Periocular Dermatitis: How to Treat a Rash Around the Eyes at Home
Face skin guide
Part of our Perioral and face rash guide
Periocular dermatitis is a rash of small red bumps and dryness around the eyes, part of the same condition as perioral dermatitis. It is most often linked to steroid creams, inhalers or nasal sprays. Home treatment means stopping facial steroids with your doctor's guidance, pausing eye makeup and creams, washing gently and using only bland products. Doctors may add metronidazole, pimecrolimus or antibiotic tablets.
- Periocular dermatitis is periorificial dermatitis around the eyes, often alongside the mouth and nose.
- Topical steroid misuse is the strongest known cause; inhaled and nasal steroids can contribute in children.
- Home care: stop facial steroids with medical advice, simplify skin care and use bland products.
- Avoid tea tree oil, essential oils and menthol products near the eyes.
- Eye pain, vision changes or a very red eye need prompt medical care.
What is periocular dermatitis?
Periocular dermatitis is a rash of small red or skin-coloured bumps, often with dryness and flaking, around the eyes. It is part of the same condition as perioral dermatitis, which is why doctors group them as periorificial dermatitis: the rash can appear around the mouth, nose and eyes, alone or together (DermNet). It affects adults and children, and in children it has been reported as young as 3 months (Kellen and Silverberg, 2017).
What causes a rash around the eyes?
The strongest link is with steroid use. A systematic review found topical steroid misuse to be the main factor behind perioral and periorificial dermatitis (Searle et al., 2021), and in children, inhaled and nasal steroids can also play a role (Kellen and Silverberg, 2017). Heavy creams, cosmetics and a disturbed skin barrier may contribute.
| Condition | How it looks around the eyes | Clue |
|---|---|---|
| Periocular dermatitis | Tiny red bumps, sometimes pustules, with dryness; often a clear rim next to the lid margin | Often follows steroid creams or inhalers |
| Eyelid eczema or contact dermatitis | Dry, red, scaly, itchy eyelids | Can be triggered by cosmetics, nail polish, eye drops or hair dye |
| Seborrheic dermatitis or blepharitis | Greasy scale on the lid margins and eyebrows | Crusting at the lashes, dandruff |
| Rosacea | Flushing, redness and bumps on the cheeks and nose, sometimes gritty eyes | Triggered by heat, alcohol, spicy food |
How do you treat periocular dermatitis at home?
- Stop steroid creams on the face, but if you have used a strong one for weeks or months, ask your doctor first, as the rash often flares temporarily when steroids stop (Lee and Zirwas, 2015).
- Simplify your routine. Pause eye makeup, eye creams, serums and fragranced products for a few weeks.
- Wash gently with lukewarm water and a mild, fragrance-free cleanser, then pat dry.
- Use only a thin, bland moisturiser if the skin feels tight; avoid thick ointments on the bumps.
- Use a cool compress for a few minutes if the area burns or itches.
- Avoid rubbing your eyes and touching the rash.
- Be patient. Even with treatment, periorificial dermatitis often takes several weeks to settle.
Do natural remedies help periocular dermatitis?
There is no good evidence that natural remedies cure periocular dermatitis, and the skin around the eyes is especially sensitive. Tea tree oil, essential oils, apple cider vinegar and menthol products can irritate the eyes and should be avoided. Pure aloe vera gel is sometimes used for comfort, but it can cause allergic reactions, so patch test it on the arm first and keep it out of the eyes.
What will a doctor prescribe?
Doctors usually start with gentle prescription treatments. A systematic review found the best available, though low-certainty, evidence for oral tetracycline antibiotics and pimecrolimus cream (Gray et al., 2022). Topical metronidazole is widely used, including in children, and for children who need tablets, doctors choose antibiotics suitable for their age (Kellen and Silverberg, 2017).
See a doctor promptly if you have eye pain, blurred vision, light sensitivity, a very red eye, significant swelling, or if the rash is spreading or in a young child.
Can you use herbal creams around the eyes?
For rashes around the mouth or nose rather than the eyes, see our perioral dermatitis guide.
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Frequently asked questions
How do you get rid of periocular dermatitis fast?
There is no instant cure. Stopping facial steroids with your doctor's guidance, simplifying your routine and using a prescribed treatment such as metronidazole or pimecrolimus usually clears it over several weeks.
Can I put hydrocortisone on periocular dermatitis?
It is best avoided. Steroids may calm the rash briefly but are a common cause of periorificial dermatitis and often make it come back worse.
Is periocular dermatitis the same as eyelid eczema?
No. Periocular dermatitis causes small bumps around the eyes, while eyelid eczema causes dry, scaly, itchy lids, often from an allergy to cosmetics or nail polish. A doctor can tell them apart.
What natural remedy is safe around the eyes?
Cool compresses and a bland, fragrance-free moisturiser are the safest choices. Avoid essential oils, tea tree oil, vinegar and menthol products near the eyes.
Is periocular dermatitis contagious?
No, it is not contagious and cannot be spread to other people.
Related articles
References
- DermNet. Periorificial dermatitis.
- Kellen R, Silverberg NB. Pediatric periorificial dermatitis. Cutis. 2017;100(6):385-388. PMID 29360899
- Searle T, Ali FR, Al-Niaimi F. Perioral dermatitis: diagnosis, proposed etiologies, and management. J Cosmet Dermatol. 2021;20(12):3839-3848. PMID 33751778
- Lee GL, Zirwas MJ. Granulomatous rosacea and periorificial dermatitis: controversies and review of management and treatment. Dermatol Clin. 2015;33(3):447-455. PMID 26143424
- Gray NA, Tod B, Rohwer A, et al. Pharmacological interventions for periorificial (perioral) dermatitis in children and adults: a systematic review. J Eur Acad Dermatol Venereol. 2022;36(3):380-390. PMID 34779023
Educational information only. This article does not replace medical advice. Any rash near the eyes with eye pain, vision changes or significant swelling needs prompt medical assessment.
