Dr. Gott: Finding the source of the itchiness

DEAR DR. GOTT: I have itchy, dry eyelids that burn. My doctor prescribed 10 milligrams of prednisone, a steroid. It seemed to help, at least while I was taking it, but I can feel the burning sensation coming back.

He asked me if I had done something new or contaminated my eye, but I can't think of anything that I've applied or eaten differently. I don't wear eye makeup.

Is there something safe that I can put on my eyelid that will help with that? I'm assuming it's either psoriasis or eczema of the eyelid. I've looked online for a cure, and there seem to be so many people with this ailment who can't seem to find relief. I hope you can help.

DEAR READER: Unfortunately, the cure for itchy eyelids depends on the source of the irritation, so I cannot be as precise as I might like, but I will hit on a few possibilities.

Blepharitis can be caused by a bacterial infection, allergies, rosacea, eyelash mites and more. The outside of the lid will be crusted and look like dandruff. Dryness, swelling, itching, crusting, burning and redness may also occur.

Treatment includes warm compresses and daily cleansing of the edges of the eyelids with baby shampoo or special cleaners to help remove skin oils. In some cases, antibiotic ointments or topical steroids may be recommended.

Conjunctivitis, otherwise known as pink eye, is commonly caused by allergies, a virus or bacteria. Itching, burning and redness will be present.

This unpleasant condition will disappear in a matter of days without treatment in almost half of all cases. In those cases with persistent symptoms from a bacterial infection, there are a number of prescription drugs your physician might consider. Frequent hand washing is vital.

Allergies can occur at any time of the year as the result of dust, pollen, mold, grass, fragrances and chemicals, with the eyes literally bearing the brunt of the problem with itching, irritation, redness, pain and a host of other symptoms. Exposure can be so minimal as to be inconsequential. For example, I had one patient who cleaned a bathroom floor with a well-known cleaner the day before. By the following morning, her eyes had all the classic symptoms. She vociferously denied using anything unusual but did so without realizing it.

Allergies can generally be treated with over-the-counter drops, allergy medication or through prescription. Avoidance of the offending substance is necessary.

If I had to wager a guess, and bypassing countless other possibilities, I would say you have blepharitis (infection of the eyelash follicles). Your physician may be able to diagnose you through visual examination and get you on a course of treatment. Speak with him or her regarding the treatment possibilities I mentioned before attempting to try any on your own. You simply cannot afford to guess about your eyes.

Readers who would like related information can order my Health Report "Allergies" by sending a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Dr. Peter Gott, P.O. Box 433, Lakeville, CT 06039-0433. Be sure to mention the title when writing or print an order form off my website's direct link at www.AskDrGottMD.com/order_form.pdf.