Key takeaways:
Blepharitis is a painful and irritating eye condition that causes inflammation of the eyelid’s edges.
Bacteria, mites, and eyelid dandruff can trigger a blepharitis flare, causing eyelid redness, irritation, and swelling.
Cosmetics, smoke, and contact lenses can also aggravate blepharitis and lead to a flare.
Blepharitis is an eye condition that causes inflammation along the eyelid. During a blepharitis flare up, you may have eyelid redness, swelling, itching, and burning. Blepharitis can cause intermittent blurred vision. It can be uncomfortable and make you more likely to develop other eye problems, like styes, chalazions, and cornea damage.
There are treatments for blepharitis that can calm inflammation and relieve your symptoms. But staying away from things that can aggravate blepharitis can keep a blepharitis flare from starting in the first place. Here are eight triggers that can make blepharitis act up.
1. Bacteria
Skin bacteria can cause a blepharitis flare. Staphylococcus, Corynebacterium, and Cutibacterium are types of bacteria that live on the skin, including the skin over the eyelids. These bacteria can cause blepharitis to act up by triggering an inflammatory response from the immune system. This causes redness, swelling, burning, and pain.
These bacteria can also damage the meibomian glands, the glands on the eyelid that make tears. Damaged glands aren’t able to make tears with enough sebum (oils) to keep the eye lubricated. This creates an environment that makes it easier for bacteria to grow, causing a vicious cycle of inflammation and ongoing bacterial growth.
Everyone has these bacteria on their skin, including on their eyelids. But not everyone develops blepharitis. It's not clear why some people develop blepharitis from skin bacteria while others don’t. But there’s some evidence that the amount of bacteria on people’s skin may play a role. In studies, people with more bacteria on their eyelids had a higher chance of developing blepharitis.
Antibiotic eye ointment can help treat cases of blepharitis that are triggered by bacteria.
2. Eyelash mites
Eyelash mites are tiny insects that are so small they can only be seen with a microscope. They live on people’s faces and especially along eyelashes, eyebrows, and facial hair. There are two types of eyelash mites: Demodex folliculorum and Demodex brevis.
Demodex folliculorum lives on the eyelash hair follicles and eats skin cells. This can cause direct damage to the eyelid, triggering a blepharitis flare. Demodex brevis lives along the inner part of the eyelid on the meibomian glands. Demodex brevis eats the sebum made by meibomian glands, so tears contain less oil. This creates a situation where people are more vulnerable to developing blepharitis from other triggers.
There’s also evidence that Demodex mites themselves can trigger the immune system. This can also lead to a blepharitis flare.
Best treatments for blepharitis: From home remedies to prescription medications, our experts review blepharitis treatment options.
Eyelid scrubs for blepharitis: Learn why eyelid scrubs are an important part of blepharitis care, and how to do them at home.
Have more questions? Our blepharitis guide has the information you’re looking for.
But scientists haven’t quite figured out the relationship between Demodex and blepharitis. In studies, there was no relationship between the numbers of Demodex on a person’s eyelids and their likelihood of experiencing blepharitis.
So, while it’s clear how these mites can trigger a flare, scientists still don’t know why Demodex mites cause blepharitis to act up in some people, but not others.
Blepharitis from Demodex infections was often treated with a combination of treatments, including tree tea oil. But, in 2023, the FDA approved the first medication that specifically treats Demodex blepharitis. In studies, 50% of people treated with Xdemvy (lotilaner ophthalmic solution 0.25%) had significant improvement or even resolution of their symptoms.
3. Eyelid dandruff (seborrheic dermatitis)
Seborrheic dermatitis — also known as dandruff — is best known for causing an itchy, flaky scalp. But you can develop dandruff anywhere you have lots of oil glands on your skin, like your eyelids.
People with eyelid dandruff are more likely to develop blepharitis for several reasons. First, the eyelid dandruff itself can trigger inflammation. Also, eyelid dandruff can make you more susceptible to blepharitis from other causes because it leads to a buildup of skin cells that can block oil glands and affect tear production. The buildup of skin cells also creates a fertile feeding ground for mites and encourages bacterial growth. So, people with eyelid dandruff often have several causes for their blepharitis flare.
Any skin condition that increases skin cell buildup along the eyelashes can also trigger blepharitis, not just seborrheic dermatitis. Rosacea, eczema, and psoriasis are all known to cause blepharitis to act up.
Treatment for eyelid dandruff includes daily eyelid scrubs and warm compresses. Treating rosacea, eczema, or psoriasis can also help improve blepharitis.
4. Dry eye
Dry eye is a complex medical condition that develops when there aren’t enough tears — or the improper consistency of tears — to lubricate the eye. This can happen when people don’t make enough tears, or when they make tears that don’t contain enough oil.
Unlike other triggers, dry eye flare-ups don't directly cause blepharitis. But the two conditions often occur together since both are triggered by damage to the meibomian glands, which make the oily substance found in tears. Treatments for dry eye may also help relieve blepharitis symptoms and keep flares from coming back.
5. Cosmetics
Cosmetics that come in contact with the eyelids can trigger a blepharitis flare. This includes:
Eyeshadow
Mascara
False eyelashes
There are a few ways that cosmetics can cause blepharitis to act up:
Bacteria on makeup applicators: Over time, bacteria can build up on applicators and then transfer to the eyelids when you apply a cosmetic. This can increase the amount of bacteria that lives on your eyelid, which can trigger a blepharitis flare.
Contact dermatitis: The cosmetics themselves can trigger blepharitis and lead to a condition called contact dermatitis. Contact dermatitis is a type of allergy that develops when something touches your skin and triggers inflammation. You can develop contact dermatitis over time. This means that even if you've been using a product for weeks or months without any problems, you can suddenly develop an allergy to it.
Treatment for blepharitis caused by contact dermatitis includes warm compresses, eyelid scrubs, and staying away from products that trigger blepharitis. Experts also recommend avoiding placing eye makeup directly on the waterline. It’s also a good idea to avoid using expired eye makeup.
6. Smoke
Smoke exposure, especially ongoing cigarette smoke exposure, is linked to blepharitis. It's not clear whether smoke directly causes blepharitis or only makes people more prone to developing it.
There’s some evidence that people who smoke are more likely to develop problems with their meibomian glands, which can then lead to blepharitis. There’s stronger evidence linking smoking to the development of dry eye syndrome. So, it's possible that smoking triggers dry eye syndrome, which then makes people more vulnerable to blepharitis.
7. Retinoids
Retinoids are a class of medication used to treat acne and other skin conditions. They’re also used to prevent wrinkles and other signs of skin aging and damage. Retinoids come as creams, lotions, and gels that are applied directly to the skin. There's also a form of retinoids called isotretinoin (Accutane) that you take by mouth.
Retinoids can damage the meibomian glands which can lead to blepharitis or dry eye. In some studies, 25% to 50% of people who use retinoids experienced either dry eye symptoms, blepharitis symptoms, or both. Although symptoms are more common among people who take oral retinoids, they can happen in people using creams and lotions, too.
Treatment for blepharitis triggered by retinoids includes switching to a different type of medication to treat acne or other skin concerns.
8. Allergies
Allergic conjunctivitis (eye allergies) can also trigger blepharitis. People with eye allergies develop inflammation along the eye surface whenever they’re exposed to allergens, like pollen or dust. This can also trigger inflammation around the eyelid and cause blepharitis symptoms.
Treatment for blepharitis caused by eye allergies includes warm compresses and allergy medications, which can reduce symptoms of eye allergies.
Frequently asked questions
Many things can trigger blepharitis. Eye infections can increase the risk of developing blepharitis. Allergic reactions to eye makeup can also trigger blepharitis. You’re also more likely to develop blepharitis if you have certain skin conditions, like seborrheic dermatitis (dandruff).
Some people report that their blepharitis flares up when they eat certain foods. But there’s no clear evidence that any specific food can cause a blepharitis flare. Heavy alcohol use can trigger ocular rosacea and dry eye. These conditions can cause blepharitis-like symptoms.
There’s no cure for blepharitis, but there are ways to manage it and prevent flares. Using a warm eyelid compress and eyelid cleanser each day can help control symptoms. Prescription treatments, like Xdemvy, can also help.
Many things can trigger blepharitis. Eye infections can increase the risk of developing blepharitis. Allergic reactions to eye makeup can also trigger blepharitis. You’re also more likely to develop blepharitis if you have certain skin conditions, like seborrheic dermatitis (dandruff).
Some people report that their blepharitis flares up when they eat certain foods. But there’s no clear evidence that any specific food can cause a blepharitis flare. Heavy alcohol use can trigger ocular rosacea and dry eye. These conditions can cause blepharitis-like symptoms.
There’s no cure for blepharitis, but there are ways to manage it and prevent flares. Using a warm eyelid compress and eyelid cleanser each day can help control symptoms. Prescription treatments, like Xdemvy, can also help.
The bottom line
Blepharitis is a medical condition that leads to eyelid inflammation, redness, itching, and discomfort. There are several things that can lead to a blepharitis flare, including bacteria, eyelid mites, eyelid dandruff, and smoke exposure. Retinoids, eye allergies, contact lenses, and cosmetics can also aggravate blepharitis. If you're prone to blepharitis, staying away from these triggers can prevent future flares and keep your eyelids symptom-free.
Why trust our experts?
References
Bergler-Czop, B., et al. (2016). Side effects of retinoid therapy on the quality of vision. Acta Pharmaceutica.
Eberhardt, M., et al. (2025). Blepharitis. StatPearls.
Fromstein, S. R., et al. (2018). Demodex blepharitis: Clinical perspectives. Clinical Optometry.
Jagadeesh, D., et al. (2025). Impact of definition of meibomian gland dysfunction on the frequency of MGD in dry eye disease from the DREAM study. Contact Lens and Anterior Eye.
Kemal, M., et al. (2005). The prevalence of Demodex folliculorum in blepharitis patients and the normal population. Ophthalmic Epidemiology.
McCulley, J. P., et al. (1986). Bacterial aspects of chronic blepharitis. Transactions of the Ophthalmological Societies of the United Kingdom.
National Eye Institute. (2024). Blepharitis. National Institutes of Health.
Rhee, M. K., et al. (2023). Demodex blepharitis: A comprehensive review of the disease, current management, and emerging therapies. Eye & Contact Lens: Science & Clinical Practice.
Tarsus Pharmaceuticals. (2023). Xdemvy (lotilaner ophthalmic solution) 0.25%, for topical ophthalmic use [package insert].
Vernon, S. A. (2019). Smoking and eye disease - An evidence based review. The Royal College of Ophthalmologists.
Wang, S., et al. (2016). Impact of chronic smoking on meibomian gland dysfunction. PloS One.
