Periocular dermatitis is an outbreak of rashes, spots or dry skin on or around the eye. It can be persistent, but will it go away on its own? We take a closer look.
Periocular dermatitis refers to dermatitis that occurs around the eye, just as its name suggests. It can sometimes be the furthest reach of perioral dermatitis, a rash around the mouth that can spread up across the face to the eyes, in which case the condition is known as periorificial dermatitis.
The cause of the rash is not always hard to pinpoint, which makes treating it pretty hard! Sometimes, a rash around the eyes is obviously attributable to a type of contact dermatitis, triggered by direct contact with an allergenic substance. Culprits could include the irritant chemicals in cosmetics, toiletries, makeup, sunscreen, perfume or haircare; these substances damage the particularly delicate, thin skin around the eyes, disrupting the skin barrier, and causing an inflammatory response.
It’s worth knowing that the skin around the eyes can also be affected by airborne irritants: pollen, particulates, industrial or household chemicals, plants, or dust.
Periocular or periorificial dermatitis tends to be diagnosed if the rash looks spotty, rather than just dry. It can look a bit like acne, or papulopustular rosacea, and can sometimes be mistaken for seborrheic dermatitis, all of which are also characterised by bumpy, spotty, inflamed rashes, though the different conditions vary slightly in the type of spots and the location of the rash.
Any rash around the eyes is likely to need a dermatologist to determine which diagnosis is most appropriate, and to check that it is not damaging your eyes themselves.
So if you do have a definite diagnosis of periocular dermatitis, what can you expect?
Well, the good news is that the condition does tend to resolve eventually, whether you treat it or not. However, if whatever is triggering the flare-up is still present, periocular dermatitis, like its close relative perioral dermatitis, is likely to come back. You could get waves of flare-ups, across months or even years, if you don’t find an effective management plan for your skin.
What can you do to support your skin to heal from periocular dermatitis, and, even more importantly, prevent it coming back?
Once you have a diagnosis and you know what’s causing your rash, then you can manage it! The first thing is to identify and then avoid your triggers. As discussed above, irritant substances in your environment or your toiletries are big triggers for dermatitis. But if you’ve eliminated those possibilities, it’s worth knowing that one of the most common causes of periorificial dermatitis are topical corticosteroids.
Steroid creams are fairly commonly prescribed for skin issues, even on the face. If you’ve been treated for eczema or inflammation on the face with topical steroids, and then find your skin erupting with persistent spots around the mouth or eyes, with a rash that looks different from the original problem, then it could be steroid-induced. So the one thing you don’t want to use to treat periocular dermatitis is more steroid creams! (For more information about the side-effects of topical steroids, see our blogs on topical steroid withdrawal syndrome.
Instead, switch to the simplest, gentlest skin care you can find. Steer clear of makeup and perfumed cosmetics for a while. Check the ingredients lists in your sunscreen and shampoo. Basically, you only want a very few, extremely mild products on your skin. Sometimes just eliminating problem ingredients from your life is enough to ‘treat’ the condition on its own, and to prevent it reoccurring.
It's worth looking at the skincare tips in this article, as the two conditions are so similar: How To Treat Perioral Dermatitis. We'd recommend switching to an oil-based cleanser, a gentle soap-free and SLS-free wash, and using a nourishing, non-pore clogging balm like Skin Salvation to support healthy, hydrated skin.
Recommended products for skin prone to periocular dermatitis:
Balmonds Omega-Rich Cleansing Oil
with rosehip and calendula
Balmonds Natural Shampoo & Body Wash
with calendula & chamomile
Balmonds Skin Salvation
with hemp and beeswax