Blepharitis: Symptoms, Causes and How to Manage It

By Nizam Diveli, registered optometrist and founder of BlinkBetter

Blepharitis is inflammation along the edges of your eyelids. It makes them red, sore, itchy and crusty, often worse first thing in the morning. It's very common, it isn't contagious, and for most people it's managed at home with a daily routine: a warm compress, a gentle massage and cleaning along the lash line. It tends to come and go, so the goal is keeping it under control rather than a one-off cure.

Not sure what's going on with your eyelids? Try our free eyelid symptom checker. It takes about a minute.

If you've been told you have blepharitis, or you suspect it, this guide covers what's going on, why it keeps coming back, and what actually helps.

What is blepharitis?

Blepharitis is inflammation of the eyelid margins, the strip of the lid where your lashes grow (nidirect). It can start at any age. Moorfields Eye Hospital notes it's more common in young children and in people over 50, and that most people have repeated episodes with symptom-free spells in between (Moorfields Eye Hospital).

It's rarely serious and doesn't usually threaten your sight. But it can be persistent, and it's one of the most common reasons people end up seeing an optometrist about their eyes.

Blepharitis symptoms

Symptoms usually affect both eyes, though one can be worse than the other. The most common are:

• red, swollen or sore eyelid edges
• itchy eyelids
• crusty or greasy lashes, sometimes with flakes like dandruff at the roots
• eyelids stuck together when you wake up
• a gritty, burning or stinging feeling in the eyes
• sensitivity to light
• contact lenses that feel uncomfortable

In more severe or long-standing cases, lashes can fall out or start growing in the wrong direction (nidirect). Symptoms are often at their worst in the morning, because oil and debris build up along the lids overnight.

The types of blepharitis

Blepharitis is usually described by where on the lid it starts.

• Anterior blepharitis affects the front of the lid edge: the skin and the base of the lashes. This is where you see crusts and flakes.
• Posterior blepharitis affects the back of the lid edge, where the meibomian glands sit. These tiny glands release the oil that stops your tears evaporating. When they block, the oil thickens, your tears dry out faster and your eyes feel gritty and dry. This is closely linked to meibomian gland dysfunction (MGD).
• Mixed blepharitis is a combination of the two, and it's the most common type (nidirect).

The good news is that the same daily routine helps all three.

What causes blepharitis?

There often isn't one single cause. The usual contributors are:

• Bacteria. Staphylococcus bacteria normally live on the skin. In some people, the lids react to them, which inflames the base of the lashes (Moorfields).
• Blocked oil glands. Debris, skin flakes or inflammation can block the meibomian glands (nidirect).
• Skin conditions. Blepharitis is linked with seborrhoeic dermatitis (which also causes dandruff) and rosacea. It's also more common in people with eczema, acne or allergic conditions like asthma.
• Demodex mites. These tiny mites live in lash follicles. Large numbers are linked to stubborn blepharitis with waxy "collars" around the lashes. There's more in our Demodex guide.

Blepharitis isn't a sign that you're not washing properly. Plenty of people with good hygiene get it, because the problem is how the lid edge reacts, not how clean you are.

Is blepharitis contagious?

No. You can't catch blepharitis from someone, or pass it on (nidirect). It's still sensible not to share towels, flannels or eye make-up, but that's general hygiene rather than a risk of spreading it.

How to treat blepharitis at home

UK guidance puts eyelid hygiene first for blepharitis (NHS Scotland Eyecare Guidelines). The routine has three steps, done once or twice a day:

1. Warm. Hold a warm compress on closed eyes for 5 to 10 minutes. This softens the oil in the glands and loosens crusts.
2. Massage. Gently roll the lids towards the lashes to ease the softened oil out.
3. Clean. Wipe along the lash line to clear oil, crusts and debris.

Our step-by-step guide, how to clean your eyelids, walks through each step with diagrams.

The biggest thing that decides whether this works is keeping it up. NHS guidance stresses that blepharitis is long-term, can't usually be cured outright, and that doing the routine consistently reduces both symptoms and flare-ups (NHS Scotland). Many people stop once their eyes feel better, and a few weeks later it's back.

A few other things help while it's active:

• skip eye make-up, especially eyeliner on the waterline and mascara
• switch to glasses for a while if your contact lenses feel uncomfortable
• if your eyes feel dry or gritty, lubricating eye drops can make them more comfortable, since dry eye often comes with blepharitis
• if you have rosacea, seborrhoeic dermatitis or dandruff, getting those under control helps your eyelids too

What helps with blepharitis

You can do the routine with a flannel and diluted baby shampoo. Products make it quicker and easier to keep up every day, which is what actually matters.

• For the warm step: a heat mask holds its temperature far better than a flannel. Our SelfHeat eye mask is designed for this; it warms up on its own, with no microwave.
• For the clean step: our BetterScrub eyelid wipes are a UKCA-registered medical device for eyelid hygiene. They have a soft side and a textured side for crusts at the lash line, plus tea tree. If you'd rather cleanse at the sink, our Eyelid Cleansing Foam is designed to gently cleanse the lids and lashes.
• For comfort overnight: our BetterLids eyelid ointment is a UKCA-registered medical device that keeps dry, sore lid edges comfortable while you sleep.

You can find the whole range in our blepharitis collection.

Treatments your optometrist or GP might suggest

If the daily routine isn't enough after a few weeks, an optometrist can look at your lids under magnification and work out what's driving it. Depending on what they find, NHS guidance includes:

• a short course of antibiotic ointment or drops for the lid edge, when hygiene alone hasn't worked
• a longer course of antibiotic tablets for stubborn posterior blepharitis, which works partly by calming inflammation in the oil glands
• tea tree–based lid cleaning when Demodex mites are suspected
• occasionally a short course of mild steroid drops for a severe flare

These are all from the NHS Scotland Eyecare Guidelines. Some optometrists with an independent prescribing qualification can prescribe these themselves. Even with treatment, you'll still need the daily routine; the medicines settle a flare, and lid hygiene stops the next one.

Can blepharitis cause other problems?

Usually it's just uncomfortable. But left alone, it can lead to:

• chalazions, firm lumps in the eyelid caused by a blocked oil gland
• styes, painful red bumps on the lid edge (see our styes guide)
• dry eye, because blocked glands mean your tears evaporate too quickly
• lash changes, such as lashes falling out or growing in the wrong direction
• scarring of the lid edges in long-standing cases, which daily cleaning helps prevent (nidirect)

Blepharitis, styes, conjunctivitis or dry eye?

These often get mixed up, and they can overlap. As a rough guide:

Condition	Where it is	Typical signs
Blepharitis	Along the lid edges, usually both eyes	Red, itchy, crusty lid edges, worse in the morning, comes and goes
Stye	One spot on the lid edge	A single painful, red bump, often with a yellow head
Chalazion	Within the eyelid	A firm, usually painless lump that develops slowly
Conjunctivitis	The white of the eye and inner lids	Pink or red eye, sticky discharge or watering, often starts suddenly
Dry eye	The surface of the eye	Gritty, tired, sometimes watery eyes, worse with screens or in heating

If you're not sure which you have, an optometrist can tell you in a few minutes.

When to see an optometrist or GP

See an optometrist if:

• symptoms haven't improved after 3 to 4 weeks of doing the routine every day
• it's only in one eye and isn't settling
• you have a lid lump that keeps coming back or is getting bigger
• your lashes are falling out or the lid edge looks notched or misshapen

Get help urgently, the same day, if you have sudden severe symptoms, eye pain, a very red eye, strong sensitivity to light or any change in your vision. Contact an optometrist or GP straight away, or go to A&E if you can't reach either (nidirect). These aren't typical of blepharitis and need checking.

Frequently asked questions

Does blepharitis go away on its own?

A flare can settle, but blepharitis usually comes back if you stop looking after your lids. Most people find it stays quiet as long as they keep up the routine, even if that's just once a day or a few times a week.

How long does a blepharitis flare-up last?

With daily lid hygiene, many people notice their eyes feel better within a couple of weeks. A flare can take several weeks to settle fully, which is why it's worth sticking with it.

Can blepharitis affect your eyesight?

It can make your vision feel blurry for a moment, usually because the tears are unstable, and blinking normally clears it. It doesn't usually cause lasting damage to your sight. Any real change in vision needs checking the same day.

Can I wear contact lenses with blepharitis?

Many people can, once it's under control. During a flare, lenses often feel uncomfortable. Switching to glasses until it settles is sensible, and always take your lenses out before cleaning your lids.

Can children get blepharitis?

Yes. It's more common in young children and in people over 50 (Moorfields). If you think your child has it, get their eyes checked by an optometrist before starting any products.

Is baby shampoo good for blepharitis?

Diluted baby shampoo (one part to ten parts warm water) is a long-standing option for cleaning the lid edge. Some people find it stings or dries the skin over time, in which case an eyelid wipe or cleanser made for the job is gentler.

The short version

Blepharitis is common, not contagious and very manageable. Warm, massage and clean your lids every day: twice a day during a flare, then keep it up once it settles. If it isn't improving after a few weeks, or anything feels more than just irritated, see an optometrist.

Shop the routine: SelfHeat eye mask · BetterScrub eyelid wipes · Eyelid Cleansing Foam · or browse the blepharitis collection

This article is general information and doesn't replace an eye examination. If you're worried about your eyes, see an optometrist. Here's how we write and review our health information. About the author: Nizam Diveli, optometrist.