Eyelid eczema… or is it psoriasis?

I was writing a review in makeupalley.com and realised I was going on an on about my eczema (I have my doubts it is actually eczema, but I will continue referring to it as such for simplicity), which would be out of place in the review, but which might come handy to someone with a similar problem. So I decided to expand on that here and provide a link in my reviews. There’s two products in particular that have worked great for me. Let me emphasize: FOR ME. I’d be thrilled if this helps you, but everyone’s skin is different. I had to experiment, and what has worked for me could be terrible for you.

So, I’ll start from the beginning. Many years ago now, I started having small, dry and flaky spots on my eyelids. I put it down to eyeshadow drying my eyelids (my skin is generally very dry), and took care to use cream. Gradually it got worse, I got a definite red rash on one eyelid, and I stopped wearing makeup, which didn’t actually have an effect, it still kept on getting worse. But makeup over flaky dry patches just doesn’t work. The spot moved on to the other eyelid, then to both. I tried several creams. I was given a tiny tube of ointment in the pharmacy for ocular infections, which in a way was weird, but this cream was very oily and it calmed the itchiness and the flaking somewhat.

Years passed. I have never really gotten flareups, because it never really got better on its own either. It only got gradually worse. I don’t think this is typical of eczema, but I might be wrong. My GP only offered me 1% cortisone cream. She prescribed one for particular use on the eyelid, but the pharmacist saw it had just been discontinued, and there is now no cream for use there, so she gave me a regular 1% cream. I was hesitant to use it because it would get in my eye and that is damaging long term. I still had to use it now and then when it got too bad. In addition to the itchiness and constant flaking, the skin would swell, crack and bleed. The cortisone would eventually bring the swelling down, but after I stopped using it it would again get gradually worse. At some point I couldn’t completely open my eyes because of the bulge of my eyelids. The skin looked stony and was producing cells at an alarming rate. This period was hard, but I stayed strong and didn’t give in to the mermaid calls of pseudoscience.

I tried several pharmacy creams targeted to eczema, to no avail. I tried washing, not washing, soap, no soap mild detergents, just water, micellar water, you name it. I found that soap is too drying and no water at all is too drying (warm water then immediately after applying cream seems best). I tried antihistamines, which did nothing.

Luckily, perhaps due to the cortisone use, the spots gradually drifted upwards towards the browbone and my mobile eyelids cleared. It took months for the skin there to heal, and I was afraid it would remain scarred, but it did recover. At the time, I was using a hyaluronic acid and urea cream (Eucerin Hyal-Urea Day Creme, no SPF), and very sporadically small courses of cortisone cream (used daily for a week or two). This was already a great improvement, I mean, my browbone and upper eyelids were a mess, and one of my eyebrows started balding, but I was happy it wasn’t so close to my eyes anymore. The urea in the cream burned a bit when applied, but it was very calming afterwards and the skin started to look more like skin. The itchiness was still maddening though (and I have to say I do not have the steel will power to not scratch such an itch –  it is in fact a temporary relief from the itch). Huge amounts of skin cells were constantly produced, and flaking off. I rubbed them off with a towel wet with warm water twice a day and applied cream immediately afterwards. I found that doing this relieved the itchiness noticeably (I get this impression: a thick layer of dead skin cells does not let whatever cream get absorbed by the live layers underneath, after removing them, cream is absorbed and the skin relieved).

eucerin
I switched to Eucerin Replenishing Face Creme with 5% Urea, which is the review I was writing when I decided to make this post.

INGREDIENTS Aqua, Urea, Glycerin, Caprylic/Capric Triglyceride, Cyclomethicone, Dimethicone, Pentaerythrityl Tetraisostearate, Triisostearin, Cetyl Alcohol, Sodium Lactate, Glyceryl Stearate, Benzyl Alcohol, PEG-40 Stearate, Biosaccharide Gum-1, Methylparaben, Lactic Acid, Lanolin Alcohol, Phenoxyethanol

Supposedly what works here is the urea and the lactate. This cream is awesome! It worked better than the Hyal-urea one on my ezcema, and I absolutely love it for the rest of my face. And the price is fair. This is my makeupalley review. I used it after my scrubbing, and throughout the day, many times. The skin would absorb it and become dry again incredibly fast.

dermalexSome time after that, I decided to try the psoriasis cream from Dermalex:

Ingredients: Purified water, Alkaline earth minerals complex optimised for Psoriasis treatment, Modified Alumino-Silicates, White petrolatum, Cetearyl alcohol, Paraffinum liquidum, Polysorbatum 60, Ethyl alcohol, Methyl 4-hydroxybenzoate

Dermalex Repair reduces the typical symptoms by normalising skin cell production and the maturation time. It accelerates the skin barrier recovery via activation of the skin’s own repair mechanism and fortifies the skin barrier through the creation of a protective shield and prevention of water loss from inside to outside.

This cream burned a lot (only on the damaged skin) the first times I used it. I persevered, and it worked. The burning decreased, but this cream always burned. This is the only thing I had found that brought the itch and cell production down. The swelling and flaking were thus reduced. I used it twice a day.

Now, this cream is explicitly formulated for psoriasis, and the Replenishing Face Creme is also recommended for it. Whatever I tried geared to eczema and atopic dermatitis didn’t really work (also several other Eucerin creams). Do I have psoriasis? maybe. Is there even a clear distinction? I have no idea. Doctors have not been very helpful. I’ve been offered cortisone, which is good to bring you down from a really rough place, but it is not helpful long term. Is is psychosomatic? neurologic? autoimmune? I have no idea.

I did visit a dermatologist (I was there for another reason and this was just a passing question, however) and she was surprised I was using the Dermalex cream on my eyelids (I suppose because of the burning) but she said if it works, keep on using it. But she also recommended me another cream. This was a tiny tube that cost me 17 euro! SVR Topialyse palpébral (irritated eyelids anti-itching cream). This was worse than nothing. Using it meant I could not use the other two creams that were actually working, and my patches got worse straight away.

Acqua, butylene glycol, beheneth-25, cyclopentasiloxane, dicaprylyl carbonate, glycerin, panthenol, hydrolyzed hibiscus esculentus extract, magnesium PCA, ammonium glycyrrhizate, escin, ruscus aculeatus extract , cucumis melo fruit extract, calendulla officinalis extract, glycerin, sodium, methylparaben, cera alba, dissodium EDTA, potassium sorbate, benzoic acid, citric acid, glycerin, tropolone.

Is there anything good in there beyond glycerin (three times??) and trace extracts? I can’t tell.

So I hobbled on with the Eucerin Replenishing Face Creme and the Dermalex for months. Still itchy, still a bit swollen, still flaky, but not too bad.

paulasMy latest breakthrough has been BHA! Four months ago I got a large tube of Paula’s Choice 2% BHA weightless body treatment.

Product Ingredients:
Water (Aqua), Butylene Glycol (slip agent), Cetyl Alcohol (thickener), PPG-14 Butyl Ether (thickener), Salicylic Acid (beta hydroxy acid/exfoliant), Dimethicone, Tocopheryl Acetate (vitamin E/antioxidant), Chamomilla Recutita (Matricaria) Flower Extract, Epilobium Angustifolium (Willow Herb) Flower/Leaf/Stem Extract (anti-irritants), Camellia Oleifera (Green Tea) Leaf Extract, Cucumis Melo (Melon) Fruit Extract (antioxidants), Bisabolol, Allantoin (anti-irritants), Cyclopentasiloxane, Cyclohexasiloxane, Dimethiconol (silicone slip agents/texture enhancers), PEG-40 Stearate (thickener), Sorbitan Stearate (emulsifier), Polysorbate 20 (solubolizing agent), PVM/MA Decadiene Crosspolymer, Polyacrylamide (film-forming agents), C13-14 Isoparaffin (thickener), Laureth-7 (emulsifier), Disodium EDTA (chelating agent), Sodium Hydroxide (pH adjuster), Hexylene Glycol (solvent), Caprylyl Glycol (preservative), Ethyhexylglycerin (skin-conditioning agent), Phenoxyethanol, (preservative).

I was intending to use it on face and body. As I do, I experimented on my eczema. I put a very tiny bit first, afraid it would irritate it. It burnt a tiny bit but it wasn’t irritating. I started using more, in the evening, and it’s been amazing! It has almost completely stopped the itching. I stopped using the Dermalex cream. After one month, I could start wearing makeup again.

I also then experimented with Paula’s AHA products, but this did not work at all, the patches got worse and the skin hardened again. I went back to BHA which works great.

So now my routine is:

In the evening I remove my makeup with a lotion cleanser and I follow with micellar water (both Sensitive 0% purple bottles from Kruidvat -a local drugstore in Belgium and the Netherlands- brand, cheap and great!); if I am not wearing makeup, I just use a bit of micellar water on a cotton pad; I splash some more warm water, dry and apply Paula’s Choice BHA exfoliant (also to the rest of my face). I wait a minute or two, then add a good gloop of Eucerin Replenishing Face Creme to my “eczema” (on the rest of my face, I either use the same, ora Paula’s Choice retinol cream for the body). Later, before I go to bed, I top up the Eucerin. 

In the morning, I scrub the dry flakes that formed overnight (lately though, after a few months, I am getting less and less flakes in the morning) with a towel dampened in very warm water. I place the towel over my skin for a few moments, then gently rub a couple of times. A glob of Eucerin follows (I also use it on the rest of my face). I am then ready to go, or wait a while for it to absorb and follow with makeup. I am amazed that I can use makeup! my “eczema” looks good enough, it is still slightly raised, and it is red, but I cover it with a greenish khaki-ish corrector and you’d have to get very close to notice. This routine carries me through the entire day. I don’t have to re-apply cream, it barely itches now and then, and the flaking is very minimal. 

I have to say I am thrilled!

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