19 Blepharitis Treatment Tips, Home Remedies, and Other Stats & Facts
What is Blepharitis? Blepharitis Definition
Blepharitis is inflammation of the eyelids, which often leads to red and swollen eyelids. It is a very common condition which can occur at any age, however it is more prevalent in elderly individuals. The vast majority encounter flare-ups in symptoms followed by episodes without any side effects. It is not a contagious condition, although bacteria can be spread from person to person. When this bacteria spreads, it has the potential to cause everything from blepharitis to meibomian gland dysfunction (MGD), styes, and dry eye disease.
What is the Main Cause of Blepharitis?
Blepharitis is mainly associated with the excessive growth of bacteria that live along the eyelids and at the base of the eyelashes. Staph bacteria is the most common culprit. Over time, these bacteria multiply and form a biofilm, which can cause symptoms to develop. You can think of biofilm like a fortress surrounding and protecting the bacteria. Eventually, it will be very difficult to remove the bacteria and biofilm if the condition is not properly treated.
What Are Other Causes of Blepharitis?
Sebaceous gland blockage or eyelid dysfunction
Seborrheic dermatitis - dandruff of the scalp and eyebrows
Rosacea - a condition of the skin characterized by redness of the skin, specifically the face
Demodex mites or lice on the eyelashes
Entropion, where the eyelids turn in, or ectropion, where the eyelids turn out
Allergies, including allergic reactions to eye medicines, contact lens solutions or eye makeup.
There are several symptoms of blepharitis, but the most common are:
Crunchy residue at the bottom of the eyelashes
Irritated and watery eyes
Grittiness or a foreign body sensation
Depending on the severity of blepharitis, any of these symptoms may occur intermittently or constantly. Other symptoms of blepharitis are:
Eyelashes encrusted upon awakening
Frothy or bubbly tears
Swollen or thickened eyelids
More frequent blinking
Photosensitivity (light sensitivity)
Loss of eyelashes
Dry skin around the eyes
Frequent styes or chalazia
In some cases, blepharitis can result in the loss of eyelashes, which is called madarosis. For those who wear contact lenses, blepharitis can make them uncomfortable to wear.
Anterior vs. Posterior Blepharitis
Blepharitis can be divided into two separate conditions:
1. Anterior blepharitis: This appears at the eyelid's outside front edge, where the lashes are known to be attached.
2. Posterior blepharitis: This occurs at the eyelid's inner edge known to be in contact with the eye’s surface. This is also known as meibomian gland dysfunction (MGD).
Both anterior and posterior blepharitis can be problematic for patients, and they're most often seen together. For the majority of people with dry eye disease, MGD is the major contributing factor due to loss of the oil glands in the eyelids.
How to Treat Blepharitis/How to Cure Blepharitis Fast
How to Get Rid of Blepharitis Naturally with Home Remedies
Those with blepharitis are advised to avoid touching their eyes frequently, as this helps bacteria to travel and multiply. It is best to keep good hygiene in mind.
It has been shown that good hygiene goes a long way to control blepharitis. Habits like making use of warm compresses and cleansing the eyelids with a hypochlorous acid eyelid cleanser can be great places to start. Also, wash the face and scalp regularly, making sure to remove any makeup or hair products.
If blepharitis is more severe and not going away with the home remedies we'll discuss below, medications such as antibiotics or steroids can be prescribed.
Our number one recommendation for all patients with blepharitis is eyelid hygiene. If you don’t already have a great eyelid hygiene routine, look into starting one as soon as possible. You can read more about Dr. Jenna’s eyelid hygiene routine here. The basics are as follows:
Then, cleanse your eyelids with a hypochlorous acid cleanser. This natural cleanser is simple to use and is very effective at eliminating microorganisms that may be contributing to your blepharitis condition. Simply spray the solution onto closed eyelids, rub it in, and let it dry. No need to rinse!
A warm compress eye mask can be a nice addition to your eyelid hygiene routine. We recommend using it after washing your face, but before using an eyelid cleanser. Warm compresses will help heat up the oil within the meibomian glands, allowing it to flow like olive oil (vs. be stagnant like hardened butter). When done consistently, this can be a great symptom reliever. However, note that if you have ocular rosacea, you'll want to alternate warm and cool compresses.
NuLids or BlephEx
When we talk about the overabundance of bacteria on our eyelids, we inevitably need to talk about biofilm (which we've discussed a bit already). When bacteria proliferate, they begin to form biofilm. Basically, biofilm creates a fortress around bacteria and allows it to continue to thrive, giving off harmful toxins in the process. The hard thing about biofilm is that simply cleansing your eyelids isn’t going to tackle the whole picture, because it won’t penetrate the biofilm that’s already there. However, there are great ways of doing so!
For home use, the NuLids device (NuSight Medical) is a wonderful tool for removing biofilm from the comfort of your own home. Using disposable tips, this device is simple to use and can remove biofilm in as little as one minute per day. If the thought of doing this yourself scares you, BlephEx is available through many eye doctors’ offices, and it’s a great in-office alternative for removing biofilm. Read more about BlephEx here. Both devices are great, both companies are great, and we recommend using one or the other.
We could discuss green smoothies all day long, diving into the benefits you’ll notice. For nearly everyone we meet with dry eye disease or blepharitis, we recommend replacing your current breakfast with a green smoothie. Why is this? Because most people are eating horrible food for breakfast that’s doing nothing but increasing inflammation in your body. Cereal, milk, bacon, pancakes, you name it...all of it can be horrible and contribute to inflammation.
When you replace these foods with a green smoothie, you’re not only ensuring hydration first thing in the morning, but you’re also making sure you’re packing in tons of antioxidants and carotenoids. Both are great for fighting oxidative stress and inflammation. Even if you find yourself sensitive to something in the green smoothies we recommend, there are so many ways to make a healthy green smoothie that it’s almost impossible for them to be harmful if you follow our green smoothie chart.
Steroid or Antibiotic Eye Drops
As a last resort, and after all of the above alternative treatments have been tried, steroid eye drops are a great option for knocking down inflammation fast. We use these when someone is incredibly red, inflamed, and miserable, and they usually work quite well when prescribed and used correctly. Steroid eye drops encompass the entire inflammatory cascade and really knock out inflammation for most people, at least getting them back to a healthier baseline to begin all of the alternative blepharitis treatments above.
I also added topical antibiotics here, although these will usually not be needed unless you're currently suffering from a stye or other eye or eyelid infection. If you feel that you have an eye infection, or you're suffering from severe inflammation, speak with your eye doctor today.
Remove your Makeup with a Tea Tree Oil Makeup Remover
It’s amazing that so many people either forget to, or completely ignore that they need to, remove their makeup at night before they go to bed. Makeup is a breeding ground for bacteria, and when it’s left on your eyelids all night you’re just asking for blepharitis, styes, and dry eyes to creep in. Removing your makeup with an oil-based cleanser means that you’re going to get all of the makeup off (even the waterproof kind!)
We recommend using an oil-based remover that contains tea tree essential oil, because the tea tree can help eliminate demodex eyelash mites and ensure that your eyes stay healthy. Simply place 3-5 drops of the remover onto a cotton ball or round and swipe it across your eyelids and lashes, concentrating at the base of the eyelashes until all of the eye makeup is removed.
Wash your Face with Tea Tree Oil Soap
Tea tree essential oil is fantastic for killing demodex eyelash mites and cleansing your skin. To use, simply lather the soap between your hands for a few seconds and then work it into your skin in circular motions. Keep your eyelids closed tightly! Take care to avoid getting the soap directly into the eyes, as this will burn. Rinse well after you’re finished. You’ll be amazed at how using a soap such as this can help eliminate crusty eyelashes, inflammation of the eyelids and skin, and other skin conditions.
Eyelid Cleansing Wipes with Tea Tree
If you prefer a little extra friction with your eyelid cleansing, consider using an eyelid wipe. There are a few great ones out there and they work great for really decreasing the crustiness on your lashes. Simply remove the pre-moistened eyelid wipe from the package, close your eyes, and wipe the pad over your closed eyelids (concentrating on the lash margin). Most formulas do not require rinsing and can be found with or without tea tree essential oil.
So, what does stress have to do with this? So much. This all comes back to inflammation. Inflammation is at the core of most chronic diseases today, including heart disease, cognitive issues, GI distress, and even dry eye disease. Emotional stress can cause hormonal shifts, weight gain, and inflammation.
Stress is your body’s “fight or flight” response, which occurs when you are in a stressful situation. Your nervous system releases hormones that prepare you to fight whatever the offending agent is or to run. This is your body’s short-term response to stress and it recovers quickly from this. This is a survival mechanism in the body and does more good than harm.
Cortisol, or the "stress hormone," is an absolutely essential part of your normal health and function, and it helps control blood sugar levels, regulate metabolism, helps reduce inflammation and control blood pressure, and assists with memory.
However if stress is present and cortisol is elevated chronically, further health problems can arise. This is when we find that some people shift from doing fine to struggling with their health (including with their dry eyes). Stress pushes them over the edge from manageable to unbearable.
What Causes Stress?
There are so many things that can cause stress in our lives, and even good things can lead to stress (think getting married!) Here are a few things that can contribute to stress:
The most important determinant of how your body will handle stressful situations is your attitude during the event. How you react to a particular situation will make a world of difference. Unrealistic expectations can cause a ton of harm, both emotionally and physically for you, so it’s best to not sweat the small stuff (as Richard Carlson would say). But what are a few other things you can do to handle stressful situations as they arise?
Limit Screen Time
I put this one first because it’s often an overlooked cause of stress for your eyes, specifically. Being in front of a computer or other screen all day long means that you’re blinking less frequently. This lack of blinking can eventually lead to the loss of functioning of the meibomian glands, and we know that when we lose those glands, we fall deeper into dry eye disease.
Devices are essential to our everyday lives, yet they are leading to the higher level of MGD that we’re now seeing in younger and younger patients, even children. To combat this, limit your screen time and take visual breaks. Follow the 20-20-20 Rule, which states that every 20 minutes, you should be looking 20 feet away for at least 20 seconds. Even better, get up and do something else (like pushups, squats, or even just go grab a glass of water).
What if you could meditate in as short as 10 seconds per day? It’s both possible and beneficial! This simple meditation could decrease stress levels, therefore decreasing your risks of disease, such as blepharitis, dry eyes, heart disease, neck pain, and more.
Meditation does NOT have to be an ultra spiritual, out-of-body experience, and all it takes is you, a comfy spot to sit or lie down, and maybe a meditation/mindfulness app on your phone. We like Insight Timer and Calm.
This is by far my favorite tip for decreasing stress in your life and setting real expectations. It is as simple as writing down three or more things every day in a paper journal. Keep a paper journal or notebook beside your bed with a pen. Every night before you go to sleep, write anything that happened during that day that you’re grateful for, anything positive that made you smile or that put you in a better mood.
Expressing gratitude on a nightly basis will help you look for positivity in people and the world around you because you are starting to train your brain to do so. Items can be big, such as being thankful for health and a nice home, or small, such as being grateful for the smile on your son’s face in the morning, your hot coffee, or the compliment your boss gave you at work.
Yoga (Especially Yin)
Yin yoga is a slow paced style of yoga with postures, or asanas, that are held for longer periods of time. Usually postures are held for one minute or more, and may be held up to 5 minutes. Not only does yin yoga increase flexibility, but it also improves circulation and gives your body and mind a time to rest.
We love to use yin yoga at night to help us wind down. This allows us to stretch, slow our minds, and get ready for a great sleep ahead. We tend to start our yin yoga practice around 9:00 pm at night and then go to sleep afterwards.
Laughter is truly the best medicine, and we see this time and time again. While laughter will never take away the pain completely, it will shift your mindset into focusing on what’s great in life. Here are just a few of the benefits of laughter: it relaxes your whole body, boosts your immune system, releases endorphins (happy hormones), protects the heart, burns calories, and may even help you live longer. So, put on a comedy with your dog, kids, or significant other, and get laughing!
There are so many other tips I could give on decreasing stress, but the above few are enough to get you started on the road to a healthier you, both physically and mentally. You may not believe that stress reduction techniques can make a difference, but I’ve seen this be the case time and again.
Can Makeup Cause Blepharitis?
The answer is yes, and this includes your favorite bronzers, eyeliners and lipsticks. Your makeup bag harbors some potentially harmful bacteria, and this was seen in a study conducted at London Metropolitain University. They found six different types of bacteria living on makeup brushes and cosmetic products. In addition to this, the makeup you're using likely contains chemicals that you don't want around your eyes.
When it comes to your eyesight, most eye makeup, especially eyeliner, can cause blepharitis because it blocks the eyelid's meibomian glands and reduces the secretion of oils needed on the surface of the eye, causing tears to evaporate too quickly.
If you want to wear eye makeup more safely, choose better options! You'll do your eyes a favor by avoiding the following ingredients in your cosmetics:
Argireline (Acetyl Hexapeptide-3)
Benzalkonium Chloride (BAK)
Sodium Laureth Sulfates
And although I shouldn't have to say it, make sure you're cleaning your makeup brushes regularly with soap and water and allowing them to dry completely. Also, don't forget to replace your liquid and cream-based makeup products at least every three months.
FAQs About Blepharitis
Is there surgery for blepharitis?
When we treat blepharitis, many of the treatments can be done at home. Eyelid hygiene is easily performed daily and can help soothe the symptoms. But we’re often asked if there is surgery for this condition. For most people, there is no blepharitis surgery that will help them. There are in-office procedures that can be done, such as LipiFlow, Intense Pulsed Light (IPL), and BlephEx. However, these are not surgeries.
The only surgery that may be of benefit for someone with blepharitis and subsequent dry eye disease would be blepharoplasty, or eyelid surgery. The reason this may be beneficial for a small number of people is because those people either have eyelids that turn outward, and do not rest on their eyeball as they should, or turn inward, which causes the eyelashes to rake against the eyeball. However, while it may help dry eye symptoms in some people, this is not a surgery specifically for blepharitis.
How long does it take for blepharitis to go away?
Unfortunately, there is no cure for blepharitis, but it can be well managed. When using proper eyelid hygiene, blepharitis can be controlled in a matter of weeks, and sometimes the patient will feel relief within a few days. The key is daily eyelid hygiene, which can help keep the symptoms at bay and help prevent progression into something more serious.
Is baby shampoo good for blepharitis?
Absolutely not! Baby shampoo contains multiple synthetic ingredients and detergents which will throw off the pH balance of your eyelids. Many of the ingredients can contribute to eye allergies (including Cocamidopropyl Betaine, PEG-80 Sorbitan Laurate, Phenoxyethanol, and fragrance). If you’re considering baby shampoo or have been told by your doctor to use it, consider using a better product. There are safer eyelid hygiene products out there, like hypochlorous acid.Read more about baby shampoo here.
Is there a cure for blepharitis?
Yes...and no. Blepharitis is a chronic condition for most people, and this means that you’re going to be dealing with it throughout your life. However, we believe that blepharitis and other conditions such as dry eye have the ability to be cured by getting to the root of the problem. For example, if your blepharitis is caused by demodex and you really center your daily hygiene regimen around using tea tree oil to kill those mites, you’re more likely to find relief. However, this is not necessarily a “cure” because you will still need to practice that hygiene every single day, twice per day, to keep the blepharitis at bay.
Is blepharitis the same as conjunctivitis?
Blepharitis and conjunctivitis are two conditions that can disrupt the comfort of your eyes and the smooth functioning of your eyesight. Although the symptoms and the reasons for the onslaught of these diseases appear similar, there are differences in both of these conditions. Blepharitis is inflammation of the eyelids.
Conjunctivitis is a condition in which there is inflammation of the thin membrane present on the surface of the eyes called the conjunctiva. Inside this thin membrane is a space that can fill with fluid if inflammation is present from such causes as bacteria (red, goopy eyes), allergies (red, watery eyes), viruses (watery, pink eyes), dry eyes (red, gritty eyes), and other problems with the front of the eye.