Name: Blepharitis
Creator: Dr Karen Martin
Published: 2023-02-22T16:42:12.814Z

You are fit for work if you have blepharitis. 

Am I fit for work?

If your symptoms don't get better within 2 weeks or are recurrent, you should see your doctor or optometrist. 

When should I see my doctor?

General cleansing of the eyelids with cotton balls and warm wet washcloths can help. Eye care, which should be performed twice daily, is key to blepharitis treatment. Start with 5 to 10 minutes of warm compress on closed eyelids, then clean the eyelid gently with a cloth or cotton ball, wiping along the lid margins in the direction of the lashes to help remove any pore-blocking dried oil deposits. Avoid wearing eye makeup or contact lenses while you're in a flare-up. 

How can I improve symptoms?

Zenoptiq Eyelid & Eyelash Cleanser (100ml)

Systane Lid Wipes Eyelid Cleansing Wipes (30 count)

Bausch + Lomb Soothe Lubricant Eye Ointment Night Time 0.13 oz (3.5 g)

GenTeal Tears Severe Night-Time Lubricant Eye Ointment, 0.12 fl oz (3.5g) 

A cleansing solution such as Blephasol preservative-free eyelid cleansing solution can provide daily hygiene of sensitive eyelids caused by blepharitis. It can be used to clear debris, particularly near the edge of the eyelids between the eyelashes and the surface of the eye. It is free from alcohol, detergents, or preservatives and is non-greasy and non-irritant, so good for sensitive eyes. It can also be used daily as an eye makeup remover and is safe for contact lens wearers. 

Eye baths can help to wash any debris away and soothe the eye. Eye ointments, gels, or sprays may also help to moisturize the eyelids to prevent drying and flaking along the eyelashes, especially when sufferers are in a dry environment such as working in areas with air conditioning or fans. 

Healthwords pharmacists' top tips

Viscotears are used to relieve symptoms of dry eyes. They are formulated as liquid gel eye drops. They come in either a tube or as single-dose units to be disposed of after each use. This product is not available in the US. Your pharmacist can help you choose an appropriate alternative.

[Dry eyes](https://www.healthwords.ai/us/article/dry-eyes!79b1a9e8-27c0-46b5-b54f-c424938108a7) are very common, and most people will likely have suffered from the symptoms at some point in their life. Symptoms can include your eyes feeling dry, tired, gritty, and painful. Blurred vision and eye redness can also occur. Older age, tiredness, weather conditions, certain medications, and wearing contact lenses can make dry eye symptoms more common. Also, if you have certain medical conditions such as [allergies](https://www.healthwords.ai/us/article/allergic-rhinitis!b7310dec-ab06-43a5-83fc-67929bf2bf4c), [blepharitis](https://www.healthwords.ai/us/article/blepharitis!b48bf4e9-b61c-40f3-b021-c9a8fc08f872), [rosacea](https://www.healthwords.ai/us/article/rosacea!46e2bec6-793e-4a7a-9d5d-011cb6b7fd73), or Sjogren's syndrome, dry eyes can be linked to these.

Infections can affect different eye parts, causing a so-called red eye. The conjunctiva – the pink rim if you pull down your lower lid – is the most common site of infection, called conjunctivitis. This usually affects both eyes and goes alongside viral respiratory infections causing cold symptoms. Children may be more prone to bacterial conjunctivitis. You might get a clear, yellow, or green discharge which might cause blurring of the vision until they’re cleaned, and your eyes may be crusty and stuck together upon waking. The usual whites of the eyes look pink, the pink rim looks red, and it looks a bit red and swollen around the eyes. It’s not usually very painful. 

A stye is a mild bacterial infection of glands on your lashline, causing a painful red pimple on your upper or lower eyelid. This does not usually need treatment and improves after a few days. 

Other infections are more likely to affect one eye and may be more serious. Keratitis affects the cornea, the glass-like coating of your eye, which may come from bacteria, viruses, or parasites in tap water, and contact lens wearers are at particular risk. 

You may get the appearance of red-eye, pain, and watering for reasons other than infection, such as uveitis or glaucoma, which require urgent medical assessment. Allergy can cause a similar red eye, but it’s more likely to feel itchy, and both eyes are affected, usually with lots of watering and a gritty or burning feeling.

Conjunctivitis is an infection of the eye by either a virus or bacteria. The conjunctiva is the pink rim that you can see if you pull down your lower lid, and it extends onto the white of your eye. It’s an area that often gets infected in children and is usually linked to a common viral cold. Children may get a bacterial infection on its own, usually starting in one eye then spreading. 

Conjunctivitis has a number of possible symptoms, but one eye normally starts to become affected before the other. The eye looks red and swollen and this redness extends onto the eyelids as well as the white of the eye. There is often a discharge (sometimes greenish in color) around the eyelids and this is worse on waking – the eyes may seem to be ‘stuck down’ with matter. Itching and pain on rubbing the eyes is also common, with sufferers often saying their eyes feel ‘gritty’, and occasionally bright light may make all these symptoms worse. 

Allergic conjunctivitis is in response to an allergen – commonly pollen alongside other hay fever symptoms – but also any face creams, hair dyes, nail varnish, pet dander or anything in the environment that your eyes have become sensitive to. The eyes are usually profusely watery, puffy around them and they may feel a bit gritty. You may also get a runny nose or hives on other parts of the body. Treatment may help, such as antihistamine eye drops or tablets, but it’s usually mild and improves on its own within a day or two – quicker if you remove the suspected allergen. 

Cuts, scrapes, and grazes are common, especially in children. But anyone can injure themselves, so it's a good idea to know what to do if you're nearby and when you should worry. Let's talk you through it.

We've assumed in this article that you know the person you're treating, but if you're a bystander and helping a stranger, contact with blood carries the risk of disease. We would advise caution in this case, wearing single-use gloves if available or helping them to a medical facility instead. This article is also only suitable for treating non-[superficial cuts](https://www.healthwords.ai/us/article/superficial-cuts!babff8aa-5836-4b3c-ad4b-30dc8431104b)[.](https://www.healthwords.ai/article/superficial-cuts!e322e3b3-49db-4e28-a6be-6845a1bb4dba)

Rosacea is a common condition that causes redness on the cheeks and across the nose, and is sometimes accompanied by more persistent red bumps, known as papules or pustules if they have a yellow center. Its full name is actually acne rosacea. Episodes of flushing may precede a more persistent redness.

Certain triggers are thought to cause blood vessels just under the skin to widen, becoming more visible and causing the redness, but the underlying cause is not well understood. It is common in those aged 30 to 60, and in fair-skinned/blue-eyed people. The exact cause remains unknown, but triggers for its development include sun damage, leaky tiny blood vessels under the skin, a skin mite called Demodex folliculorum, and a family history of rosacea. It is not contagious, so you cannot catch it from someone else.

Symptoms of dry eyes may include:

1. **Dryness**: A sensation of dryness or grittiness in the eyes is a hallmark symptom of dry eyes. This can be accompanied by a feeling of irritation or discomfort.

2. **Redness**: The eyes may appear red or bloodshot, particularly when they become irritated due to dryness.

3. **Burning or stinging**: Some individuals with dry eyes may experience a burning or stinging sensation in the eyes, especially in environments with low humidity or when exposed to irritants such as smoke or wind.

4. **Blurry vision**: Dry eyes can cause temporary fluctuations in vision, leading to blurry or fluctuating vision, particularly during activities that require prolonged visual concentration, such as reading or using a computer.

5. **Sensitivity to light**: Dry eyes may increase sensitivity to light, making it uncomfortable to be in brightly lit environments.

6. **Watery eyes**: Paradoxically, some people with dry eyes may experience excessive tearing as the eyes attempt to compensate for the lack of adequate lubrication.

Several factors can contribute to the development of dry eyes, including:

- **Ageing**: Dry eyes are more common as people age, as tear production tends to decrease with age.
- **Environmental factors**: Exposure to dry or windy climates, air conditioning, heating, and smoke can exacerbate dry eye symptoms.
- **Medical conditions**: Certain medical conditions, such as autoimmune diseases (e.g., Sjögren's syndrome, rheumatoid arthritis), hormonal changes (e.g., menopause), and eyelid abnormalities, can increase the risk of dry eyes.
- **Medications**: Certain medications, including antihistamines, decongestants, antidepressants, and hormonal therapies, can reduce tear production or affect tear composition, leading to dry eyes.
- **Prolonged screen time**: Extended use of digital devices can contribute to dry eyes due to reduced blinking and increased tear evaporation.
- **Contact lens wear**: Contact lens use can exacerbate dry eye symptoms, particularly if lenses are worn for extended periods or if proper hygiene practices are not followed.

Dermatitis (sometimes also called eczema) simply means inflammation of the skin, and so contact dermatitis is the name used when this inflammation is caused by direct or indirect contact of the skin with something in your environment that it reacts to.

## What causes contact dermatitis?

There are two main types of contact dermatitis:

- **Irritant contact dermatitis.** This type develops when the skin comes into contact with things that irritate the skin, such as detergents or very hot water that strip the skin of its natural oils and so dry it out. If you have regular contact with these you can then get an irritant dermatitis. This means it’s common in people who put their hands in water a lot, such as nurses, hairdressers, and cleaners. This type of contact dermatitis is more likely to happen in people who have suffered from childhood eczema.

- **Allergic contact dermatitis.** This type occurs when you develop an allergy to a specific substance that’s been in contact with your skin. Common examples of these include hair dye, cosmetics, and perfumes. It’s unclear why some people who are exposed to these develop dermatitis while others don’t but unlike irritant dermatitis, contact dermatitis doesn’t seem to be more likely in people who had eczema when young.

## What are the symptoms of contact dermatitis?

The commonest symptom is itching of the skin, and this can be very intense and to a level where you can’t stop scratching it. The skin can also become sore and red, with blisters developing that can weep. In contact dermatitis of the hands, there may be painful cracking of the skin that can make it difficult to use your hands normally. The hands are the commonest area where contact dermatitis occurs, followed by the arms, neck and face.

Dr Kandi - Contact dermatitis

An ectropion happens when the lower eyelid sags away from your eye, leaving the inner surface of the eyelid exposed. It can happen in one eye or both eyes.

When the lower eyelid droops away from the eye, it can affect the ability of teardrops to drain properly. This can cause the eye to water excessively, as well as feel dry and gritty. The eyes can also become red, sore, and inflamed, and this makes the eye more vulnerable to infections such as conjunctivitis.

In severe untreated cases, it's possible to develop a corneal ulcer (a sore on the eye's surface) that could affect your vision. But this is rare. An ectropion is different from an entropion, which is where the eyelid turns inwards, towards the eye.

If you have dark brown or black lumps, tiny in size and multiple in number, sitting on the cheekbones and under the eyes, it’s likely you have dermatosis papulosa nigra. Despite the grand title, these are completely harmless. 

These usually feel smooth and soft and are each only 1 to 5 mm wide, and you may have a few or many, of differing sizes. They appear from the teenage years onwards and don't usually cause any symptoms, but some find them unsightly, especially with their prominence on the face. 

Brolene eye drops are antibiotic eye drops used for minor bacterial eye infections causing conjunctivitis, but are not available over-the-counter in the US. The pharmacist may suggest an alternative eye treatment that may be more appropriate than Brolene. Depending on your symptoms, other causes of eye infections (viral and fungal) can have very similar symptoms but cannot be treated with antibiotic eye drops.

Xailin Night is an eye ointment for treating [dry eye](https://www.healthwords.ai/us/article/dry-eyes!79b1a9e8-27c0-46b5-b54f-c424938108a7) conditions, corneal erosion, and lubricating the eyes before or after eye surgery. It contains paraffin and wool alcohols (lanolin) which all serve to lubricate and protect water loss from the eyes. This, in turn, relieves symptoms of dry eyes and forms a protective barrier on the surface of the eye.

Hypromellose eye drops are used to relieve symptoms of [dry eyes](https://www.healthwords.ai/us/article/dry-eyes!79b1a9e8-27c0-46b5-b54f-c424938108a7). They are often described as artificial tears used to moisturize and soothe the eyes' surface. They can be useful when you either don’t produce enough natural tears or when your eyes are drying out too fast, causing discomfort. Adults and children can use them; however, it is recommended that you speak to your pharmacist or doctor before using them in children. Some formulations contain preservatives that may irritate. If this is the case, preservative-free formulations are also available.

Chloramphenicol is a broad-spectrum antibiotic that works against a wide variety of bacteria and is used to treat minor bacterial eye infections. The eye drops can be used in children and adults and must be prescribed by your doctor. In some cases, your doctor may prescribe an alternative eye treatment that could be more appropriate than chloramphenicol. Viral and fungal eye infections can cause very similar symptoms but need different treatments. Due to the frequency that the eye drops need to be applied, using them at night is not advised; therefore, the doctor may also prescribe chloramphenicol eye ointment for use at night.

A stye is a tiny painful lump caused by bacteria, commonly *Staphylococcus aureus*, which resides on the skin and can enter the oil glands in the eyelids through small openings or breaks. Factors contributing to the development of styes include poor eyelid hygiene, touching the eyes with unwashed hands, and using expired or contaminated eye makeup.

It can look like a little pimple – red or with a white/yellow center and can cause lots of red inflammation and swelling around it. It may cause your eyes to water, but it should not affect your vision.

It does not usually require treatment and gets better on its own after a week or two. You can relieve the pain and swelling with a cool washcloth, and you can keep the area clean and encourage any discharge out with a warm compress – soak a washcloth with warm water and press against the eye for 5 minutes three or four times a day.

A blister occurs when fluid collects in a pocket between two of the upper layers of the skin. It's very common and most often a result of friction such as shoes rubbing on the skin of your heel. The fluid that fills a blister is serum, the liquid part of blood. 

There can be other causes for blisters, such as a burn, abrasive substances, and sometimes viruses or medical conditions can cause blistering. 

Blisters should go away within seven days and the majority can be treated at home. Blisters caused by friction or heat or toxic substances are not contagious. Blisters caused by some viral infections (such as impetigo, herpes, shingles and chickenpox) can be contagious. 

Blisters on the feet are the most common type of blister and there are a number of reasons why these typically form: 

- Poorly fitting shoes that rub your feet 

- Wearing high heels that put pressure onto one part of the foot 

- Wearing shoes with no socks, or wearing socks that are too large and have wrinkles in them 

- Having hot or sweaty feet 

Head lice (nits): signs, tips and treatments

Head lice, also known as nits, are tiny insects that live on human hair and feed on the scalp. They are very common in young school children and their families and there is no link between head lice and unwashed/dirty hair. The eggs laid by the head lice are what’s known as nits, they stick to the hair and hatch after 7 - 10 days.

Head lice produce symptoms of an itchy scalp and sometimes a feeling of something moving in your hair. The only way to diagnose them is to find a live head louse (it will look black and the size of a sesame seed) by combing the hair with a head lice detection comb which you can get from here at Healthwords or any regular pharmacy. They like to live close to the scalp and cannot survive for very long away from hair.

Dr Kandi - Head lice

Milia (milk spots): causes and treatments

Milia is a condition described by tiny pearly-white bumps on the skin under the eyes. These are little cysts (or sacks) containing a hard semi-solid protein called keratin.

There may be one, two, or a few, and they usually cause no symptoms except that people become self-conscious about their appearance. They are entirely harmless, they need no treatment, and most disappear within a few months (although new ones may form in time).

## What causes milia?

In adults, these may form in response to recent [sunburn](https://www.healthwords.ai/us/article/sunburn!9902e7f5-5d08-4ce9-91a8-78e1e5a8afed) or from skin damage, such as from [burns](https://www.healthwords.ai/us/article/burns!22591115-32c3-49fb-ba7c-ca365c2b4a40) or unusual skin conditions. They appear in up to half of newborn babies, appearing around the eyes, nose, and across the cheeks and clearing up a short while later.

Dr Kandi - Milia

Scabies is an infection from a mite that produces an itch like no other - you (and family members) will be furiously scratching, especially at night. The mite (fancy name: Sarcoptes scabiei var. hominis) burrows under your skin, causing very subtle, but characteristic gray "track marks" towards a more defined skin mark.

The skin mark may be a tiny red bump (a papule) or may appear as a fluid-filled blister or a pus-filled bump (a pustule). The mite's favorite hide-outs include the webs between fingers, palms, wrists, forearms, chest and breasts, and genitals.

Preventing insect bites while traveling is always at the front of people’s minds, especially when traveling to far-flung corners of the earth. But what is the best way to do it? Are certain products better than others? In this article, Healthwords expert travel pharmacists will explain everything you need to know to help you be fully informed and put your mind at ease!

The reality is that some mosquitos carry severe diseases, so rather than an annoyance while on holiday in Ibiza – it may be a medical imperative that you do everything to avoid receiving a bite. Because different mosquitos carry different diseases, and they all fly at varying times of day in some areas, it may be necessary to use insect repellents day and night. Insect repellents have been around for nearly a century, and the most effective of these is the product DEET (the active ingredient in most common repellent products). Other products include picaridin and oil of lemon eucalyptus.

Molluscum contagiosum are small protruding, smooth, shiny bumps, often flesh-colored or pink/red, and distinguished by the dip in the center of their tip.

If squeezed (and we advise not), a semi-solid substance may ooze out. This is not recommended as this liquid contains the molluscum virus that causes the bumps, and as these are highly contagious, squeezing risks spreading to other parts of the body or gifting to friends and loved ones.

Molluscum is common and usually seen in children. It causes no harm, but parents or sufferers may be bothered by the appearance, and occasionally, a molluscum may become itchy and irritated, or even infected with bacteria.

Bedbugs are tiny insects that cause an intense itch and can be troublesome to get rid of as they live in clothing, bedding, mattresses, and any other soft furnishings at home. They feed on blood to survive, and when they bite, they inject a local anesthetic that numbs the area so you won't feel it. It's this that causes the irritation. 

They're a real nuisance, but they don't carry specific diseases to pose a threat to your health. 

Infestations range from light, with a couple of bites in a week, to heavy, with 40 or 50 bites in a night. More severe infestations are likely to need pest control to decontaminate your home. 

A bursa is a small fluid-filled sac that is located near the joints and acts as a cushion for the bones, muscles, and tendons. When a bursa becomes inflamed, the condition is called bursitis – and it leads to a red, swollen, painful, and stiff joint. This is commonly diagnosed based on history and examination alone, and no further investigation is usually needed.

Commonly this inflammation occurs in the elbows, knees, shoulders, and hips, but you can suffer bursitis in any joint area of the body. Bursitis can be managed at home and usually subsides within a few weeks, but it can reoccur again in the future.

Head lice are tiny insects that live on human hair and feed on the scalp. They are very common in young school children and their families, and there is no link between head lice and unwashed/dirty hair. The eggs laid by the head lice are what are known as nits. They stick to the hair and hatch after 7 - 10 days. Head lice produce symptoms of an itchy scalp and sometimes a feeling of something moving in your hair. 

The only way to diagnose them is to find a live head louse (it will look black and the size of a sesame seed) by combing the hair with a head lice detection comb which you can get from the pharmacy. They like to live close to the scalp and cannot survive for very long away from hair.

Head lice can be treated at home and should be treated as soon as they have been detected.

The best way to treat them is wet combing with a special head lice detection comb. You need to do this every 4 days for 2 weeks to make sure you catch any recently hatched lice (some doctors would advise combing for 3 weeks to be 100% sure you're clear of the critters!). 

Wash the hair and then apply a generous amount of conditioner (you can also use olive oil). Leave the conditioner in as you brush the hair with a normal hairbrush to get out the knots, and then use the head lice detection comb, combing from the scalp to the end of the tips of the hair. Check each brushstroke for head lice or nits (tiny black insects or white/brown eggs) and wipe or wash them off the comb if you see any. Do this for all sections of the hair. Wash out the conditioner, then comb one more time through.

If after 2 - 3 weeks of wet combing, there are still head lice detected, then seek guidance from your pharmacist, who can recommend certain lotions/sprays that can kill the head lice. Some of these need to be repeated or paired with combing to remove the dead lice/eggs.

Dry combing can be used to detect head lice in hair but not for treating them.

Uveitis is when part of the eye suddenly becomes inflamed, giving you a very painful, red eye. You might also experience discomfort in bright light (photophobia), blurring, or reduced vision. It's important to seek help and get this treated promptly, as severe cases can lead to a loss of sight.

Uveitis affects the middle layer of the eyeball, including the iris, which gives your eye its unique color, a muscle behind the iris called the ciliary body, and a layer called the choroid.

Most cases of uveitis affect just one eye, but it can affect the other later on. Most cases are acute, meaning it comes on suddenly, and lasts for a few days, although it can be a few weeks. Some people get repeated episodes, and others have an ongoing inflammation, known as chronic uveitis, which is defined as lasting more than six months.

Uveitis can come out of the blue, and we don't know what has caused it. An autoimmune process may be behind it, where your body attacks certain parts of itself, and this may go along with certain other conditions. Other triggers include an eye infection or injury. If you wear contact lenses, you should switch to your glasses as soon as possible. Sunglasses may make you feel more comfortable when in daylight.

Uveitis puts you at a higher risk of developing [glaucoma](https://www.healthwords.ai/us/article/glaucoma!d27252bc-e853-417e-8978-981850a5f08a) or [cataracts](https://www.healthwords.ai/us/article/cataracts!dccd86ac-1b27-4b87-a3a1-e45e5c81e5fd) in the long term, so make sure you get regular eye checks.

Dr Karen Martin

Pharmacist and Head of US Content

Blepharitis is a common and treatable inflammation of the inner rim of the eyelid, usually affecting both eyes. Irritation, itching, burning, excessive tears, and crusty debris or skin flakes around the eyelashes may occur. 

You may also have redness around the eyes and missing eyelashes. Common causes are bacterial eyelid infections, meibomian gland dysfunction, dry eyes, fungal eyelid infections, and parasites. Blepharitis can be a recurrent or chronic problem, and patients often have other associated skin conditions, such as rosacea and dandruff. Blepharitis is not contagious. 

Blepharitis

Doctor’s advice

How can I improve symptoms?

Healthwords pharmacists' top tips

Pharmacist recommended products

Am I fit for work?

When should I see my doctor?

Related topics

Viscotears

Eye infection

Conjunctivitis

What to do if someone’s bleeding

Rosacea

Dry eyes

Contact Dermatitis

Ectropion (eyelid)

Black dots under the eyes

Brolene eye drops

Xailin Night eye ointment

Hypromellose eye drops

Chloramphenicol eye drops

Stye

Blisters

Head lice (nits): signs, tips and treatments

Milia (milk spots): causes and treatments

Scabies

Preventing insect bites while traveling

Molluscum

Bedbugs

Bursitis

Nits

Uveitis