How long does eyelid dermatitis last?

Pain, swelling, itching, or a rash in the eye area: These bothersome symptoms may point to eyelid dermatitis, also called eyelid eczema. With treatment, eyelid dermatitis can last anywhere from a few days to a few weeks, according to the Cleveland Clinic and experts with All About Vision.

But what’s behind eyelid dermatitis? The main cause is allergic contact dermatitis, according to Brian Morris, MD, for UCLA Health. He notes a few other facts as well, such as 90% of cases are found in women, the skin condition can affect both eyelids, and a good prognosis is likely if people follow the treatment (but more on that later).

Suspect a case of eyelid dermatitis? Read ahead for what to expect.

Typical timeline of eyelid dermatitis

When it comes to how long the symptoms last, there’s not a super clear-cut answer. “The timeline of eyelid dermatitis can vary widely depending on the underlying cause, the individual’s response to treatment, and the specific type of dermatitis,” says Julia Giyaur, MD, a board-certified ophthalmologist, ophthalmic surgeon, and founding director at New York Laser Vision. 

But generally, these are the phases and their timeframe:

Day 1: Trigger phase

Various factors can trigger eyelid dermatitis, or eyelid contact dermatitis, according to Dr. Giyaur, including allergies or hay fever, irritants, or skin conditions. One of those skin conditions is eczema, according to the American Academy of Dermatology Association.

“The timeline begins when the underlying cause or trigger comes into contact with the eyelid skin,” says Dr. Giyaur. A physical trigger or allergen is the most common cause of eyelid dermatitis.

Hours or days later: Acute phase

Dr. Giyaur notes that the acute phase of eyelid dermatitis is when common symptoms—such as redness, itching, burning, swelling, and skin dryness—start to appear. “The severity and duration of this phase can vary,” she adds. “The onset of symptoms might occur within hours or take several days after exposure to the trigger.”

Diane Hilal-Campo, MD, a board-certified ophthalmologist and founder of Twenty/Twenty Beauty, has found the same to be true. “Eyelid dermatitis typically develops within 24 to 48 hours from exposure to the irritant or allergen that triggered it, with redness, itching, swelling, and scaliness,” she says. “It can onset very suddenly in that you wake up with all of these symptoms simultaneously.”

It’s important to note here that blepharitis, a chronic condition in which an eyelid periodically swells, gets flaky, stings, and causes other uncomfortable symptoms, may look similar to eyelid dermatitis. A healthcare professional can help determine the cause of the symptoms.

The following weeks to months: Subacute phase

“In some cases, eyelid dermatitis can become a chronic or recurring condition,” says Dr. Giyaur. Flare-ups are especially likely, she continues, if the underlying cause isn’t identified and managed. The amount of time it takes to find the culprit of this skin condition varies, too, she believes. Is it hay fever? Cosmetic products? Environmental factors?

One evaluation that can help is a patch test. While thousands of substances can be allergens contracted through direct contact, patch testing—a type of skin test—can be completed by a dermatologist and provide results (aka the problematic allergen) within a week.

Days or weeks after the cause is accurately identified: Treatment phase

Dr. Giyaur says treatment options for eyelid dermatitis usually entail topical corticosteroids, emollients, or systemic treatment. Hydrocortisone cream is often used first to treat contact dermatitis in the affected area. Sometimes a short course of oral corticosteroids may be needed in more severe cases. FYI: While having to pay for medication is no fun, pharmacy discount cards help!

“Improvement happens over days to weeks,” she continues. “If the trigger is removed or avoided, and the appropriate treatment is administered, there may be a noticeable improvement in symptoms.”

Dr. Hilal-Campo believes the timeline is more toward the shorter end. “Once treatment begins, you can expect relief within several days,” she says.

If that doesn’t work? The National Eczema Society states that topical calcineurin inhibitors (TCIs) can treat adults and children older than 2 years old if topical steroids aren’t cutting it. TCIs are useful in treating and preventing flares and are particularly suitable for delicate areas, such as eyelids.

Further, topical treatment with tacrolimus ointment can be safe and effective for patients who have moderate to severe cases.

The perhaps even better news: If the trigger substance is successfully addressed and the triggers are avoidable, Dr. Giyaur believes eyelid eczema can resolve completely, and Dr. Hilal-Campo says it’s unlikely to come back.

Factors that affect the duration of eyelid dermatitis

As mentioned above, many factors can play a role in how long eyelid dermatitis lasts for people: how severe the condition is, if they’ve gotten treatment and how quickly, if the initial treatment helped, if they’re still exposed to the trigger—that sort of thing.

The type of eyelid dermatitis is another factor, though not a major one. According to Dr. Hilal-Campo, two types exist: irritant contact dermatitis and allergic contact dermatitis. “Typically, with treatment of either form, you’ll start to get some relief within two days,” she says.

Diagnosis is simple, Dr. Hilal-Campo adds, in which your eye care provider will look for symptoms (such as redness, inflammation, itching, and flaking skin) and prescribe medication. “I typically prescribe corticosteroids to relieve eyelid dermatitis, usually a topical ophthalmic ointment.”

Can eyelid dermatitis go away on its own?

Yes, eyelid dermatitis can go away on its own, but that doesn’t mean it’s the best route. Receiving medical attention from a healthcare provider is a good idea. 

“Eyelid dermatitis may go away on its own in some cases, but treatment is often needed to effectively manage and speed up the healing process,” Dr. Giyaur says. 

Dr. Hilal-Campo also “really would not recommend letting dermatitis go untreated. You only get one set of eyes, and any condition related to ocular health can escalate quickly and put you at risk.”

Dr. Giyaur lists some of the complications of untreated eyelid dermatitis, such as chronic eyelid discomfort; secondary infections; changes in the skin’s texture, color, and thickness; eyelash loss; cosmetic concerns such as redness, swelling, and scaling; vision changes (if the case is severe); and a psychological toll, including anxiety, depression, and reduced self-esteem.

“It’s crucial to seek prompt evaluation and appropriate treatment from a healthcare professional if you suspect eyelid dermatitis to prevent potential complications,” she urges.

Otherwise, Dr. Hilal-Campo says that no treatment or knowledge of the trigger substance can result in indefinite eye dermatitis.

When it comes to approaching treatment, however, eye doctors will first look at two factors, according to Dr. Giyaur: the underlying cause and the severity of the condition.

Can eyelid dermatitis come back?

Some unfortunate yet important news: If someone has eyelid dermatitis once, they may see it again. “It frequently is a recurring condition with waxing and waning symptoms that can last for years,” Dr. Giyaur says.

Dr. Hilal-Campo agrees, pointing primarily to the trigger substance. “If you have not isolated the irritant or allergen triggering your eyelid dermatitis and removed it from your lifestyle/routine, it can still cause dermatitis down the line,” she adds.

Unfortunately, several factors can cause eyelid contact dermatitis to keep flaring up, though Dr. Hilal-Campo says there’s a main reason. “Plain and simple, dermatitis tends to continue to flare up because the trigger has not been removed from your routine,” she says. People having difficulty identifying and avoiding the trigger are at a higher risk.

Dr. Giyaur lists other risk factors, such as allergic reactions to cosmetics or skin care products; climate changes; stress; underlying skin conditions; genetic predisposition; and inadequate treatment.

However, those tidbits don’t mean the condition is chronic, nor does they mean everyone has an equal chance of developing it. According to Dr. Hilal-Campo, those with a personal or family history of atopic conditions and sensitive skin have an increased risk.

At the same time, the two experts share lots of preventive measures that can decrease the chances it’ll pop up again (phew!). Without living in fear, keeping them in mind is a good idea.

How to prevent eyelid dermatitis

1. Identify and avoid physical triggers and allergens

What might have contributed to the case in the first place? “Take steps to avoid or minimize exposure to them,” Dr. Giyaur recommends, adding allergy management is crucial.

Common contributors include metals, shellac, preservatives, topical antibiotics, fragrances, acrylates, and surfactants, according to a 2021 study. Many of these allergens may be found in makeup, skincare products, and eyewear. More specifically, on the note of metals, a study in Dermatitis found gold was the most frequently encountered allergen. A number of products that are used on or around the eyelids contain gold. Dr. Mari Paz Castanedo Tardan, an assistant professor at the University of Michigan, noted the nickel in eyelash curlers and eyeglasses can also increase the risk.

2. Practice eyelid hygiene and moisturization

When looking through eye cleansers and moisturizers at the pharmacy, Dr. Giyaur suggests picking ones that are mild, hypoallergenic, and fragrance-free, then applying them gently. For the cleanser in particular, she says even baby shampoo will work.

While cleansers remove debris and external irritants, as well as reduce the risk of inflammation, moisturizers keep eyelids well-hydrated, she explains.

3. Avoid harsh cosmetic products

The same guidelines apply here. “Choose hypoallergenic and fragrance-free cosmetics for the eyes,” Dr. Giyaur says. She also advises removing eye makeup before sleeping. (It’s a lot to ask after a long night out, but it’s important!)

Further, Dr. Hilal-Campo encourages skincare and beauty products that are ophthalmologist-tested, safe for sensitive skin, and uncontaminated. “I’d recommend tossing all of your existing beauty products in case they are contaminated or contain allergens and starting from scratch,” she says.

4. Keep your hands away from your eyes

Especially with allergies or after a long night, it’s hard to avoid eye rubbing, but doing so does help. “Beyond avoiding the triggers that cause it to form in the first place, you’ll want to avoid touching or rubbing your eyes as much as possible, which causes irritation and inflammation,” Dr. Hilal-Campo notes. 

Can’t help it? She advises solid handwashing beforehand. 

5. Protect your eyes from the sun

Grab those sunglasses (just not ones with nickel or gold, as mentioned above). “Use sunglasses to shield your eyes and eyelids from UV radiation, as sun exposure can exacerbate dermatitis,” Dr. Giyaur says.

RELATED: Which medications increase sun sensitivity?

6. Be careful and hygienic with eye products

While eye drops are great for reducing irritation, dryness, and redness, they can surprisingly cause problems, too. “Occasionally, allergy to medicated eye drops, such as glaucoma drops, may cause severe dermatitis,” Dr. Giyaur says. To be safe, she urges bringing the eye drops to the eye doctor so they can ensure they’re okay to use (and how often and long they’re safe for).

Similar advice goes for contact lenses. For contact users, Dr. Giyaur encourages using proper hygiene and care guidelines. Additionally, she says to consider daily disposable lenses.

7. Talk to an eye doctor

Talking to a professional is a smart choice. “If eyelid dermatitis persists or recurs,” Dr. Giyaur says, “consult with your doctor for a thorough evaluation and tailored treatment plan.”