14 Possible Causes of Blepharitis

2. Reaction to Makeup

Makeup can irritate the eyelids and lead to blepharitis because products such as mascara, eyeliner, and eye shadow sit close to the lash line, where tiny oil glands open along the eyelid edge. Certain ingredients, especially fragrances, preservatives, dyes or pigments, and glitter or shimmer particles, may trigger irritation in sensitive eyelid skin.

When makeup particles collect along the eyelid margin, they can block these tiny oil glands. Trapped oil then builds up inside the glands and irritates the eyelid edge, which may cause redness, swelling, itching, or soreness. Some people also notice flaky skin or crusting at the base of the lashes. Sleeping with makeup on or wearing heavy eye makeup every day increases the chance of buildup along the eyelid edge, which makes blockage more likely.

False eyelashes and lash glue may worsen irritation because they place additional chemicals near the eyelid surface. Old or expired makeup can also increase risk because bacteria may grow inside tubes, brushes, and cases over time. When contaminated products touch the eyelids, germs can spread to the lash line and add to the inflammation.

3. Reaction to Moisturizers and Grooming Products

Moisturizers, facial cleansers, and grooming products can irritate the eyelids because the skin around the eyes is thin and sensitive. Common triggers include fragrances, preservatives, hair dyes, makeup, makeup removers, shaving creams, aftershaves, and sunscreens. When these products touch the eyelids, irritation often starts along the lash line.

In other cases, a person may apply a product to the face or scalp and later transfer it to the eyes by rubbing or touching them. Some people then develop contact dermatitis, which is a skin reaction caused by contact with an irritating ingredient. This reaction may not appear right away. Hours or even days after exposure, the skin can become red, itchy, sore, or flaky.

As irritation continues, burning may develop along the eyelid edges, crusting can form, and the lashes may stick together. Repeated exposure can make the reaction worse because once the skin becomes sensitive, even small amounts may trigger symptoms again.

4. Seborrhoeic Dermatitis

Seborrhoeic dermatitis is a common skin condition that can lead to blepharitis. It usually affects oily areas of the body, including the scalp, face, sides of the nose, eyebrows, and ears. In these areas, skin cells shed too quickly and mix with oil produced by nearby glands.

This buildup often appears as greasy skin, white or yellowish flakes, mild redness, itching, or burning. The condition commonly occurs with dandruff because the same process that affects the scalp can also involve nearby skin surfaces. When seborrhoeic dermatitis affects the eyelids, flakes and oil collect along the lid margins and at the base of the eyelashes.

The skin may look red, feel sore, and develop crusts, especially after sleep. Extra oil and dead skin can then block the small glands along the eyelid edge. When these glands do not release oil properly, the tear film becomes unstable. This may cause dry, gritty, or watery eyes and contribute to repeated eyelid irritation.

5. Ingrown Hair

An ingrown hair forms when an eyelash grows in the wrong direction and turns back toward the skin or the surface of the eye. This problem is also called trichiasis. Several factors can raise the risk of ingrown lashes, including chronic eyelid inflammation, skin conditions that affect the face, scarring from past infections or injuries, and repeated styes or cysts.

Changes in the shape of the eyelid can also push lashes inward, and in rare cases, a person may grow an extra row of lashes. When a lash rubs against the skin or the eye, it creates friction along the eyelid margin. This irritation may make the eyelid look red, swollen, or tender.

Some people feel as if sand or dust is in the eye, while tearing, light sensitivity, and mild pain can develop as the surface becomes irritated. If the rubbing continues, inflammation along the lid margin may persist. Over time, this can lead to crusting and discomfort that contribute to blepharitis.

6. Blocked Meibomian Gland

The meibomian glands sit along the edges of the eyelids and produce an oily layer that slows tear evaporation and helps keep the eyes moist. Several factors can contribute to blockage of these glands, including thickened oil, excess oil production, skin conditions such as rosacea or acne, hormonal changes, and exposure to dusty or smoky air.

When a gland becomes blocked, oil builds up inside it and pressure increases within the eyelid. This may cause irritation, redness, and swelling along the eyelid edges. Crusting may also form around the eyelashes along the lid margin. When the glands do not release enough oil, the tear film becomes unstable because the eye surface loses part of its protective oily layer.

As a result, the eyes may feel dry, gritty, or watery at the same time. In some cases, trapped oil forms a small lump in the eyelid called a chalazion. This lump usually causes painless swelling but may become red and sore if infection develops.

7. Allergies

Allergies can inflame the eyelids and lead to blepharitis when the body reacts to a trigger and releases chemicals that cause swelling, itching, and redness around the eyes and at the base of the eyelashes. Common allergy triggers include pollen from trees, grass, or weeds, dust mites, pet dander, mold, and eye makeup or skin care products.

Symptoms often become worse during seasons when airborne allergens are more active. When these triggers touch the eyelids, the skin may become sore. Some people notice burning, crusting near the lashes, or a gritty feeling in the eyes. Other allergy symptoms often appear at the same time, including watery eyes, sneezing, or a runny nose.

Rubbing the eyes can make the reaction worse and may affect the small oil glands along the lid margin. If inflammation continues, debris may collect around the eyelashes and allow bacteria to increase on the eyelid surface, which can worsen the irritation.

8. Trauma

Trauma to the eyelids can lead to blepharitis when an injury affects the lid margin. Common causes include rubbing the eyes too hard, scratches from fingernails or makeup tools, burns from heat or chemicals, injury during contact sports, and complications after eyelid surgery.

Even minor injuries can disturb the normal balance of the eyelid because the skin along the lash line is thin and sensitive. When this skin becomes damaged, redness, swelling, and tenderness may develop, and bacteria can grow more easily along the eyelid edge. Swelling may also block the small oil glands that help keep the eyes moist.

When these glands do not work properly, dryness and discomfort may follow. In some cases, healing leaves scar tissue along the lid margin. This can change how the eyelashes grow or how the eyelid rests against the eye. Poor lid alignment may then cause ongoing irritation and raise the risk of repeated flare-ups.

9. Eyelash Mites and Lice

Tiny organisms can live along the base of the eyelashes and trigger blepharitis. The most common are eyelash mites, also called Demodex, which are so small that people cannot see them without a microscope. Lice can also infest the eyelashes, although this is less common, especially through close contact.

Mites feed on oil and dead skin cells around the lashes, while lice attach to the lash hairs and lay eggs. When too many of these organisms gather, they irritate the eyelid edges and interfere with the normal function of the oil glands along the eyelids.

As the eyelids become irritated, itching, burning, redness, or a gritty feeling in the eyes may develop. Some people also notice dandruff-like flakes stuck to the lashes, especially in the morning. When the oil glands become blocked, swelling and ongoing irritation may follow, and some people may lose a few eyelashes.

10. Scleroderma

Scleroderma is an autoimmune disease in which the body attacks its own tissues. It causes skin to become thick and hard and can also affect blood vessels and internal organs. Although the name means “hard skin,” the disease often involves more than the skin alone.

When scleroderma affects small blood vessels, blood flow may decrease in different parts of the body, including the eyes. Reduced blood flow can irritate the eyelids and disturb the oil glands along the lid margin. When these glands do not work properly, the tear film becomes unstable because the eye surface loses part of its protective oily layer.

This can lead to eyelid discomfort and raise the risk of blepharitis. Some people also develop dry eyes, which increases sensitivity and may cause redness, crusting, or swelling along the eyelid edges. In rare cases, blood vessel damage also affects deeper parts of the eye.

11. Rosacea

Rosacea is a long-term skin condition that causes redness on the face, often affecting the cheeks, nose, chin, and forehead. In some people, it also involves the eyes and eyelids, a form known as ocular rosacea. When rosacea affects the eyelids, the small oil glands along the lid margin may produce thick oil that does not flow normally.

These glands normally help keep tears from drying out too quickly. When the oil becomes clogged, the eyelid margins become inflamed and the risk of blepharitis increases. As inflammation develops, the eyelids may look red, swollen, or irritated. Common eye and eyelid signs include red or bloodshot eyes, a burning or stinging feeling, crusting along the lash line, and a dry or gritty sensation.

People with facial flushing or acne-like bumps may have a higher risk of blepharitis linked to rosacea. Symptoms often come and go, and triggers such as heat, spicy foods, alcohol, or stress may worsen both skin and eye symptoms.

12. Reactions to Medications

Some medications can trigger or worsen blepharitis because certain drug classes reduce tear production or change the normal balance of oils on the eye surface. Common examples include antihistamines, antidepressants, antipsychotics, anticholinergics, and diuretics.

When tears or oils become inadequate, the tear film becomes unstable and the eyelid margins become more vulnerable to dryness and inflammation. This may lead to redness, swelling, or crusting along the eyelid edges. Long-term use of some acne treatments, including oral medicines used for skin conditions, may also affect the oil glands in the eyelids.

When these glands produce thicker oil, the openings may become blocked and inflammation may increase. In some cases, eye drops used for other eye problems can irritate the eyelid skin. Preservatives in certain drops may cause redness or burning in sensitive people, and repeated exposure can lead to ongoing lid inflammation.

13. Conjunctivitis

Conjunctivitis is inflammation of the thin, clear tissue that covers the white part of the eye and lines the eyelids. Many people call it pink eye. Viruses and bacteria commonly cause conjunctivitis, although allergies, smoke, and other irritants can also affect the conjunctiva.

This condition can occur along with blepharitis because inflammation along the eyelids allows bacteria and debris to spread more easily to the eye surface. In people with blepharitis, blocked oil glands and excess bacteria increase the chance of repeated irritation. When the eyelid margins stay irritated, blinking can repeatedly spread discharge and inflammatory material across the conjunctiva, which can prolong surface irritation.

As the conjunctiva becomes inflamed, redness, soreness, and a gritty feeling often develop. Common symptoms include red or bloodshot eyes, watery or thick discharge, crusting along the lashes, and burning or itching. Some people wake up with their eyelids stuck together, while others notice increased tearing or light sensitivity.

14. Dry Eye Syndrome

Dry eye syndrome develops when the eyes do not make enough tears or when tears evaporate too quickly. Tears need a balanced mix of water, oil, and mucus to keep the eye surface smooth and protected. Blepharitis often links to dry eye syndrome because inflamed eyelids can block the tiny oil glands along the lash line. These glands normally release oil that slows tear evaporation and helps tears stay stable on the eye surface.

When they become clogged or do not work properly, tears break up too quickly and leave the eye surface exposed. Without enough protective moisture, blinking creates more friction across the eye surface and increases irritation. As dryness develops, the eye surface becomes irritated and unstable. Common symptoms include burning or stinging, a sandy or gritty feeling, redness, and blurred vision that often clears with blinking.

Watery eyes can also develop because the eyes produce reflex tears in response to surface dryness. Dry eyes can also make blepharitis worse because discomfort often leads to more rubbing and additional inflammation. In many people, both conditions appear at the same time and can continue to affect each other.