Redness under the eyes: what are the causes and how to make it disappear?

The physiology of the eye contour is complex, given that it is a particularly vulnerable and sensitive area. Indeed, the skin in this area is very thin, on average 5 times thinner than the rest of the face, and the hydrolipidic film is almost non-existent. Moreover, this area is poor in collagen and elastin, the support fibres of the dermis. Thus, the eye contour is often subject to an inflammation or infection, which can cause a discharge of tears or pus, accompanied by itching, tightness, burning and more generally redness. The causes of this redness around the eyes are numerous, but here are the main ones:

• Conjunctivitis.

  This inflammation of the eyes is most commonly caused by a bacterial or viral infection, or overexposure to dust or allergens. Certain preservatives found in cosmetics, eye drops or contact lens cleaning products are notably responsible. Conjunctivitis can also result from a dryness of the eyes or a vision defect. This condition usually affects both eyes at the same time and is accompanied by tearing, intraocular redness, which may or may not be associated with itching and tingling. As a result of scratching, it is not uncommon for the area around the eye to also become red. The eyelids may also suffer from swelling and sensations of pain.

• Blepharitis.

  Similar to conjunctivitis, this disease causes redness in the eyes and swelling of the eyelids. However, unlike conjunctivitis, blepharitis is defined as a inflammation of the eyelid margin which results in redness of the free edge of the eyelids, tearing, and intense itching. Most of the time, blepharitis is associated with severe dry eye. Several factors can cause this inflammation: the worsening of existing conjunctivitis, exposure to allergens in the air or in skincare products, or colonisation by Demodex folliculorum. An excessive proliferation of these microorganisms can indeed block the opening of the Meibomian glands and harden the meibum of the glands which then stagnates.

• Eyelid Eczema.

  A chronic inflammatory dermatosis, eczema is characterised by the emergence of red patches on the epidermis and intense itching. Despite the pruritus, it is crucial to not scratch as this exacerbates the inflammation and promotes the formation of oedema. Able to occur anywhere on the body, it is not uncommon for eczema to take up residence on the eyelids, a thin and delicate area. This dermatosis can be caused by an atopic genetic predisposition but, when it is located around the eyes, it generally results from a contact with an allergen. The main culprits are toiletry products (creams, shampoos...), medical treatments (contact lenses, ophthalmic ointments...), pollen, dust and pollution.

Note : Only the redness under the eyes is detailed here, not those directly affecting the eye itself.

Maintaining good eye hygiene is one of the keys to preventing redness. Therefore, ensure you avoid touching your eyes unless you have washed your hands beforehand and rinse them thoroughly in case of contact with shampoo, cleansing gel or the like. Indeed, hands are often carriers of bacteria and can easily introduce pathogens into the eyes, increasing the risk of eye infections. Furthermore, if you experience fatigue or itching, try to avoid repeatedly rubbing your eyelids. This could irritate the delicate skin in this area and cause tissue damage.

Also, as much as possible, try to reduce the time you spend daily in front of a screen. Whether it's a computer, tablet or phone, staring at a screen for extended periods strains the eyes, which must constantly contract to form a clear image. Moreover, when we look at a screen, our eyelids tend to blink less often, which can lead to dry eyes. Lastly, to take care of the delicate area around the eyes, the use of a cosmetic cream specifically formulated for this purpose can be beneficial.

In the event of persistent redness under the eyes, it is essential toseek medical advice. Untreated redness can lead to complications and affect vision.

Not all redness is treated in the same way. The skincare protocol implemented depends on its origin, which only a doctor will be able to determine.

• In the event of conjunctivitis.

  The treatment of this disease is determined by the type of infection. In the case of viral conjunctivitis, physiological saline washes are sufficient. If the conjunctivitis is of bacterial origin and is quite severe, the doctor may need to prescribe local antibiotics such as fusidic acid, tobramycin or rifamycin. Finally, if it is an allergic reaction, the intake of oral antihistamines is sometimes necessary.

• In the event of blepharitis.

  Non-chronic forms of blepharitis, caused by a bacterial infection, require an antibiotic ointment to eliminate symptoms such as redness. Antihistamines may also be prescribed to treat blepharitis when it is due to an allergy. Everyday actions such as massaging the eyelids or applying warm water compresses and artificial tears often complement the treatment.

• In the event of eyelid eczema.

  Eyelid eczema is typically treated with dermocorticoids, anti-inflammatory creams designed to soothe irritation and redness. In addition, you can use an emollient to hydrate and nourish the delicate skin of the eyelids and strengthen the skin barrier. Finally, to prevent the risk of recurrence, it is necessary to identify the allergen causing the eczema and eliminate it from your daily life. This can be done by a healthcare professional using patch tests.

• BERNARDES T. BONFIOLI A. Blepharitis. Seminars in Ophthalmology (2010).

• GOLDENBERG G. & others. Eczema. The Mount Sinai Journal of Medicine (2011).

• AZARI A. & BARNEY N. Conjunctivitis A Systematic Review of Diagnosis and Treatment. Clinical Review & Education (2013).

• SCHMIDT C. Pollen Overload: Seasonal Allergies in a Changing Climate. Environmental Health Perspectives (2016).