s syndrome, which disrupts tear production, causing dry eyes, blepharitis, and red, irritated, scaly eyelids
• Discoid lupus erythematosus (DLE), which causes a scaly, red, raised, discoid-shaped rash
• Dermatomyositis, a rare condition causing a red or purple rash on the eyelids

Appearance

While your eyelids appear red, purple, scaly, and/or swollen, autoimmune diseases cause other symptoms throughout your body.

Sjogren’s syndrome also causes dry mouth. DLE typically causes a red, scaly rash on your face and scalp, often leading to scarring. Dermatomyositis causes muscle weakness and may lead to a rash anywhere on your body.

Autoimmune diseases are also known for causing fatigue, muscle aches, and joint pain.

How It’s Diagnosed

Your healthcare provider can diagnose eyelid dermatitis based on your symptoms and a physical examination of your eyes. A patch test can help determine if your symptoms are caused by an allergen.

The test involves having suspected allergens applied to patches, which are placed on your skin. The patch stays on for 48 hours to see if your skin reacts.

Healthcare providers that can diagnose and treat eyelid dermatitis include a primary healthcare provider or a specialist such as an allergist or dermatologist. 

How to Get Rid of the Rash

Treatment for an eyelid rash depends on the cause. An acute case of eyelid dermatitis may clear up on its own in a few days, but most people require treatment. A chronic case can take up to a month to heal with treatment.

Contact or atopic dermatitis are both commonly treated with topical creams or ointments.

A low-potency, over-the-counter hydrocortisone cream may be used. However, you should only use this under the supervision of a healthcare provider and for no longer than seven days (unless your healthcare provider suggests otherwise).

Two non-steroidal eczema creams, known as Elidel and tacrolimus, are safe on the eyelids. These can be applied twice daily until the rash is fully resolved.

If you have allergic dermatitis, treatment includes avoiding your allergens. Your healthcare provider may also recommend allergy shots (immunotherapy) to reduce your allergic reactions.

Always follow a physician’s guidance to treat eyelid dermatitis.

Prescription Medication

Severe cases of contact or atopic dermatitis may require a low-dose oral corticosteroid, such as prednisone. This medication is usually prescribed for no longer than one to three weeks to help relieve symptoms.

For blepharitis, antibiotics or steroid eye drops (in certain cases) may be prescribed. Oral or intravenous (IV) antibiotics are given to treat eye cellulitis.

Home Remedies

Some home-based remedies may also help with a rash around the eyes, such as:

• Applying a cold compress to the inflamed area to reduce itching, swelling, and redness
• Applying an unscented moisturizer or cream on the affected area
• Using cool or lukewarm water when cleansing around the eyes
• Washing your face with an unscented, gentle cleanser

When to See a Healthcare Provider

See a healthcare provider for treatment if you’re not sure what’s causing your eyelid rash. Also, make an appointment if you have:

• Pain
• Swelling
• Drainage
• Pimple-like bumps
• Rash that doesn’t go away with home care