Eye rosacea

Eye rosacea is inflammation that causes redness, itching and burning around the eye area.

It’s associated with the common skin condition rosacea, which mainly affects people aged between thirty and fifty. Eye rosacea tends to develop in people who flush and blush easily too.

Although there’s no specific cure for eye rosacea, there are effective medications and techniques for managing the symptoms.

No one knows the exact cause of skin rosacea including eye rosacea, but it’s thought to be a response to several genetic and environmental factors including:

• Bacterial infections either on the skin or in the gut which cause blood vessel abnormalities and disrupt the health of the skin
• Helicobacter pylori bacteria in the gut stimulate the production of a protein (bradykinin) that causes blood vessels in the skin to dilate
• Microscopic mite infection (Demodex folliculorum) blocking oil glands in the skin
• Sun damage

People who have migraines are at a slightly higher risk of developing rosacea, which may be due to abnormal opening and closing (dilation and constriction) of the blood vessels.

Eye rosacea normally develops with skin symptoms, but it’s possible to have eye rosacea on its own.

Symptoms and complications of eye rosacea include:

• Irritation and itchiness
• A feeling as though there is something in the eye
• Dry eyes
• Watering eyes
• Blurred vision
• Visible small blood vessels in the white of the eye
• Stinging or burning
• Discomfort in bright light
• Blepharitis: reddening or swelling of the eyelids and other eyelid problems including styes
• Red, sore eyelids, possibly conjunctivitis
• The oil-producing meibomian glands inside the eyelid can become blocked causing secretions to build up
• Inflammation, ulceration and scarring of the cornea – in this case keratitis can lead to loss of vision and will need immediate treatment by a specialist

What triggers eye rosacea?

There are several triggers that can make eye rosacea worse including:

• Being in a hot environment and moving into the cold, and vice versa
• Alcohol, particularly red wine
• Caffeine in coffee, cola and other caffeinated drinks
• Spicy foods and hot drinks
• Strenuous exercise
• Sunlight
• Some skincare products
• Emotional stress
• Medications that dilate blood vessels, including some that treat high blood pressure
• Humidity
• Hot baths
• Dairy products
• Coughs, colds, fevers and other conditions

At The London Clinic one of our dermatologists will diagnose if you have eye rosacea by examining the skin on your face, eyes and eyelids.

They will ask you about your medical history including your general health and symptoms. There’s no specific test or blood test to diagnose eye rosacea or skin rosacea.

Although there isn’t a cure for eye rosacea, it’s possible to manage the condition with lifestyle changes and medications like antibiotics.

To start off with, your dermatologist will talk to you about the triggers or factors that make your symptoms worse. Then together you’ll work out ways to avoid these factors.

One of the most important steps for most people is to avoid sun exposure. Targeted medicine and laser treatment may also help.

At The London Clinic your dermatologist may offer you medication for your skin including:

• Topical spot treatments e.g. metronidazole or azelaic acid which you apply directly to the skin
• Antibiotic tablets that you swallow e.g. tetracycline, doxycycline or erythromycin which need to be taken for several weeks or months to achieve maximum benefit
• Isotretinoin, a potent acne treatment that can also treat rosacea
• Eye drops and rosacea eye cream or ointments that can help with dry eyes

At The London Clinic, we also offer laser treatment for eye rosacea which can help control the redness, veins and flushing symptoms.

Laser treatment can help in two ways:

• It can target visible blood vessels (telangiectasia) helping them to shrink and become less noticeable
• It can reduce the thickness of the skin, particularly around the nose

Laser treatment may not be suitable for you if you are:

• Pregnant
• Have epilepsy
• Taking light sensitive medication (e.g. Roaccutane)
• Have vitiligo

Laser treatment can occasionally have side effects including:

• Burns
• Blisters
• Scars
• Change in the colour of your skin