Eyelid problems are common and rarely serious, but see your GP if you’re worried or your eye is particularly uncomfortable.

The information below should give you an idea of what might be wrong, although it shouldn’t be used to self-diagnose your condition. It covers possible causes for the following eyelid problems, plus specific advice about what to do. You can find out about:

• Swollen eyelids or eyelid cysts
• Itchy, flaky or sticky eyelids
• Lumps on or around the eyelids
• Hooded or droopy upper eyelids
• Rolling outwards of the lower eyelids (ectropion)
• Rolling inwards of the eyelids (entropion)
• Yellow plaques on the eyelids
• Excessive blinking or uncontrollable closure of the eyelids

Swollen eyelid or eyelid cyst:-

swollen-eyelid

It’s quite common for the upper or lower eyelid to become swollen because of a meibomian cyst (also called a chalazion). This occurs when the glands in the eyelid become blocked. These cysts vary in size, from barely visible to the size of a grape. They usually take weeks to develop. They’re not usually painful, but can become red and painful if infected. The cysts can come and go by themselves, although they may take a few months to get better. You can help them heal by holding a clean flannel warmed in hot water to the closed eye for five minutes, and repeating this three to four times a day for up to four weeks. Another common cause of a swelling on the eyelid is a stye. A stye is a minor infection of the base of an eyelash that usually clears up on its own in a week or two. Holding a warm flannel to it regularly may help it heal faster.

Itchy, flaky or sticky eyelids:-

Itchy, flaky or sticky eyelids

Itchy and flaky eyelids are usually caused by an inflamed eyelid edge (blepharitis) or dry eye. Your eyelids may also stick together and be difficult to open, particularly when you wake up. These conditions can be irritating, but are rarely serious. You can reduce the irritation by keeping the eyelids clean and using artificial tears if your eyes are dry. Read about treating blepharitis and treating dry eyes. Contact dermatitis is another possible cause of itchy or flaky eyelids. This is a type of eczema triggered when the skin comes into contact with something you are irritated by or allergic to, such as make-up. The condition usually clears up after you stop using the substance your skin is reacting to.

Lumps on or around the eyelids:-

Lumps on or around the eyelids

Just like anywhere else on the skin, lumps can occur on or around the eyelids. Many lumps are simple cysts or styes (see above). However, occasionally a lump can be a sign of a more serious condition such as skin cancer and may need to be removed. Most skin cancers are basal cell carcinomas, which very rarely spread to other parts of the body. These often appear as a red or pink lump containing small blood vessels, although they can be pearly-white or “waxy” looking. Sometimes they may bleed. Less commonly, the lump may be a squamous cell carcinoma, which is more serious as there’s a small risk it could spread to other parts of the body. These usually look like an ulcer with a red base and a scaly and crusted surface. You may also lose eyelashes where the lump is growing. In rare cases, the lump could be a sign of a very serious type of skin cancer called melanoma that can spread to other parts of the body and can be very dangerous. A lump is more likely to be melanoma if it’s an irregular shape, dark or changing in colour, and getting a lot bigger over time.

Hooded or droopy upper eyelids:-

Hooded or droopy upper eyelids

As you get older, it’s quite common to have excess skin above the upper eyelids that can overhang and block your vision. This is called dermatochalasis. If it affects your vision, surgery may be considered to remove the excess skin (blepharoplasty). If the edge of your upper lid droops down over your eye, it’s called ptosis. This is usually age-related and develops slowly. Surgery may be needed if the edge of the lid droops so much your vision is affected. In rare cases, ptosis isn’t related to age and may be caused by serious conditions such as myasthenia gravis or a brain tumour. In these cases, it’s likely there would be other symptoms too.

Lower eyelid that rolls outwards (ectropion):-

Ectropion

As you get older, one or both lower eyelids can sometimes droop away from the eye and turn outwards. This is known as an ectropion. The drooping eyelid can disrupt the normal production of tears, which can cause your eye to become dry, red and irritated. Treatment may not be needed in mild cases, although drops or ointment may help make your eye more comfortable. Sometimes a minor operation is needed to correct the position of the eyelid. Read more about treating ectropion.

Eyelids that roll inwards (entropion):-

Entropion

Entropion is where the eyelid rolls inwards. It usually affects the lower lids, but it can also affect the upper lids. Like ectropion, this is often age-related. Entropion usually causes an uncomfortable watery eye because the lashes irritate the front of the eye (cornea). If this is mild, using eyedrops may be enough to protect the eye and keep you comfortable. Severe entropion can be painful and cause vision loss by damaging the cornea. Occasionally, a corneal ulcer can form and become infected. Surgery may be needed to correct entropion if it’s posing a risk to the health of your eye or is causing considerable discomfort. This is carried out under local anaesthetic.

Yellow plaques on the eyelids:-

Xanthelasma

Flat yellow patches (plaques) over the upper or lower eyelids are called xanthelasma.  Although these plaques are harmless, they indicate you have high cholesterol. See your general practitioner because you may be at risk of developing cardiovascular disease, such as heart attacks and strokes. Making changes to your diet and taking medication may be recommended to reduce your cholesterol level and reduce your risk of serious problems in the future, although these may not improve the plaques. If you’re bothered by the appearance of the plaques, it may be possible for them to be surgically removed or treated with a laser.

Excessive blinking or uncontrollable closure of the eyelids:-

Blepharospasm

It’s quite common and normal for the eyelid to flicker or twitch occasionally, particularly when you’re tired. It’s more unusual to have repeated spasms of excessive blinking and involuntary closure of one or both eyes. This is a type of dystonia (a movement disorder that causes muscle spasms and contractions) known as blepharospasm. Each spasm can last for a few seconds to a few minutes. The exact cause of blepharospasm is unknown. However, the blinking and closure can be triggered by bright light, stress or tiredness. Severe blepharospasm can be very disabling and embarrassing. However, an effective treatment is available. It involves having small injections of botulinum toxin (such as Botox) into the face to relax the muscles controlling the eyelids.

Blepharitis

Blepharitis is a common condition where the edges of the eyelids (eyelid margins) become red and swollen (inflamed).

Blepharitis can develop at any age, and symptoms can include:

• Itchy, sore and red eyelids that stick together
• Crusty or greasy eyelashes
• A burning, gritty sensation in your eyes
• Increased sensitivity to light (photophobia)
• Swollen eyelid margins
• Finding contact lenses uncomfortable to wear
• Abnormal eyelash growth or loss of eyelashes in severe cases

In most cases both eyes are affected, but one eye can be more affected than the other. The symptoms tend to be worse in the morning.

What causes blepharitis?

There are three main types of blepharitis:

• Anterior blepharitis – where the inflammation affects the skin around the base of your eyelashes
• Posterior blepharitis – where the inflammation affects your Meibomian glands, found along the eyelid margins behind the base of the eyelashes
• Mixed blepharitis – a combination of both anterior and posterior blepharitis

Anterior blepharitis can be caused by either:

• A reaction to Staphylococcus bacteria – these usually live harmlessly on the skin of many people, but for unknown reasons they can cause the eyelids to become inflamed
• Seborrhoeic dermatitis – a skin condition that causes skin to become oily or flaky and sometimes irritate the eyelids, causing the Meibomian glands to block

Posterior blepharitis is caused by a problem with the Meibomian glands, where the glands get blocked by either debris, skin flakes or inflammation.

Sometimes blockages in the Meibomian glands are associated with a skin condition called rosacea. If too much oily substance is being produced, this may be caused by seborrhoeic dermatitis.

Mixed blepharitis, which is the most common, is caused by a combination of both anterior and posterior blepharitis.

How blepharitis is treated:-

Blepharitis is usually a long-term condition. Most people experience repeated episodes, separated by periods without symptoms. It can’t usually be cured, but a daily eyelid-cleaning routine can help control the symptoms and prevent permanent scarring of the eyelid margins.

There are three main steps to eyelid hygiene that should be performed once or twice a day:

• Using a warm compress – to make the oil produced by the glands around your eyes more runny
• Gently massaging your eyelids – to push the oils out of the glands
• Cleaning your eyelids – to wipe away any excess oil and remove any crusts, bacteria, dust or grime that might have built up

More severe cases may require antibiotics that are either applied to the eye or eyelid directly, or taken as tablets.

Complications:-

Blepharitis isn’t usually serious, although it can lead to a number of further problems.

For example, many people with blepharitis also develop dry eye syndrome, where the eyes don’t produce enough tears or dry out too quickly. This can cause your eyes to feel dry, gritty and sore.

Serious, sight-threatening problems are rare, particularly if any complications that develop are identified and treated quickly.

Acne

Acne is a common skin condition that affects most people at some point. It causes spots, oily skin and sometimes skin that’s hot or painful to touch.
Acne most commonly develops on the:-
• Face – this affects almost everyone with acne
• Back – this affects more than half of people with acne
• Chest – this affects about 15% of people with acne

Types of spots:-
There are six main types of spot caused by acne:
• Blackheads – small black or yellowish bumps that develop on the skin; they’re not filled with dirt, but are black         because the inner lining of the hair follicle produces pigmentation (colouring)
• Whiteheads – have a similar appearance to blackheads, but may be firmer and won’t empty when squeezed
• Papules – small red bumps that may feel tender or sore
• Pustules – similar to papules, but have a white tip in the centre, caused by a build-up of pus
• Nodules – large hard lumps that build up beneath the surface of the skin and can be painful
• Cysts – the most severe type of spot caused by acne; they’re large pus-filled lumps that look similar to boils and         carry the greatest risk of causing permanent scarring.

Diagnosing acne:-
How many spots you have and how painful and inflamed they are will help determine how severe your acne is. This is important in planning your treatment.
Four grades can be used to measure the severity of acne:
• Grade 1 (mild) – acne is mostly confined to whiteheads and blackheads, with just a few papules and pustules
• Grade 2 (moderate) – there are multiple papules and pustules, which are mostly confined to the face
• Grade 3 (moderately severe) – there’s a large number of papules and pustules, as well as the occasional inflamed       nodule, and the back and chest are also affected by acne
• Grade 4 (severe) – there’s a large number of large, painful pustules and nodules

Treatment acne:-
Treatment for acne depends on how severe it is. It can take several months of treatment before acne symptoms improve.
The various treatments for acne are outlined below. You can also read a summary of the pros and cons of the treatments for acne, allowing you to compare your treatment options. If you just have a few blackheads, whiteheads and spots, you should be able to treat them successfully with over-the-counter gels or creams (topical treatments) that contain benzoyl peroxide.

Prescription medications that can be used to treat acne include:-
• Topical retinoids
• Topical antibiotics
• Azelaic acid
• Antibiotic tablets
• In women, the combined oral contraceptive pill
• Isotretinoin tablets

A combination of antibiotic tablets and topical treatments is usually the first treatment option for severe acne. If this doesn’t work, a medication called isotretinoin may be prescribed. Hormonal therapies or the combined oral contraceptive pill can also be effective in women who have acne. However, the

-only pill or contraceptive implant can sometimes make acne worse.
Many of these treatments can take two to three months before they start to work. It’s important to be patient and persist with a recommended treatment, even if there’s no immediate effect.

Skin Tags

If you’ve noticed fleshy little growths on your skin that are tempting to pick at, you likely have skin tags. These raised bumps and flaps are known as “acrochordons” or “cutaneous tags” by dermatologists. Fortunately, they’re completely harmless—but they can be super-annoying if you don’t like the way they look. “They often occur in areas of friction like around the neck, under the arms, and by the groin and are thought to be caused by irritation from skin rubbing against skin or clothing. You can probably blame them on your parents—skin tags are usually genetic. Obese people have a higher incidence of them since there is more flesh likely to rub against itself to provoke more tags. You may have just one or a couple of skin tags, or they can sprout up as a small, isolated group of bumps. And if you have them, you’re definitely not alone. About one in four people will grow skin tags at some point, and it’s especially common after the age of 50 to start seeing more of them. While harmless, skin tags can become irritated and inflamed and even bleed if you scratch at them or catch the skin on something like a zipper. While there are a plethora of DIY methods on the Internet that claim to remove skin tags at home—like tying the base of the tag with thread. “You’re opening yourself up to risk of scarring and infection,” he says. The good news is that they’re easily removed if you’d rather do without them. At the dermatologist’s office, a local anesthetic and quick snip of special doctor’s scissors will do the job. Super-freezing or heating (known as cauterizing) the tag are other common options. Discomfort is minimal with any method, and you can immediately return to your normal activities. There should be no mark left behind after your tag is removed. The same skin tag shouldn’t grow back, but there’s always a chance that new skin tags may form in other areas. If your skin tags don’t bother you, it’s totally fine to forget about them. But as with any skin growths, if there’s a noticeable change in the appearance or growth, you should have it looked at by your dermatologist.