Blepharitis is a chronic (long-term) condition. Most people experience repeated episodes followed by periods with no symptoms.
Blepharitis cannot be cured, but symptoms can be effectively controlled with good eye hygiene. You will need to continue this eye hygiene programme indefinitely.
Eye hygiene
Developing a regular routine of eye hygiene is essential for the effective treatment of blepharitis. It is important to clean your eyelids every day, whether or not you have any symptoms. Make it part of your daily routine, like showering or brushing your teeth.
Effective eye hygiene will help reduce the severity and frequency of your symptoms. Follow the steps below to keep your eyes clean:
- Apply a warm compress (a cloth or cotton wool warmed with hot water) to your closed eyelids for five to ten minutes.
- Gently rub the compress over your closed eyelids for two to three minutes, then repeat. This will help loosen any crusting.
- Use a cloth or cotton bud with warm water and a small amount of cleaning solution (see below), and gently rub the edge of your eyelids to clean them.
- Always use a mirror when cleaning your eyelids to prevent any possible damage to your eyes.
- Carry out these steps twice a day at first, then once a day when your symptoms have improved.
- Do not wear eye make-up, particularly eyeliner and mascara, as this can make your symptoms worse. If you have to wear eyeliner, make sure that it washes off easily.
Cleaning solution
To clean your eyelids, use one of the following with warm water:
- a small amount of baby shampoo (1 part baby shampoo to 10 parts warm water)
- sodium bicarbonate (1 teaspoon dissolved in a cup of water which has been boiled and then cooled)
- a lid-cleaning solution (there are a number of commercial products available)
Your GP or pharmacist can tell you which cleaning solutions are suitable for you. However, you may need to try more than one product to find one that suits you.
Topical antibiotics
If you have blepharitis that does not respond to regular cleaning, you may be prescribed a course of antibiotic ointments or creams (topical antibiotics). You will need to use these for four to six weeks.
You may be prescribed:
- chloramphenicol eye ointment
- fusidic acid eye drops
The ointment or drops should be rubbed gently onto the edge of your eyelids, using either clean fingers or a cotton bud. You may need to do this:
- after you have finished cleaning your eyes
- before you go to sleep at night
- after cleaning your eyes and before bed
Once your condition begins to respond to the treatment, you will only need to apply the antibiotic once a day.
Cautions
Avoid wearing contact lenses when using topical antibiotics. If wearing contact lenses is essential, you may be given additional eye drops. If you are using more than one type of eye drop, leave at least five minutes before applying the second type of drops to your eyes.
You may experience some mild stinging or burning when applying antibiotic ointment or drops to your eyes, but this should pass quickly. Do not drive if the ointment makes your vision blurred.
Oral antibiotics
In some circumstances, you may be prescribed oral antibiotics (to take by mouth) at the start of your treatment. For example, oral antibiotics may be prescribed when it is clear that a skin condition, such as rosacea, is aggravating your blepharitis. Oral antibiotics may also be recommended if your blepharitis does not respond to other forms of treatment.
Most people respond well after two to four weeks of treatment, although you will probably be required to take them for at least six weeks. It is important for you to finish the course of antibiotics, even if your symptoms get better.
Cautions
Some of the oral antibiotics that are used to treat blepharitis have been known to make people more sensitive to the effects of the sun. Therefore, avoid prolonged exposure to sunlight and using sun lamps or sun beds while you are taking them.
Side effects of oral antibiotics are rare because the dose is relatively low. However, they may include:
- nausea (feeling sick)
- vomiting
- stomach ache
- diarrhoea
- yeast infections, such as thrush, in women
If you develop a severe headache or notice any changes in your vision, see your GP immediately or call NHS Direct on 0845 46 47. These symptoms may indicate a rare but serious side effect that is caused by some types of oral antibiotics.
Treating other conditions
You may need to use an anti-dandruff shampoo on your scalp and eyebrows if you have:
- seborrhoeic dermatitis (a skin condition that causes your skin to become inflamed or flaky)
- dandruff (dry, flaky skin on your scalp)
See the Health A-Z topic about Dandruff - treatment for more information about treating this condition.
If you have dry eye syndrome, which frequently occurs alongside blepharitis, you may need separate treatment for this, such as eye drops.
See the Health A-Z topic about Dry eye syndrome - treatment for more information about treating this condition.
