Itchy Eyelids – Causes and Treatment

Stye (Hordeolum)

Picture 1. Stye (hordeolum)
(source: Samuel Freire da Silva, MD, Atlasdermatologico)

Stye (Lat hordeolum = barleycorn) is a red, tender, painful, or itchy red bump, resembling a pimple, occurring on the eyelash. It represent an infection (usually by bacterium Staphylococcus aureus) of an oil gland attached to the hair follicle. In children it mostly occurs due to bad eye or hands hygiene, and eye rubbing; in women it may be due to sharing makeup. Stye usually heals on its own in 1-2 weeks. Warm wet compresses applied for 1o minutes 2-3 times a day may help in draining pus and relieving pain. Stye should not be rubbed or squeezed. Topical ointments are usually ineffective (1). Rarely, surgical incision and drainage is needed.

Chalazion

Picture 2. Chalazion
(source: Wikimedia)

Chalazion (Greek chalazion = small lump) appears as a red, non-tender lump on the eyelid. It represents a non-infectious inflammation of the eyelid soft tissue, due to fats squeezed from obstructed meibomian (oil)glands. Warm compresses soften thick fats thus helping in drainage. If chalazion is big or it doesn’t clear in several weeks, injection of steroids or surgical incision may be performed (1).

Blepharitis

Blepharitis (Greek blepharon = eyelid) is inflammation of eyelid, appearing as reddened, swollen, itchy, and burning eyelid margin. Scaling, pustules, crusts, or ulcers may appear. Acute blepharitis may be caused by Herpes simplex or Herpes zoster (varicella) virus, bacterium Stapylococcus aureus, or allergy. Chronic blepharitis may be associated with seborrheic dermatitis, acne rosacea, lice, or allergies.

Therapy. Viral infections are treated with antiviral drugs by mouth, and bacterial infections by antibacterial ointments. In marked swelling or allergy, topical corticosteroids may be used (2).

Picture of Blepharitis 

Allergies

Itchy, red, and severely swollen eyelids are common symptom in hair dye allergies, nail polish allergy, or make-up allergy. Treatment is by antihistamines and corticosteroids by mouth. Local antihistamines should be avoided since they themselves may cause allergy. Topical corticosteroids should be also avoided since they may thin the eyelid skin. 

Seborrheic Keratosis

Seborrheic keratosis (Greek sebum = oil; rhein = flow; keratosis = thickening of corneal skin layer) is an itchy, pigmented, greasy outgrowth from the eyelid, occurring mostly in old people. Surgical removal is curative.

Picture of Seborrheic Keratosis 

Actinic Keratosis

Picture 3. Actinic keratosis
(source: Samuel Freire da Silva, MD, Atlasdermatologico)

Actinic (Greek aktis = ray) keratosis is a flat, whitish, shiny, or reddish, purplish, brown, or black, slightly raised lesion appearing on the sun exposed skin, caused by ultraviolet light. It may develop into cancer, so it has to be removed.

Additional Pictures of Solar Keratosis (search for “keratosis solar”)

Eyelid Wart (Papilloma)

Picture 4. Eyelid wart (papilloma)
(source: Wikimedia)

Warts, caused by Papilloma virus can appear on eyelid. They may be threadlike or flat, skin-colored, yellow, or brown. They may occasionally itch. In general they don’t cause any problems. If they are disturbing, they may be surgically removed.

Basal Cell, Squamous Cell, and Sebaceus Gland Carcinoma

Basal cell carcinoma usually appears on the lower eyelid as a pearl-like hard nodule, often covered by tinny vessels or with ulceration in the middle. Squamous cell carcinoma usually appears on the upper eyelid. Sebaceus gland carcinoma may mimic chalazion. Treatment is with complete surgical removal.

Pictures of Basal Cell and Sebaceus Carcinoma 

Head and Pubic Lice

Head or pubic lice can be sometimes found on eyelash. 

Demodex Mites

Human Demodex mites, often living in hair follicles and oil (sebaceus) glands of eyelashes or eyebrows may cause eyelid itching and scaling, dry or red eyes.

Eye Diseases

Eye diseases like conjunctivitis or trachoma also cause eyelid itch. 

Other Articles About Itch

Itch – Diagnosis, Prevention, and Treatment
Causes of Itchy Skin
Itchy Legs
Itchy Feet and Toes
Itchy Arms and Hands

1. Stye and chalazion treatment  (merck.com)
2. Blepharitis treatment  (merck.com)
3. Seborrheic keratosis  (aafp.org)