Blepharitis is usually treated with home remedies. In some cases, prescription medications may be needed.
Blepharitis responds well to treatment. However, it usually does not disappear completely and tends to keep coming back. People with blepharitis need to practice good eyelid hygiene and apply a mild cleanser (such as baby shampoo) to the eyelids to keep them free from crusts, especially during flare-ups.
The first treatment for blepharitis is placing a warm compress on the affected eyelid several times a day.
To make an eye compress, wet a washcloth or paper towel with warm water. Hold it on your eyelid for a few minutes or until the compress cools to room temperature.
You can also use a warm teabag as an eye compress. Allow the teabag to cool after steeping so that it is warm but not hot.
According to the American Academy of Ophthalmology, a teabag compress does not have any additional benefits over warm water. However, its shape may make it easier to use.
To keep bacteria levels low, it is important to scrub your eyelids with a gentle cleanser and water.
Baby shampoo is commonly recommended because it is gentle and does not sting eyes. You can also use a specially formulated eyelid wash.
To scrub your eyelids, put a drop of cleanser on a warm washcloth and bring it to a lather. Close your eyes and gently scrub the eyelid using a horizontal back and forth motion. Then, rinse with cool water.
Eyelid scrubs can be effective for relieving dry, itchy, flaking eyelids due to ALMD or PLMD, though PLMD is more likely to return over time.
Eyelid scrubs are exactly what they sound like: a process for removing material from the eyelids in order to treat blepharitis. Since they're inexpensive and easy to perform at home, eyelid scrubs are a great way to keep your eyelashes clean and alleviate symptoms.
Making Your Own Eyelid Scrub
You can find over-the-counter eyelid scrubs in pharmacies, and these can be very handy, especially in the office or on the go. If you will be using them at home, it's easy to make your own for a fraction of the cost.
What You Need
A clean washcloth or Q-tip
It is best to use medical-grade Q-tips because they are sterile and more tightly wound, so you won't get pieces of the Q-tip in your eye.
What to Do
Mix baby shampoo with clean, warm water in an equal one-to-one ratio to make the eyelid scrub solution.
Wash your hands thoroughly with soap and water.
Soak a clean washcloth in warm water.
Apply a small amount of the diluted baby shampoo solution to the washcloth or Q-tip.
Close one eye and gently rub the base of your eyelashes with the warm washcloth or Q-tip. Rub the entire area for one minute.
Carefully rinse your entire eyelid with clean, cool water.
Repeat with your other eye, using a fresh clean washcloth/Q-tip.
Do this twice a day after applying a warm compress for best results. This can help clear up mild blepharitis
Medicated eyelid washes that treat blepharitis are available over the counter. These cleansers can help clear up chronic blepharitis and prevent further eyelid inflammation.
Avenova is an eyelid wash that contains hypochlorous acid 0.01%. Clinical studies show hypochlorous acid treats the bacteria that cause blepharitis.
To apply, spray Avenova on a cotton ball or cotton round. Then, wipe it in a horizontal motion across your upper and lower lashes three times. Repeat with a fresh cotton pad on the other eye. Use twice a day.
Cliradex is a medicated wipe that contains Melaleuca alternifolia, a form of tea tree oil that treats blepharitis. Research shows a compound in tea tree oil known as 4-Terpineol is what helps ease blepharitis symptoms.
To treat blepharitis, wipe eyelids and lashes with Cliradex wipes twice a day for 10 days. If symptoms do not clear up, continue to use Cliradex wipes once a day for another 10 days.
Cliradex is safe for everyday use and also works to remove eye makeup.
Blephadex is a medicated wipe that treats blepharitis caused by eyelash mites. The wipes contain a gentle eyelid cleanser, tea tree oil, and coconut oil.
According to research, tea tree oil can reduce Demodex mites and help clear up blepharitis. In addition, tea tree and coconut oils have anti-microbial properties, meaning they kill microorganisms like bacteria, viruses, and fungus.
Coconut oil also has powerful anti-inflammatory and pain-killing properties that help to relieve blepharitis symptoms.
Newer treatments—Avenova, Blephadex, and Cliradex—contain ingredients that treat the root causes of blepharitis and help clear up chronic infections.
If at-home care does not relieve blepharitis symptoms, see an eye doctor (ophthalmologist).
They can prescribe medicine that treats the causes and symptoms of blepharitis.
Antibiotics are used to treat blepharitis caused by bacterial overgrowth. Depending on the severity of the infection, your healthcare provider may prescribe a topical antibiotic applied to the skin or an oral antibiotic taken by mouth.
Topical antibiotic ointments used to treat blepharitis include:
If topical treatments do not fully clear up the infection, your healthcare provider may prescribe an oral antibiotic such as tetracycline or doxycycline.
In some cases, corticosteroids are used to control eyelid inflammation and irritation.
Prescription steroids used to treat blepharitis can be delivered in eye drops, topical ointments, or oral medicine.
Blepharitis is often treated with a combination of antibiotics and corticosteroids. Research shows combination treatments can be more effective than antibiotics or steroids alone.
The prescription medication Blephamide combines an antibiotic (sulfacetamide sodium) with a corticosteroid (prednisolone acetate).
Blephamide comes in eye drops and as a topical ointment.
Eyelash Mite Treatment
When eyelash mites cause blepharitis, your healthcare provider may prescribe a medication that kills parasites.
Stromectol (ivermectin) is an oral drug that is used to kill Demodex eyelash mites. The medication is taken in two doses one week apart.
Home treatments for blepharitis include applying warm compresses and scrubbing the eyelid with baby shampoo. Medicated eyelid washes that treat blepharitis, sold over the counter, can also help treat mild cases.
If at-home treatments are unable to calm the irritation and inflammation, see an eye doctor. You may need prescription eye drops, topical ointments, or oral antibiotics and steroids.
Your eye doctor may recommend that you use an eyelid scrub two or three times each day to help alleviate your symptoms.
Some eye doctors may suggest using a different over-the-counter cleansing agent in place of baby shampoo.
Always use a clean washcloth for each eye to avoid spreading germs or bacteria from one eye to the other. If you have recurrent blepharitis, eyelid scrubs might become part of your daily eyelid hygiene routine.
When to See a Doctor
If your blepharitis doesn't get better or keeps coming back, you may need to talk to your eye doctor about other treatments.
Other treatment options that an eye doctor may recommend include:
Steroid eye drops for reducing swelling and inflammation
Antibiotics, if a bacterial overgrowth is identified
Treatment of the underlying health problem, such as dandruff or rosacea