• Seborrheic dermatitis can cause flaky, scaly, or oily skin around the eyes.
• Other types of dermatitis can affect the area around the eyes, so dermatologists will rule out other skin conditions when making a diagnosis.
• Treating seborrheic dermatitis around the eyes requires extra care, including gentle skin care practices, over-the-counter products, and prescription treatments.

Although seborrheic dermatitis most often affects the scalp, it can also be found on the face — including the eyelids. This condition can be irritating and embarrassing, but luckily, there are treatments to help manage it. Learning to recognize the signs of seborrheic dermatitis on the eyelid and how to treat it can help keep your skin clear and reduce your discomfort.

What Does Seborrheic Dermatitis on the Eyelid Look Like?

Seborrheic dermatitis mainly affects the scalp, face, and chest because these areas tend to have more sebaceous glands. These glands are responsible for making sebum, an oily substance that lubricates and protects the skin. However, when the sebaceous glands make too much sebum, it builds up, creating dandruff (white skin flakes) and scaly patches of skin.

Seborrheic dermatitis on the eyelids can appear as discolored, scaly skin or as a buildup of dandruff or oil along the eyelashes. You may also have dandruff or scales in your eyebrows. These symptoms are similar to another skin condition known as blepharitis. In fact, around two-thirds of people with anterior blepharitis — which affects the front layer of the eyelid — also have seborrheic dermatitis.

People with blepharitis may have a more significant buildup of oils along the eyelashes, as well as swelling, burning, and flaking of the eyelid skin.

How Is Seborrheic Dermatitis on the Eyelid Diagnosed?

Seborrheic dermatitis is usually diagnosed with a physical exam and medical history. Your doctor or dermatologist may make a diagnosis based on your symptoms and other information you provide.

During your physical exam, your doctor or dermatologist will look for more than seborrheic dermatitis symptoms on your eyelids. Other symptoms that can point them to a diagnosis include:

• Dandruff on the scalp, facial hair, or eyebrows
• Scaly, discolored skin
• Rashes in skin folds, including the armpits, groin, and under the breasts
• Areas of discolored plaques or thick skin on both sides of the face
• Inflamed hair follicles on the chest and cheeks
• Flower- or petal-shaped flaky patches of skin on the hairline or chest

Be sure to tell your doctor how long your symptoms have been occurring. Seborrheic dermatitis is a chronic condition, meaning it will come and go in flares and bouts of clear skin. This may help point your doctor or dermatologist to a correct diagnosis.

Differential Diagnosis

Seborrheic dermatitis often looks like other inflammatory skin conditions, including:

• Psoriasis
• Acne
• Contact dermatitis
• Atopic dermatitis (the most common type of eczema)
• Rosacea
• Eyelid dermatitis

Your doctor or dermatologist will consider all your symptoms when making a diagnosis. During a process called differential diagnosis, they’ll use some symptoms to rule out other conditions and confirm that you have seborrheic dermatitis. Telling your doctor about all your symptoms can help them make a correct diagnosis.

Because seborrheic dermatitis is a chronic condition, you’ll have periods of flare-ups and of clear skin. Other conditions last for weeks to months without clearing or may go away once triggers are removed. For example, other types of eyelid dermatitis look similar to seborrheic dermatitis. Allergic contact dermatitis develops when your immune system reacts to an allergen (a substance to which you’re allergic). The symptoms usually clear once exposure to the allergen stops. Most cases of eyelid dermatitis are thought to be due to contact, but it’s often difficult to identify the cause.

Substances that can trigger allergic contact dermatitis on the eyelids include:

• Eye makeup, such as eye shadow and mascara
• Hair dye
• Cleansers, soaps, and moisturizers
• False eyelashes
• Eye drops
• Contact lens solution
• Allergens such as pollen or dust mites
• Fragrances
• Nail polish (when eyelids are rubbed)

Irritant contact dermatitis develops when your skin touches an irritating substance, such as a harsh face wash or detergent. Both allergic and irritant contact dermatitis can cause discoloration, swelling, and itchiness of the eyelids.

To rule out contact dermatitis during diagnosis, your doctor or dermatologist may perform a patch test. During this test, they’ll place allergens on your skin and cover them with patches.

After 48 hours, you’ll return to your dermatologist’s office to have the patches removed. If your skin reacted to any of the allergens, your dermatologist can identify the cause.

You may have another follow-up appointment two to five days later because allergic reactions can take time to develop.

How Is Seborrheic Dermatitis on the Eyelid Treated?

Treatments for seborrheic dermatitis on the eyelid are similar to those used to treat it on the scalp. Take extra care when using topical treatments such as creams, foams, lotions, or ointments on the eyelids. Avoid getting any in your eyes, as this could be harmful.

Treatment options for eyelid seborrheic dermatitis include proper skin care, warm compresses, and prescription topical treatments. These treatments focus on cleaning the skin and controlling inflammation to help manage your symptoms.

Gentle Skin Care

Practicing a skin care routine using gentle cleansers and lotions can help keep your skin clean and moisturized. Warm compresses can help loosen any stubborn flakes or buildup. To make a compress, run a washcloth under warm water, then place it over your eye for a few minutes. Repeat as needed, using a clean cloth every time. You can then use a cotton swab to wipe away the scales or flakes. This area has sensitive skin, so be gentle to avoid irritation.

Topical Corticosteroids

Over-the-counter topical steroid creams, such as 0.5 percent to 1 percent hydrocortisone, can be used to help control skin inflammation. These products can be found at your local pharmacy or grocery store. You can apply them to your eyelid three or four times a day or as recommended by your doctor or dermatologist.

You may also be prescribed a stronger topical corticosteroid for more severe cases of seborrheic dermatitis. These include:

• Fluocinolone solution (Synalar)
• Desonide (Desonate, Desowen)
• Betamethasone valerate (Luxiq)
• Hydrocortisone 2.5 percent

These medications are prescribed for only a short amount of time because long-term use can thin the skin.

Phosphodiesterase 4 Inhibitors

Phosphodiesterase 4 (PDE4) inhibitors are a new treatment for seborrheic dermatitis. They work on the immune system to decrease levels of inflammation. Roflumilast (Zoryve) foam was FDA approved in December 2023 as a once-daily topical treatment for seborrheic dermatitis. Ask your dermatologist about instructions for using the foam around your eyes.

Topical Calcineurin Inhibitors

Calcineurin inhibitors also dampen inflammation in the skin but, unlike topical corticosteroids, don’t pose a risk of thinning the skin. Two calcineurin inhibitors commonly prescribed by dermatologists include tacrolimus ointment (Protopic) and pimecrolimus cream (Elidel). These are applied to the eyelid twice daily.

A mild antifungal such as ketoconazole also may be applied to eyelids daily.

Tell your dermatology provider if your seborrheic dermatitis treatment isn’t working or if it’s causing intolerable side effects. They’ll work with you to find the best treatment for your specific skin needs.

Treating Blepharitis

If you have blepharitis in addition to seborrheic dermatitis, you can use a few different treatments to manage your symptoms. Using artificial tears may help moisten the cornea (the eye’s outer surface) if you have itchy eyes. Try to limit wearing contact lenses, as these can irritate your eyes more. Practicing gentle skin care helps keep your skin clean to avoid any infections. If your eyes become very swollen and sore, you may need antibiotics to treat an infection.

Talk With Others Who Understand

MySebDermTeam is the social network for people with seborrheic dermatitis and their loved ones. On MySebDermTeam, more than 6,000 members come together to ask questions, give advice, and share their stories with others who understand life with seborrheic dermatitis.

Do you have seborrheic dermatitis on your eyelids? What treatments work best for you? Share your experiences in the comments below, or start a conversation by posting on your Activities page.