Dry Eye and Skin Problems

If you've got dry eye and you're wondering why it's happening, you may not think that a problem with your skin could be among the reasons. But the truth is there are several skin conditions that can cause dry eye or make it worse.

Rosacea, blepharitis, and pruritus on the eyelids or near the eye are some of the skin conditions that are linked to dry eye. They can make it hard for your eye to make tears. They also can keep you from creating the oily film that covers the surface of the eye, which helps keep it wet.

Rosacea

Rosacea is a common skin disease that causes rosy patches on your skin and dry or oily spots, usually on the face. There's a related condition called ocular rosacea that can cause dry eye.

Rosacea and ocular rosacea seem to be linked to autoimmune disorders, which happen when the immune system -- your body's defense against germs -- kicks into overdrive and attacks different parts of your body. Ocular rosacea may also be related to mites that live on your eyelashes or bacteria from the skin that end up on your eyelid.

Ocular rosacea can affect the meibomian glands. They're located on the rim of your upper and lower eyelids -- the spot where they meet when your eyes close. These glands make the oily surface layer on the eyes, which keeps them moist and prevents tears from drying up. Ocular rosacea blocks the glands, which stops your body from making this protective film.

People with ocular rosacea are also more likely to be dehydrated, which means the eyes may be short of moisture as well. Ocular rosacea may also damage the lacrimal gland, which makes tears.

Blepharitis

When you have blepharitis, your eyelids become inflamed or swollen. The condition can play a role in bringing on dry eye.

Blepharitis that's on the inside of your eyelid (the part that touches the eyeball) is called posterior blepharitis. It can be caused by scalp dandruff or by skin rosacea.

Blepharitis that affects the place where your lashes attach to the eyelid, called anterior blepharitis, can be caused by scalp or eyebrow dandruff. Dandruff and rosacea lead to swelling, which can block glands on the eyelids and interfere with the oily coating of the eye. Blepharitis can also be caused by a skin rash that's due to an allergic reaction to something like latex.

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Pruritus

Pruritus is the medical term for itching. Various skin problems can cause it. For instance, atopic dermatitis or psoriasis near the eye can be connected with itchy eyes.

Ocular (eye) itching may be linked with dry eye. It's triggered by the same things that set off itching elsewhere on the body, such as allergic reactions to medications or cosmetic products.

Besides feeling itchy, you may get swelling of the area around your eyelid or scales on your eyelids. As with ocular rosacea and blepharitis, pruritus may involve problems with the glands on the eyelids. The itchiness may stop at night, possibly because closed eyelids keep the oily film made by the glands in place, which prevents your tears from drying up.

WebMD Medical Reference Reviewed by Alan Kozarsky, MD on June 24, 2017

Sources

SOURCES:

National Eye Institute: "Facts About Dry Eye," "Facts About Blepharitis."

National Rosacea Society: "Rosacea Now Estimated to Affect at Least 16 Million Americans," "What Your Eyes May Be Telling You."

UptoDate: "Ocular rosacea."

International Rosacea Foundation: "Ocular Rosacea."

American Academy for Pediatric Ophthalmology and Strabismus: "Meibomian Gland Dysfunction and Treatment."

American Optometric Association: "Blepharitis."

National Health Service (UK): "Dry eye syndrome - Causes."

American Academy of Dermatology: "Contact dermatitis."

Medscape: "Pruritus and Systemic Disease."

American Academy of Ophthalmology: "The Itchy Eye: Diagnosis, Management of Ocular Pruritis," "Managing Blepharitis: Tried-and-True and New Approaches."

Itch: "The prevalence and characteristics of chronic ocular itch: a cross-sectional survey."

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