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A pimple on the eyelid may not be common for some people, but they certainly can occur, and are no less irritating than a breakout anywhere else on the face or body. Because other types of bumps can pop up on the eyelid, like styes, it's important to understand what to look for when assessing symptoms so that you can treat it the right way, regardless of what it may be.
We spoke with two board certified dermatologists to find out why some breakouts occur on the eyelid, what to do about them, and how to possibly prevent them from returning.
Meet the Expert
- Dr. Nadia Kihiczak is a board certified dermatologist who practices at Spring Street Dermatology in New York City. Her areas of expertise include acne, rosacea, psoriasis, skin cancer screenings and treatment, as well as minor surgical and cosmetic procedures. Dr. Kihiczak is a diplomate of the American Board of Dermatology, fellow of the American Academy of Dermatology, and member of the American Society for Dermatologic Surgery.
- Dr. Roy Seidenberg of the Laser & Skin Surgery Center of New York is a board certified dermatologist who specializes in general and cosmetic dermatology. Additionally, Dr. Seidenberg is an attending Physician and Clinical Assistant Professor of Dermatology at the New York University School of Medicine.
Types of Eyelid Breakouts
While breakouts can occur wherever pores are found, some types appear more often than others in specific places, like the eyelid or eye area.
- Inflammatory papules: Inflammatory acne occurs when the body sends in white blood cells to “fight off” the bacteria created in a clogged pore when too much sebum combines with debris, like dead skin cells. This symptom usually appears as red bumps that are smaller than cysts and rest on the surface of the skin, rather than underneath.
- Pustules: Pustules are simply pimples that are filled with yellowish pus, which often collects in the center of a red bump, forming what’s known as a head.
- Comedones: Both whiteheads and blackheads are types of comedones— whiteheads are “open” comedones, while blackheads are “closed.” White-heads are the more common type of acne to appear on the eyelid, and may sometimes form in small clusters.
Of course, not all bumps found on the eyelid are pimples, and in fact, most of them are not, so it’s important to know exactly what your symptom consists of in order to find fast and lasting relief. “A stye, or hordeolum, and a chalazion present as bumps on the eyelids,” says Dr. Roy Seidenberg of the Laser & Skin Surgery Center of New York. “A stye is an inflammation or infection that presents as a pimple or pus-bump (pustule) at the base of an eyelash. Styes are irritating, tender, or painful, and may have a crust or discharge. They present more acutely, and in many cases 'come to a head,' break open and drain, then resolve. A chalazion is usually slower forming and results from a blocked gland in the eyelid that presents as a deeper bump, usually further from the eyelid margin, away from the lashes.”
In addition to styes and chalazions, milia is a condition that commonly occurs on the eyelid and the skin below the eye, which are often identified as small, white bumps. “Milia can be seen on the eyelid skin. Milia are 1-2 mm pinhead-sized, superficial, skin cysts filled with keratin debris that often occur on the skin around the eyes and on the eyelid skin itself,” explains Dr. Nadia Kihiczak of Spring Street Dermatology in New York City. “They are usually asymptomatic, meaning they don’t cause any pain, itching or discharge, unlike typical inflammatory acne pimples and pustules.”
Causes and Prevention Tips
All acne breakouts are the result of clogged pores, and while there is no known cure for the condition of acne, there are some steps you can take to prevent breakouts from recurring as regularly.
- Irritated skin. “Anything that causes itchiness, irritation or inflammation in the eye area (periorbital region) can increase the likelihood of breakouts on the eyelid,” says Dr. Kihiczak. Common culprits that might result in a breakout on the eyelid include harsh cleansers, thick eye creams, expired products and makeup, and dirty tools, like makeup sponges or brushes.
- Additional skin issues. Sometimes, other conditions that affect the skin can make some people more susceptible to eyelid breakouts. “Individuals with conditions like rosacea, eczema, hay fever or seasonal allergies tend to have an increased risk of eyelid skin sensitivity,” says Dr. Kihiczak. “Additionally, application of creams and lotions that are not typically indicated for facial or periorbital skin can also lead to irritation of the eyelids, which can lead to rubbing of the eyes and subsequently results in clogging of the pores and glands in the eyelid skin.”
- Clean your eyelids with the right formulas. Most of us probably don’t pay our eyelids the same attention that we do the rest of the skin on our face, but neglecting to wash that area, or washing it with harsh products, can lead to breakouts, just as it would anywhere else. “Use of non-comedogenic, gentle cleansing products and face-specific creams can help avoid irritation of the sensitive eyelid skin, therefore limiting breakouts on the eyelids,” Dr. Kihiczak says.
Treating a Breakout on the Eyelid
Like any type of acne, eyelid breakouts are only temporary and can be treated in various ways.
“Topical retinol products, such as Tret-A lotion, and micro exfoliating scrubs, like Neostrata AHA Glycolic Foaming cleanser, increase cell turnover and can eradicate and prevent acne and milia from forming,” says Dr. Kihiczak. Because the skin around the eye is much thinner there than other parts of the face, retinol should only be used as a spot treatment for treating acne on the eyelid. “When initially starting these topicals, one can commonly experience some mild peeling and redness of the skin, especially around the eye area,” she adds. “Therefore, use of these products is recommended only 2-3 times a week initially. As the skin adjusts to the retinol and AHA (alpha hydroxy acid), one can gradually increase their application frequency to daily if tolerated.”
Practice Good Hygiene
“Prevention includes washing hands before applying contacts or makeup, and avoiding these during a breakout, minimizing eyelid rubbing, cleaning contacts as instructed, not sharing eye makeup, and keeping makeup brushes clean,” says Dr. Seidenberg. Not only will implementing these measures prevent future breakouts, they can help banish current breakouts faster.
Keep Your Skin Hydrated
What’s the best way to tell your sebum-producing sebaceous glands that your skin doesn’t need any more of that oily stuff? Keep your skin protected from the sun or other dehydrators, and hydrate with a moisturizer. Dr. Kihiczak recommends Elta MD Barrier Renew cream, which she says “effectively hydrates the skin on the face and periorbital region and can minimize dryness, peeling and sensitivity that can occur on facial skin.”
Don't Rush the Process
Most people wouldn’t want a breakout on their face any longer that necessary, but rushing the process by picking or popping can not only result in scarring, it can spread bacteria, resulting in more or larger pimples. “Hot compresses help drainage by increasing blood flow to the skin. Patients should not squeeze them,” explains Dr. Seidenberg. “This causes rupture of the follicle or gland and spreading of the inflammation or infection. The warm compresses also help clean the eyelids of crust build-up.
Avoid Introducing Foreign Objects (Like Contact Lenses and Mascara)
“While having a breakout on the eyelid, I recommend to avoid wearing contact lenses and makeup, especially eyeliner, mascara, eye shadow,” Dr. Kihiczak states. “Gentle, non-comedogenic products like Cerave, Neutrogena Ultra Gentle facial cleansers will not clog your pores and can be used to cleanse the area once or twice daily.”
See Your Dermatologist If Breakouts Persist Beyond a Week
“If the lesion persists beyond a week, an in-office evaluation by your board-certified dermatologist is recommended,” Dr. Kihiczak suggests. “Possible in-office treatments include extraction of the pimple or deroofing of the milia with a sterile needle. Alternatively, cryotherapy (liquid nitrogen is -320 degrees) and laser ablation can be used to destroy the milial cyst or inflammatory papule. A lesion that is recurrent in the same exact area or just not resolving despite treatment, should also be evaluated by your dermatologist. As the eyelids are consistently exposed to the sun, a biopsy of this recurrent or non-healing lesion may be required to assess the possibility of skin cancer.”
Seek prescription medication if needed. If you have an underlying condition that may be causing chronic eyelid breakouts, prescription medication, like doxycycline, may reduce the amount of time before it dissipates. “For patients with underlying rosacea or recurrent lesions, a low-dose doxycycline pill like Oracea can be very effective,” says Dr. Seidenberg “The lower dose makes it that it's not an antibiotic, it’s just anti-inflammatory, so it's better for longer term use.”