Anterior Blepharitis: What it is and How to Treat it

Anterior Blepharitis: What it is and How to Treat it 1

Anterior Blepharitis Causes, Symptoms, and Treatment

Anterior Blepharitis Definition

According to the American Optometric Association, blepharitis is “an inflammation of the eyelids in which they become red, irritated and itchy with dandruff like scales form on the eyelids’.  More specifically, anterior blepharitis “occurs at the outside front edge of the eyelid where the eyelashes attach”.  

Blepharitis is not contagious and can affect anyone at any age.  However, it can be more common in those with underlying skin conditions such as rosacea, atopy, and seborrheic dermatitis.  As well, it can affect those with underlying eye conditions such as dry eyes, ectropion and entropion, infectious and inflammatory conjunctivitis, and chalazia or styes.

Anterior Blepharitis: What it is and How to Treat it

Anterior Blepharitis Causes

The two common causes of anterior blepharitis are bacteria (usually Staphylococcus aureus) and scalp or eyebrow dandruff.  

Bacteria living on the face and eyelids can over-populate, causing the eyes and eyelids to react negatively.

Other causes include allergies and eyelid mites, or demodex.

Anterior Blepharitis Symptoms

Symptoms of anterior blepharitis include:

  • A foreign body sensation (something in the eye)
  • Grittiness
  • Burning
  • Excessive tearing
  • Itching
  • Sensitivity to light (photophobia)
  • Red and swollen eyelids
  • Blurry vision
  • Eyelash loss
  • Dry eye
  • Crusty eyelashes

How is it Diagnosed?

Your eye doctor is the best place to get a diagnosis. They will diagnose you through patient history, a comprehensive examination of the front of your eyes and eyelids, including examining the eyelid structure, looking at your tears, and testing the oily secretions on your eyelids. There are a few different types of blepharitis that can be diagnosed:

  • Staphyloccal blepharitis: mildly sticking eyelids, thickened lid margins, eyelash loss, eyelashes in random directions
  • Seborrheic blepharitis: more of a greasy flaking or scales at the eyelash base, red and swollen eyelids
  • Ulcerative blepharitis:  presence of hard, matted crusted eyelashes and removing these causes bleeding.  May experience excessive tearing.  
  • Meibomian gland dysfunction/posterior blepharitis:  oil glands inside the eyelids are blocked.  Lack of tear production, redness and swelling of the eyelids.

Anterior Blepharitis Treatment

Anterior Blepharitis Treatment

For treating anterior blepharitis there are a series of measures that can be taken:

Prescription medications for more serious cases may include

  • Antibiotic eye drops, eye gel, or eye ointment such as Azithromycin drops and Erythromycin ointment
  • An antibiotic oral prescription such as Doxycycline
  • Steroid eye drops for reducing inflammation

Unfortunately, there is no cure for blepharitis because it is a chronic condition. However, by following the measures mentioned above, you can reduce the symptoms that could interfere with your daily activities.  

Click here to see the products I use in my clinic and purchase them on Amazon.

One Love,

Dr. Travis Zigler, Eye Love

Dr. Travis Zigler

SeeEO of Eye Love

What Is Anterior Blepharitis? How To Treat Anterior Blepharitis

What Is Anterior Blepharitis? How To Treat Anterior Blepharitis 3

Anterior Blepharitis Definition, Its Causes, and How to Treat

Are you irked by sore, red, swollen eyelids — sometimes coexisting with crustiness at the base of the eyelashes?

If yes, it's probable you have anterior blepharitis, as these are just a few of the symptoms of blepharitis. Blepharitis is just a fancy term which means an inflammation of the eyelids, and it often coexists with a bacterial infection, dry eyes, or meibomian gland dysfunction (a separate type of blepharitis). Anterior blepharitis is very common in the United States and around the world, so you're not alone!

Here are a few things you should know about anterior blepharitis, how to treat it and prevent it from recurring. Let's discuss treatment first.


How to Treat Anterior Blepharitis

First of all, you want to see an optometrist or ophthalmologist to be sure that you have blepharitis and not something else going on. An eye doctor’s job is to properly diagnose and treat your condition, so they’re the best place to start. Also, they have special equipment that can help them define exactly what type of blepharitis you have. Overall, washing the face regularly and practicing good eyelid hygiene are fine treatments for blepharitis, but it’s important to get into a routine of doing this once or twice per day. It can be managed in any of the following ways:


Our #1 Tip for Blepharitis Treatment: Keep Eyelids Clean With A Hypochlorous Acid Eyelid Cleanser

Keeping the eyelids clean is the best way to treat this skin condition and reduce symptoms. Use of a hypochlorous acid based solution cleans the eyelids to decrease the growth of bacteria and oil production. We love hypochlorous cleansers because our bodies make this substance naturally to fight microorganisms and inflammation. It is a very natural product and generally safe for everyone to use.

Using it is super easy! Simply spray the solution onto your closed eyelids, right on the lid margins, and rub it into the base of the eyelashes. Alternatively, you can spray it onto a cotton ball or round and apply this way. The cleanser does not need to be rinsed off, and it's recommended to do this twice per day (morning and evening is great).

We use Heyedrate Lid and Lash Cleanser for our patients. Click here to purchase on Amazon.  

The following are the steps that we use in our eyelid hygiene routine.


2. Remove makeup and debris with an oil-based cleanser

Makeup is something you should avoid when you have blepharitis anyway, but if you need to take it off the best remover to use is one that is oil based. The Heyedrate Eye Makeup Remover Oil will help remove all eye makeup (even the waterproof kind!) Oil-based removers are great because oil dissolves oil, so they really work well to remove all of the makeup and ensure that your eyelids are clean when you head to bed. In general, they also don’t contain a ton of chemicals (if any), so they’re safe for use around the eyes and for those with sensitive eyes and eyelids. This particular remover also includes vitamin E for anti-aging benefits, and it incorporates tea tree essential oil to help fight bacteria and demodex eyelash mites.

Simply put a few drops of the remover onto a cotton ball or round and swipe over your closed eyelids, concentrating on the base of the eyelashes. If you’re wearing a lot of eye makeup or it’s waterproof, you may want to wet your closed eyes a bit before using, as this will help to further loosen the makeup and make it easier to remove. Once your eye makeup is removed, follow with a tea tree oil face wash.


3. Cleanse your face with Tea Tree Oil Soap

After removing your makeup, it's a great idea to also make sure your face is clean. Specifically, we like to use a tea tree oil-based soap, because tea tree oil is known to kill demodex eyelash mites which can contribute to anterior and posterior blepharitis.

Our Heyedrate Tea Tree Oil Soap is simple to use. After removing any makeup, wet your hands and work the bar soap into a lather. Massage the lather onto your facial skin and rinse well, avoiding direct contact with your eyes (tea tree essential oil is known to burn!) After rinsing, simply pat dry and moisturize as usual. You can start out using this soap twice per day. Some people may find it drying, so if that’s you, just decrease it to once per day.


4. Application of warm compresses over the eyelids can loosen the crusts

You can purchase a specific warm eye compress somewhere like Amazon, or you can make one by putting dried rice (not instant) into a clean sock. We recommend these two types because using warm water and a cloth is tedious, and a mask is just so much easier to use. If it's easy and quick to use, you're more likely to do it!

  1. Microwave for 10-20 seconds until warm to the touch (test on your wrist).
  2. Place over your closed eyelids for 10-20 minutes.
  3. Relax and enjoy!
  4. Gently massage the area to loosen up any debris.
  5. Follow your warm compress with an eyelid cleanser to remove any extra contaminants.

5. Finish your routine with a Hypochlorous Acid Eyelid Cleanser

As we stated earlier, keeping the eyelids and lashes clean is so important to prevent anterior blepharitis and other complications that can arise such as MGD, dry eyes, demodex mites, and styes. Use of a hypochlorous acid based solution cleans the eyelids to decrease contaminants and promote healthy oil production.

This is super easy to do! Simply spray the solution onto your closed eyelids, right on the lid margins, and rub it into the base of the eyelashes. Alternatively, you can spray it onto a cotton ball or round and apply this way. The cleanser does not need to be rinsed off, and it's recommended to do this twice per day (morning and evening is great). This marks the end of your blepharitis routine! This is generally what we recommend for everyone, and you can follow this routine with a gentle moisturizer or oil of your choice to ensure that your face, lids, and lashes stay moisturized throughout the upcoming day and night.


Other Blepharitis Treatment and Avoidance Tips

  • Reduce the amount of makeup you wear during treatment, because makeup interferes with good eyelid hygiene. If you have to wear makeup, be sure to remove it with a tea tree oil based waterproof makeup remover. Also make sure to remove all your eye makeup before going to bed at night.
  • Avoid contact lenses during treatment or flare-ups, as wearing contact lenses increases bacteria in the eye and eyelid area. If you must wear them, ensure that you’re removing them at night and properly cleaning your lenses.
  • Doctors may prescribe a low-dose, oral antibiotic in some cases. However, this is not always necessary if you have simple anterior blepharitis alone. This is often reserved for those with concomitant ocular rosacea and MGD.
  • Application of a medicated eye drop may be needed, such as an antibiotic ointment, if the above still does not resolve your issues.
  • It’s always best to consult with your eye doctor before beginning any treatment regimen, so that they can give you a proper diagnosis and direction for treatment.

What is Anterior Blepharitis?

Anterior blepharitis is one of the most common eye diseases caused by either bacteria or a skin condition, such as dandruff of the scalp or rosacea. It is an inflammation of the eyelids in which they become irritated and itchy. There can also be dandruff-like scales that form on the eyelid where the eyelashes meet. While it is usually not sight-threatening, it can lead to permanent modification in the eyelid margin and may disrupt the tear film as well as the ocular surface.

It can affect anyone of any age bracket and it is not contagious. This type of blepharitis appears at the exterior edge of the eyelid where the eyelashes are attached. Alternatively, posterior blepharitis (also known as meibomian gland dysfunction or MGD) affects the inner edge of the eyelid, which is the part that comes into contact with your eyeball. This is where the meibomian glands live, and these little oil glands are responsible for the oily portion of your tears. When the glands become disrupted, they can become clogged, making it difficult for the eyes to feel lubricated.

Both anterior and posterior blepharitis can put you at risk for dry eye disease and styes. Blepharitis can disrupt the tear film and the ocular surface, making you very uncomfortable and even occasionally making it difficult for you to see.

What Causes Anterior Blepharitis?

It is often caused by the bacteria Staphylococcus aureus. Another cause of anterior blepharitis is known as seborrheic blepharitis. Such bacteria are often found on the face and lids, but if they become overpopulated, or the lid area reacts poorly to their presence, inflammation, or redness and irritation, may occur.

Sometimes, even though it is not so common, anterior blepharitis can be caused by allergies or a mite infestation of the eyelashes, known as demodex mites. These little buggers live in your eyelash follicles naturally, but they can wreak havoc if they become overpopulated. Demodex feed on the oils and bacteria of our eyelids and eyelashes, so this highlights the importance of keeping your eyelids clean and free of debris. The less food they have around, the shorter their lifespan.


Anterior Blepharitis Symptoms

  • Dried discharge on the eyelids, especially when just waking up
  • Eyelids and eyelashes matted shut upon awakening
  • Swelling of the eyelids and skin around the eyes
  • Red, irritated eyelids
  • Itching of the eyes
  • Blurry vision
  • Eyelash loss
  • Sensitivity to bright light

How Long Does Blepharitis Last?

Unfortunately blepharitis is a chronic condition. This means that there is no cure, but there are ways to maintain blepharitis and therefore reduce symptoms of inflammation, dryness, and irritation. By following a few of the easy steps above, you can live a life free of blepharitis. It all comes down to finding an eyelid hygiene routine that works for you, once or twice per day, and being committed to that routine every single day.


Do you have questions? Ask them in our Facebook Community.

One Love,

Man and woman

Dr. Travis Zigler

SeeEO of Eye Love

How to Treat Blepharitis and Crusty Eyelids with Innovative Products

How to Treat Blepharitis and Crusty Eyelids with Innovative Products 2

I was told that I can use baby shampoo on my eyelids. Is this correct?

This is something that we tell our patients never to do; it was recommended a lot a couple years ago, but now there are just much better products out there. Baby shampoo has a detergent in it, it’s a soap basically, and so it can actually irritate your eyelids and irritate your eyelashes and your eyes. What we always recommend is a Hypochlorous acid cleanser. Whether it’s ours or the prescription, it doesn’t matter. If you choose the subscription plan on our website, you’ll actually lock in that cost for life. Our spray is only $27 for a 4 months’ supply. Like stated earlier, baby shampoo was the standard in the 90’s and then lid scrubs came out. Now, hypochlorous acid products are taking its place. Most lid scrubs have about 13-20 chemicals in them, but our hypochlorous acid has 3 ingredients: hypochlorous acid, electrolyzed water, and sodium chloride (table salt).

I have crusty eyes in the morning. Can you recommend anything?

This is what we’ve built our entire product line around. First of all, an omega-3 is going to help with the inside glands of the eyelids, and our Heyedrate Tea Tree soap and Heyedrate lid and lash spray are going to help with the outside of your eyelids. The tea tree oil based soap is made of organic coconut oil, organic olive oil, organic green tea, raw shea butter, and tea tree oil. So it’s going to clean up those eyelids. That is what can treat the crustiness. Basically, crustiness is just overgrowth of the bacteria on the eyelids. When that bacteria overgrows it produces waste products which turn into the crustiness that you’re experiencing. When your eyes are closed all night, crustiness just builds up, but throughout the day you’re blinking so it doesn’t have a chance to build up as much. If we control the bacteria with tea tree oil, a natural antibiotic, it will maintain the bacterial load on your eyelids. Our spray is a hypochlorous acid spray which has natural anti-septic properties that your body creates. We went a different route than most commercial brands because we didn’t want a lot of artificial ingredients. Our soap has 5 all natural ingredients and our spray is only 3 ingredients. The hypochlorous acid does give the spray a slight chlorine smell, but it contains no bleach and is very gentle on your eyelids. If you do notice that your eyelids are burning or your eye burns after using our spray, it is because you are quite inflamed. If you put anything on an inflamed area that is cracked and broken, it’s going to burn because it is going to get in there and clean up that area!

Can you explain how to correctly use the Heyedrate Lid and Lash Spray?

We recommend using the spray twice per day, morning and evening. When you get up in the morning, spray it on a cotton ball. Close your eyelids and then rub it into your eyelids and eyelashes. There’s no need to rinse it off, so just let it sit. The spray shouldn’t be irritating unless your eyes are really inflamed, which occurs sometimes. If you want to make things even easier, you can use it a bit differently. Simply wake up in the morning and just spray it directly onto your closed eyelids, rub it in, and let it sit. Do the same thing at night after washing your face. We find that women tend to like the cotton ball/cotton round method because it helps get every single aspect of their makeup off even after they remove their makeup. Men are sometimes lazier, so they like to just spray it right on and leave it on. Do whatever works best for you! Do it after you wash and before you moisturize. If you use any moisturizers, we recommend using something simple with minimal ingredients, like jojoba oil.

Heyedrate eyelid and eyelash spray

Let us know if you have any other blepharitis questions in the comments below!

One Love,

Dr. Travis Zigler, Dr. Jenna Zigler, Eye Love

Drs. Travis and Jenna Zigler

Join Dr. Travis Zigler and Dr. Jenna Zigler LIVE on Facebook every Sunday at 5:00 pm EST in the Dry Eye Syndrome Support Community on Facebook

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Blepharitis and Dry Eyelids - What Are the Causes And What Can Be Done?

Blepharitis and Dry Eyelids - What Are the Causes And What Can Be Done? 0

Blepharitis, Eczema, and Dermatitis on the Eyelids... Why? What Can I Do?

What are some of the most common symptoms of dry eyelids? Itching, soreness, discoloration of the skin, swelling, dryness, redness, and scaly skin are conditions that indicate dry eyelids and they can be a pain to deal with when it happens.  

When to seek medical advice

We all like to look our best. With some conditions like scaling, flaking, and dry skin it is recommended you see your doctor before trying to treat it yourself. You need to find the underlying cause of why this happened. And who better to help you with this than a Dermatologist or Optometrist? Of course you may also consider any recent changes such as new makeup products, skin care products, perfumes or foods, as these products could also cause an allergic reaction when introduced for the first time.

So You Have Dry Eyelids - How Did This Happen?

It is important to have a list of questions prepared when seeking medical advice. Questions like, “Do I need a prescription?””How do you recommend I treat it?” and, “If the treatment doesn't work, how long would you suggest I wait before I come back?” Being prepared saves the doctor time and ensures you remember what you wanted to ask your physician!

What are most of the common causes of dry eyelids?

So You Have Dry Eyelids - How Did This Happen?

People love makeup, but eyeliner, eyeshadow, and even foundation can contribute to problems with the eyelids. Try going without makeup for a few days to see if that helps resolve the problem. Make sure you switch to a hypoallergenic makeup so as not to aggravate your skin!

Shampoo, eyelash curlers, and even face cleansers can also be the problem. Consider making a switch either of the product, or possibly getting new foam pads for your eyelash curler. Hair dye can also be a problem when it contains p-Phenylenediamine.

Food Allergies are a common problem, so when you see the doctor, try to determine if this may be what triggered the dry eyelids. Some allergic food reactions can lead to eczema, acne, and other skin conditions.

Medical conditions like Eczema, Blepharitis, Seborrheic Dermatitis (a chronic relapsing mild form of Dermatitis), and Psoriasis fall into this category. Some other forms of Dermatitis are atopic and caused by airborne allergens. There are so many things to consider!

How do I treat dry eyelids?

We recommend our Lid & Lash Cleanser from HeyedrateSimply clean the eyelids of any debris or makeup and spray closed eyelids with the solution.  Gently rub into the upper and lower lid and lash margin (or just let it need to rinse!) Repeat morning and evening for best results. This formula can also be used anywhere on the body to fight bacteria and inflammation, following the general steps above.

Common lotions and moisturizers do not work on the eyes and around the eyes, but there are many special products that are marketed specifically for eyes. These can help when treating dry eyelids. Sometimes even just a small dab of vaseline will also work. Just use sparingly and keep it out of your actual eyes...use on the skin only!

Keep your hands away for your face and eyes. This a difficult one as we all touch our face and eyes without even thinking about it, but try, and when you need to, make sure your hands are clean.

There is nothing worse than itchy, dry eyelids. Use common sense, use sunglasses, and protect your eyes. They are the only ones you’ve got. Let us know in the comments below if you suffer from dry eyelids. I know that, as a child, I suffered from dry eyelids. Dr. Travis suffers from Eczema. It happens to us all!

One Love,

Dr. Jenna Zigler, Eye Love

Dr. Jenna Zigler

Other Dry Eye articles by Dr. Zigler: 4 Tips to Stop Waking Up With Dry, Painful Eyes; Which Antidepressants Cause Dry Eye; Fish Oil for Fighting Dry Eye Inflammation; and What Not To Eat If You Have Dry Eye






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