**PLEASE SEE MY UPDATE AT THE BOTTOM**
So, this week I found out I have blepharitis stemming from ocular rosacea. For a few years now I’ve wondered why my eyes were often red, dry and irritated looking.
Visine would temporarily give me a boost but after about 5 hours I would experience rebound redness which is even worse and it takes a few days to recover.
We all want those beautiful, white eye balls to show off our makeup. After all, your eyes are the first thing that anyone looks at when they meet you!
At first I thought maybe it was allergies, since I test so many beauty products to write about them, but my Dr. assured me it was not allergies (at least there’s that silver lining).
I decided to write about this because I know that many people probably suffer from this condition, and I wanted to share the eye cleansing routine that works for me, and also what products don’t inflame my already sensitive eyes.
If you’ve found this post, you probably already know what blepharitis is, but in case you don’t, I’ll explain.
Blepharitis (Mayo Clinic link) is a common and ongoing condition where the eyelids become inflamed with oily particles and bacteria coating the eyelid margin near the base of the eyelashes.
This condition can cause redness and irritation, and stinging or burning of the eyes. My main symptoms have been red eyes and dryness of the eyes.
My Dr. determined that I have “posterior blepharitis” which is a dysfunction of the eye’s tiny oil glands in the eyelids at the base of the eyelashes where they often get blocked.
Basically, he said that my eyes underproduce oils and tears. Not a good combination, so now I must use moisture drops and adhere to a strict lid cleansing routine.
Sometimes blepharitis can come with age, which makes sense since I’m in my mid-40’s, and sometimes it’s also hereditary. My mother also has blepharitis and eventually went on to have an eyelid surgery in her late 50’s. More for drooping eyelids, but it was causing problems and aggravating her condition.
What is Ocular Rosacea?
When my Dr. said the blepharitis may stem from having ocular rosacea, I looked at him like he had two heads. I don’t have rosacea of the face (where you can have a lot of redness and flushed skin). But apparently you can have rosacea of the eyeballs!
Ocular rosacea often develops in people who have rosacea, and sometimes ocular rosacea is the first sign that you may later develop the facial type. I’m not happy about that prospect!
So I’m still a little confused if one caused the other or vice versa, but I do know that I’ve improved my symptoms by doing what the Dr. said and it’s only been a few weeks, so I wanted to share my routine.
- Wash eyelids (not the inside of the eye, just the lids top and bottom) with Johnson’s baby shampoo (or Aquaphor baby wash) mixed with a little water. I use cleansed fingers and also q-tips to rub the lash lines gently. Use a new q-tip for each eye.
- Hot eye compresses for 5-10 minutes for morning and night, as hot as you can stand.
- Use a lid scrub (you can do this instead of the baby shampoo) to wipe the lids clean
- I bought the OcuSoft Lid Scrub Plus which you can get at the drug store. I didn’t like these personally.
- Use the preservative free moisture drops 2x a day (the ones in the individual droppers that you throw away).
- I’ve been using Refresh Optive Advanced, or the Systane Balance. I did try the bottle type (which has preservatives) and it made my eyes sting, so I won’t use those anymore.
- Also, stop and blink 20 times quickly every hour! This helps coat the eyelids and keep them balanced. If you’re staring at a computer screen all day, this is especially helpful.
- Take 2000-3000mg per day of Omega 3. This fights inflammation but can take months to take effect, but that’s ok because I’ve always known I was low on Omega 3’s and it’s also great for skin!
- I bought the Barlean’s Omega Swirl in Citrus Sorbet. This stuff is delicious!! It takes like a creamscicle – not even a hint of a fishy taste. If this sounds gross, just take the fish oil pills!
- Flax Seed Oil or Ground Flax Seed – this is also a good way to get Omega 3. I happen to love putting a tablespoon of each in my smoothies or on yogurt so on those days I won’t take the swirl.
- I like the Barlean’s brand of flax seed oil, and the Spectrum brand of the ground flax seed. All of these supplements I buy at Whole Foods and they are in the refrigerated section of the supplements.
Hypoallergenic Anti-Aging Eye Treatment
Having blepharitis made me question the anti-aging products that I use on my eyes. Obviously I can’t use products that are going to irritate my already sensitive eyes but I know that I can’t just leave my eyes with no moisture after doing hot compresses and washing with baby shampoo. All of that is so drying!
I’ve been using the Beautycounter Countermatch Eye Rescue Cream, which contains no irritating chemicals and doesn’t irritate my eyes at all.
I use it both under my eyes and right on my eyelids. Beautycounter products are very calming, soothing and non irritating with no toxic chemicals. And it does a great job of moisturizing my crepy lids, which allows my eyeshadow to go on smoothly.
Ok, so this is a super annoying condition!! My eyes got a lot better for a while, I followed the routine above, and then got slack after about six months. Boy was that a mistake! I think I had my worst flare up ever. I want new eyeballs!!! 😉
I had used visine (HUGE mistake) for a special event and then again the next day, and holy crap my eyes looked like I almost had pink eye, just horribly red, dry and irritated. The rebound redness is no joke.
I’ve learned that with this condition, you can’t ease up on anything. It’s chronic and there is no cure. You just have to keep your symptoms in check.
I’m back on a strict routine and have gotten things under control but there are some things my Dr. added that you may find beneficial. This was a NEW Dr. and I’m so glad I switched. My eyes have improved ten fold and my old Dr. didn’t recommend any of this stuff!
Meibomian Gland Expression – He put numbing drops in my eyes and used a tool to squeeze the lower lids. He said it was thick and came out like toothpaste – super gross. At least he got them a little “unplugged.”
Lotemax Steroid Drops…this has been a Godsend but I know I can’t use it forever since it’s a steroid. It has made my eyes whiter than they have been in a very long time. During my flareup, I used 2x day for a couple weeks, now I’m at once per day in the morning (typically only use 2-3x week now).
Azasite 1% Azithromycin Eye Drops – I used this at night along my lower lids for a couple weeks during my flare up. At first it was a bit stingy so I would just put some on a qtip and gently apply to my inner lower lids. Now I can just pull my lower lid back and put a drop in. I like to do this JUST before bed, so I can just close my eyes. This will help fight infection which can all be a part of this blepharitis condition (bacteria builds up in those glands since they’re not flowing properly). During my flare up I used every night for a week, dropped down to 3-4 nights per week and did this for about a month, then stopped.
Eyelid self massage – After doing the warm/hot compresses, gently massage your eyelids and push up underneath your eye towards your inner lid, and do the same on the top. Rub downwards. This will help express the clogged oil in your glands. You won’t “see” it coming out. Don’t do what I did and try to get aggressive with a qtip to squeeze stuff out. This broke some capillaries and made my eyes all red! I definitely overdid it in the beginning. Best to be gentle with everything!
Face Steamer – I bought a little Conair face steamer from Macy’s. I couldn’t find one in BBB or Target in store, but they do sell them online. Instead of hot compresses every night, about 3-4 nights I like to steam my whole face for 15 minutes. This will open up your meibomian glands and is great for your skin as well. I flutter my eyelids open and shut during the process. I also put a towel over my head to trap the steam in. Once you’re done steaming, you can do the eyelid massage. Once you’re done, be sure and use your wipes (or baby wash) to cleanse your eyes as the massage and steaming will make the goop form in your eyeballs sometimes.
Fish Oil Supplement – I found that I wasn’t diligent enough to make a smoothy every day and use the flax seed or the Omega swirl, nor was I diligent enough to even take fish oil pills on the regular. I use MCT oil in my coffee each morning and I’ve done this for a year. MCT is a coconut oil extract and it helps my overall condition (and has other benefits as well).
Makeup Changes – I actually quit wearing eye makeup for a whole week when I started this new regime. I threw out all my old makeup and brushes. Even though I cleaned them, you can’t kill all the bacteria in those brushes and I wanted a fresh start. I usually spend quite a bit on makeup and use Mac mascara. Instead I went out and bought all cheap makeup to use until this is under control. I bought Almay mascara and I’m going to throw it away and buy new one every couple of weeks. Mascara is the worst culprit to spread bacteria around your eyes. I love the Almay just as much as the Mac so apparently I’ve been over paying for mascara all this time! LOL Now I wear makeup again all the time! However I NEVER use eyeliner on the inside of my bottom lashes, which I miss doing… not worth it.
Pillow cases – Wash them twice per week, bacteria builds up on pillow cases quickly.
Eye Mask To Sleep – My husband sleeps with the overhead fan on and a small table fan (yes, two) so the air flow was killing me. I bought one of those masks from BBB that has the concave eyes so it doesn’t touch your eyelashes. This helped my eyes from drying out over night. Sometimes I would wake up and could hardly blink because they were so dry!! (For the record, it was too hard to keep this up, once my eyes got better I found I didn’t need the mask, but in a flare up it might be beneficial).
Humidifier – I bought a small humidifier from BBB and keep it next to my bed and leave it on low during the night. I did this for a few weeks, it didn’t seem to make much difference so I stopped doing it.
Eye drops next to bed – First thing I do now when I wake up is put a drop of the Refresh Advanced Optive (the single use ones) in my eyes to freshen them up. They are always the most dry when I wake up.
Anti-inflammatory diet – I’ve been eating a low carb/ketogenic diet which is an anti-inflammatory diet (high fat/low carb/moderate protein). Dr.’s say that blepharitis is a chronic condition that you can’t cure, but I think that’s crap. Western Dr.’s just don’t seem to want to consider diet, they just want to write those scripts.
If you reduce the inflammation in your body, you’re going to have less inflammation in your eyes, and rosacea is inflammation. There is a supplement I’ve been taking called Keto OS which is exogenous ketones in a drink that puts your body into ketosis which is exactly what the ketogenic diet does. I use the MCT oil in my coffee in the mornings, and drink one Keto Nat per day in the afternoon.
So, I think I’ve found the best possible work out/fat loss supplement that I could possibly use that also helps my eye condition! I still do my warm compresses, lotemax drops and drink the ketones daily and my condition is totally kept under control. I have done this for TWO YEARS NOW and my life is much improved!
As you can see, this blepharitis condition is a huge pain in the ass! However, I’ve settled into a routine now and I just have to do it just like I have to brush my teeth.
Do you have blepharitis? I would love to hear about the treatments that work for you, leave comments below!
Thank you SO MUCH for writing this, I have just been diagnosed and felt so upset frustrated and hopeless. I am doing some of what you have written but not all. I feel like if I just stay diligent I can manage this!! I have an appointment with a dry eye specialist doctor and I am am sure she will also be able to help with the scripts. I thought anti inflammatory diet would help too! No doc wants to listen to me but I have pulled so many things out of my diet anyway thinking the same thing!! Thank you for the validation and the HOPE!!!
Cetaphil Baby Wash with Organic Calendula
Try Cetaphil Baby Wash with Organic Calendula. Daily use in the shower with gentle eye wiping helped condition improve in 4 weeks. Google, "Calendula for Blepharitis". We believe this is what helped our child after 2 years of antibiotics/steroid drops and 3 Optometrists and 2 Ophthalmologists over the 2 years. Hope this helps.
I have blepheritis and I identify with all the problems it brings. I believe the hot compress, express routine and cleansing are key to control.
I was surprised to read that you have not found the Bruder eye masks. They changed my life. There are little microwaveable bean bags that you can use on your eyes. They can be washed and reused for months. I have several pair and recommmed you give them a try.
I’ve been depressed since learning I’ve got this. You made me feel better!
I have also suffered from blepharitis (or possibly ocular rosacea) for years! It's such a frustrating and embarrassing condition. During a particularly bad flare up and when the air is really dry, I use cliradex wipes. They sting like crazy because of the tea tree oil but they really work! A humidifier in the winter also helps. When I'm not having a flare up, I use Steri-lid lid scrub for general eye cleanliness and maintenance. I still get flare ups sometimes but this regimen seems to help a lot.
This is such a frustrating condition- especially if you need to look your best for work. I’m so grateful that you’ve put this guide out there for people to follow. It’s taken me years to learn all these things. I’m excited to try Ketosis soon as well. As far as eye drops- Oculocin Propo are a Godsend- I don’t work for the company but they are definitely very anti inflammatory- huge help. They’re now on amazon. Hope this helps some one out there- diet is key! Meditation helps too!
Things to try!!
I am grateful for the suggestions. I have been exhibiting symptoms for about 8 months, appeared just out of the blue when I returned home to Alaska after a vacation. My eyes intermittently look terribly wrinkled, like I have suddenly aged 20 years (I am 62 and used to look quite a bit younger). My cheeks burn and appear red for days at a time and sometimes I wake up weepy. I was treated with a round of antibiotic, both oral and topical, but the condition reappears. I admit to being on the computer way too much during the election, and I managed my stress by taking vigorous walks outside, in the cold wind sometimes. I have an appointment with an opthamologist in January and hope I can get some answers. Thank you for more new things to try meanwhile!
Thanks so much for your blog! I’ve just been diagnosed and you have given me hope...and all the info...I need. Thank you!
User Questions and Answers
User Questions and Answers
Q: Hi! How long did it take to go away? I was diagnosed with blepharitis first. Did warm compresses and lid scrubs. Got second opinion. Told it was ocular rosacea. Again, like yourself, never knew I had rosacea. Still doing warm compresses and lid scrubs but this has been going on since July, and I'm feeling pretty hopeless. Thanks! -Ursula
11 out of 11 people found this question helpful.
Q: Wondering what Omega 3 capsules would be good for blepharitis. -Karen
9 out of 9 people found this question helpful.
Q: You state that "Basically, he said that my eyes overproduce oils and under-produce tears. Not a good combination,...". I was told the exact opposite, that my eyes over produce tears (which are drying) and under produce oil. My oil glands get clogged, which causes the oil to accumulate in the lids. This causes the swelling in the lids and eventually the oil glands respond by underproducing. TY for the info! -Jill
3 out of 3 people found this question helpful.
Q: Where did you find the aquaphor baby wash and shampoo? I have both eye conditions and my Mom had both conditions for years before she passed away. -Cindy
4 out of 5 people found this question helpful.
Q: I have blephritis. I do lid scrubs with baby shampoo and warm compresses. I have it as under control as possible but still have a little bit of (bags) Thinking of blepharoplasty but scared that since I have blephritis the bags won't go away anyway. Can anyone help?? -Samantha
3 out of 3 people found this question helpful.
Q: Hi...I just wanted to thank you for all this great info. Sometimes it's just good to know you're not alone in all this. I'm with you on the diet change and will be doing a huge lifestyle eating transformation this summer. Looking forward to getting this under control. Thanks again... -Jody
1 out of 1 people found this question helpful.
Q: Hi,I was delighted to come upon this discussion,I am at my wits end with this condition ,I developed this issues with my eyes May 2017,I initially thought it was a sty,but after visiting my optomologist after a second episode he informed me it was caused by rosacea.I wasn’t even aware I had rosacea I thought the redness I got occasionally on my face were hot flushes?.I went to see a dermatologist who put me on a 6 month course of tetralysal,not that it helped much I have had two procedures done since Jan to remove cysts from my eyelid,I am now back to my dermatologist next week to see what she can suggest to help.I have ms and thought maybe there was a connection .I most definitely will look into the products suggested here,Thank you for sharing the info! Hilary -Hilary
1 out of 1 people found this question helpful.
Q: Hi! U suggested 2 different eyedrops (Lotemax & Refresh). Also, 2 eye creams (Beauty Counter & Skinceptions) Which ones do u recommend ? -Christy
1 out of 1 people found this question helpful.
Q: I use baby shampoo on my lids but find there red and itchy. What should I use -Laurie
4 out of 7 people found this question helpful.
Q: I’m dealing with ocular rosacea as well and I was wondering if you had tried the Oculocin Propo drops another reader had recommended. I’m desperate and willing to try anything. Thanks for all your advice! -Ashley
Q: I was hoping to get an idea of what skincare is okay to use having blepharitis. My eyelids are very dry after using Cliradex and I'm weaning off Doxycyline, which is basically the only thing that has worked and I know it's temporary. I have not worn any makeup (barely) for about 2 months. I would just like to find a product that is safe for eyes - eye cream and night cream. Thanks for any info. -Lynn
Q: I found this very beneficial and helpful. I was wondering why yo chose Almay as the brand to try my doc put me in some eye ointment and recommended Almay as a good brand for eyes with sensitivities once I can safely wear make up again. Just looking for the products that won’t hurt my eyes cuz this is such a pain! Thanks -Alisha
Q: I have just been diagnosed with dry eye & the beginning of blepharitis --- I have VERY sensitive & dry skin & can't go without eye cream. Which is working best for you without causing more irritation? (I see two different eye creams made by same company here on this blog) -Sarah
Q: Hi, I have suffered with this for 5 yrs now. Still going to my same Dr. What kind of Dr. do you go to? Mine tells me the same thing every time and does nothing. I only have some steroid ointment that the greasiness I think makes it WORSE. My eyes it so bad !! Reading your blog gave me hope! -Pam
Q: I really enjoyed your article. I was recently diagnosed with ocular rosacea and blepharitis. I'm doing the non preservative eye drops like Refresh or Blink. Sometimes gel drops before bed. Cleaning with baby shampoo and the hot compresses. My eyeballs and eyelids are so red! I am feeling so discouraged and hopeless! The Lotamax you're using, isn't it a steroid drop? I didn't think it was safe to use them long term. Thank you, Lisa -lisa
1 out of 2 people found this question helpful.
Q: Not a question - just info. I spent years doing all the above but it was all a complete waste of time. Your problem is caused by demodex mites that live in the eyelash follicles. You need to address the root cause & eradicate those. Tea tree based wipes or cleaner will do that. I found Cliradex wipes, the best for that. They are expensive but will save you a whole lot of money, time & energy . My eyes have returned to normal - I wear make up, I look normal - no red eyeballs/eye rims no swollen lids. And my eyes after years of soreness & dryness are totally comfortable -DPE
Q: Finding the right eye lid cleaner and drops is so hard. Do you still use the Refresh Advanced Optive eye drops? I tried Systane Balance and didn't like it much. Also using Systane lid wipes which are find are too soapy and irritate my eyes. Thanks for suggestions. I have MGD, Ocular Rosacea and blepharitis. -Karen
Q: Hi there another question :) I was wondering with the routine you’ve gotten in to that has helped keep it under control do you still do the eye lid wash and when you were getting it under control did you do the ocusoft scrub or baby shampoo morning and night or just at night?! Finally starting to see some lash regrowth thanks to your suggestions the steamer has been a god send! -Alisha
Q: Hi just a quick question on high street brand makeup I can use for blepharitis, I’ve recently just been diagnosed, has took me at least 4months so far to try and get this under control. -Zoe
Q: I have had rosacea on my face for years. I now have ocular rosacea/blepharitis... but I was using a well known eyeshadow that had some glitter in it. It was very difficult to get it all out at night. I would thing I did only to find little glitter specks on my face in the a.m. I feel I clogged my Meibomian glands and should have them the glans extracted. Was this procedure done by an Opthamologist? I never do have dry eyes though, my eyelids get oily. -Anya
Q: Hello! I started having bad upper eyelid symptoms about a year ago (I'm only 22). Was told to do the eyelid scrub and compress, which helps, but I can barley wear make up. I'm wondering, what is the benefit of the exogenous ketones? I don't quite understand how the body's state of ketosis help blepharitis... does it just reduce the body's inflammation overall? Thanks! -Audrey
Q: Hi! Are you still using the mct oil? I think you mentioned your still drinking the keto os. Thanks so much for posting all of this great info. -Kami
Q: Has anyone thought or read about demodex follucilurum as a cause? I may have misspelled that. I was prescribed Ivermectin by my opthamologist- an antiparasitic drug. Read about mites as a possible cause. Ew- sorry to say real. -Nicole
Q: I got the blepharitis two months ago. I noticed after soak my eyes with hot towel or my heating pad my eyelashes started to coming out. Help please if you have some suggestions to preventing this let me know. I recently stared with fish oil. Thank you so much for your help. This illness is a real pain. -Lubby
Q: I have blepharitis, can you please tell me what make eye make up remover you use , thank you -Rita
Q: Can you use the eye drops if your a contact lens wearer? -DYAN
Q: Looking for a eye cream for the eyelids which are dry. Use baby shampoo and eyelid wipes but need a cream -Barbara
Q: What type of doctor did you go to? Eye doctor, regular doctor? I need to go but not for sure which dr to see. Thanks. -Jennifer
Q: Traduction en français !! -