6 Causes of Rash Around the Eyes — And What to Do About Them
Key takeaways:
Rashes and red spots under and around the eye are common. Major causes of eyelid rashes are infections and allergies.
Eyelid rashes can lead to redness, itching, swelling, scaliness, and thickened skin around your eye.
Some under-eye rashes will go away on their own. But others need treatment with medication.
Your eyelids are fragile. At less than 1 mm thick, they’re the thinnest skin on your entire body. This makes your eyelids vulnerable to damage and irritation. If you have an eyelid rash due to damage or irritation, you may notice these symptoms:
Itching in the corner of your eyes
Red dots, spots, or bumps under or around the eyes
Redness under or around the eyes
Dry patches or flakiness under or around the eyes
No matter how careful you are with skin protection, eyelid rashes are often unavoidable. Let’s take a look at the top six causes of under-eye rashes and what you can do to treat these common eyelid rashes.
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1. Dermatitis
Dermatitis means inflammation of the skin. Eyelid dermatitis is inflammation of the eyelid. It causes a red, scaly rash under or around the eye. Anything that irritates the eyelid can cause dermatitis. Because your eyelid is so thin and fragile, it doesn’t take much to irritate the skin.
Some common things that can set off eyelid dermatitis include:
Makeup
Soaps, laundry detergent, and facial cleansers
Perfumes and fragrances
Eye drops (like dorzolamide)
Tissues
Makeup sponges and brushes
If you have a new eyelid rash, take a close look at what products you’re using near and around your eye. Even if you’ve never had a problem with these products before, they might still be the cause of your rash. That’s because you can develop a mild allergy to these products over time.
2. Infections
Some infections can lead to a rash under or around your eyelid. Viruses and bacteria can all cause eyelid rashes. Your eye is a very vulnerable part of your body. Any infection near your eye needs to be checked by a healthcare professional, such as an eye doctor, right away.
An eye infection you never want to miss is eye shingles. Shingles, which is caused by the varicella virus, can also cause a rash near your eyelid. This is called herpes zoster ophthalmicus. Shingles near the eye can lead to serious eye injury. Eyelid shingles is red, bumpy, and painful.
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Another serious eyelid infection is preseptal cellulitis. Preseptal cellulitis is a bacterial infection under or around the eyelid. It causes the eyelid to become red and swollen. Preseptal cellulitis can be painful and make it harder for you to open your eyelid.
3. Allergic reactions
Allergic reactions can lead to a rash around the eye. The sap in poison ivy, poison oak, and sumac contains a chemical called urushiol. If you come in contact with urushiol you can develop a red, itchy rash. People sometimes touch these plants and transfer the sap to other parts of their body by touching their face or rubbing their eyes.
If you think you’ve come in contact with one of these plants and now have a rash around your eye, see a healthcare professional. You may need treatment with steroids to help calm the allergic reaction. Avoid scratching and rubbing your eyelid because this can lead to infections.
4. Autoimmune conditions
Autoimmune conditions like lupus and dermatomyositis can cause a rash around your eye. They’re often a sign of a flare. Often, these rashes are purple or violet and develop around both eyes. They’re not always painful or itchy. People usually experience other symptoms, like muscle weakness, joint aches, and night sweats.
People with skin conditions like eczema can also develop flares around their eyes. An eyelid eczema flare looks like a regular eczema flare. It’s often red, dry, and itchy.
5. Blepharitis
Blepharitis is another type of eyelid inflammation, but this type is caused by bacteria. Bacteria that normally live on your eyelids can clog the oil glands in your eyelid. This leads to eyelid dryness and flaking, eye redness, and feeling like you have something stuck in your eye.
Blepharitis can lead to other eye conditions including dry eye and styes.
6. Xanthelasma
Xanthelasma are yellow bumps that can develop on the eyelids. They’re made up of fat particles that collect under the skin. They are not harmful, but they can be a sign of high cholesterol. If you have these bumps, it’s a good idea to get your cholesterol checked. Xanthelasmas can be removed using laser surgery.
How do you treat rashes around the eyes?
It depends on what’s causing the rash around your eyes.
If you have eyelid dermatitis or mild eyelid eczema, at-home treatments can help relieve your symptoms. A cool compress and petrolatum-based barrier cream (like Aquaphor or Vaseline) can help soothe the skin. More serious dermatitis and eyelid eczema often needs treatment with prescription medications like steroid ointments and calcineurin inhibitors like pimecrolimus (Elidel) and tacrolimus (Protopic).
Meanwhile, warm compresses and eyelid scrubs can help ease eyelid rashes from blepharitis. If these don’t help, there’s also prescription treatments for blepharitis including antibiotic ointments and Xdemvy.
Eyelid infections always need immediate medical attention and treatment. Shingles around the eye needs to be treated with acyclovir or valacyclovir as soon as possible. Preseptal cellulitis
needs immediate treatment with antibiotics. These medications can be given by mouth, but people with more severe infections may need treatment in the hospital with intravenous (IV) medication.
How serious is a rash around the eyes?
Rashes around your eye can be a sign of a serious infection or illness. It’s always a good idea to see an optometrist or ophthalmologist as soon as possible if you have a rash under or around your eye. If you don’t have an eye doctor, you can see your primary care provider, too. But it’s best to see an eye doctor if you have any other eye symptoms — like pain or vision changes.
How can I prevent a rash on the eyelid?
There are many things you can do prevent eyelid rashes like:
Using sunscreen with at least 30 SPF
Wearing UV protective sunglasses when outdoors
Avoiding rubbing, scratching, and touching your eyelids
Always washing your hands before touching your eyes and removing contact lenses
Using eyelid scrubs if you’re prone to blepharitis
Choosing facial products and cosmetics that are hypoallergenic
The bottom line
Because your eyelids are very thin and sensitive, they are more likely to become damaged and irritated. This damage can show up as a rash on your eyelids. Eyelid rashes can be caused by anything from an allergy to eye makeup to a flare of an autoimmune condition. And most rashes under or around the eye need treatment.
If you have an eyelid rash, it’s a good idea to see your healthcare professional. They can help you figure out the best treatment for you. You can also prevent eyelid rashes by using sun protection and opting for hypoallergenic cosmetics and skin care products.
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References
Fonacier, L., et al. (2016). Contact dermatitis. Pediatric Allergy: Principles and Practice.
Homer, N. (2023). Dermatomyositis. American Academy of Ophthalmology.
Lee, S. J., et al. (2015). Allergic contact dermatitis caused by dorzolamide eyedrops. Clinical Ophthalmology.
MedlinePlus. (2023). Poison ivy – oak – sumac.
Murphy, P. B., et al. (2023). Allergic contact dermatitis. StatPearls.
National Eczema Society. (n.d.). Eczema around the eyes.
National Eye Institute. (2023). Blepharitis.
Porter, D. (2021). What is xanthelasma? American Academy of Ophthalmology.
