Blepharitis: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Blepharitis?
An ophthalmologist, a doctor who specializes in eye care and eye surgery, treats blepharitis. Optometrists, who examine and treat eye problems, also care for it. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is blepharitis?
Blepharitis is inflammation of the eyelids. They may look red or swollen, or feel like they are burning or sore. Flakes or oily particles, called crusts, often collect at the base of the eyelashes. Blepharitis is very common, especially in people who have oily skin, dandruff, or rosacea, which is a skin condition that causes a red rash on the face.
Symptoms
Symptoms often include:
- Red, irritated eyelids.
- Scales or flakes that stick to the base of the eyelashes.
- A burning feeling, itching, or swelling of the eyelids.
- A feeling of sand or dust in the eye when you blink.
Sometimes eyelashes fall out. If the condition lasts a long time, the eyelids can become scarred. Styes and chalazia, which are small bumps on the eyelid, are more common in people with blepharitis.
Causes and who gets it
The exact cause is unknown. It is thought to come from one or more of these:
- An overgrowth of bacteria that normally live on the skin.
- A skin mite called Demodex, a tiny mite that lives in eyelash follicles.
- A decrease or breakdown of the normal oils made by the eyelid.
It is more likely in people with seborrheic dermatitis, a skin problem that can involve the scalp, eyebrows, and eyelids, and in people with rosacea.
How doctors diagnose it
A doctor can usually make the diagnosis by looking at the eyelids during an eye exam. Special photos of the glands that make oil for the eyelids can be taken to see whether they are healthy.
Treatment
There is no cure for blepharitis, but the symptoms can be controlled. Cleaning the edges of the eyelids every day helps remove extra bacteria and oil. A warm compress, a clean washcloth soaked in warm water held over closed eyes, loosens flakes and helps keep the oil glands from clogging. Doctors often suggest gently scrubbing the eyelids with diluted baby shampoo or special cleansers.
If home care is not enough, a doctor may prescribe an antibiotic ointment on the eyelid or antibiotic pills. Artificial tears or steroid eye drops may calm redness, swelling, and dry eye.
If Demodex mites are the cause, a prescription eye drop called lotilaner ophthalmic solution can help. It was approved by the FDA in July 2023 to treat Demodex blepharitis. This drop is used twice a day for six weeks. Some people also get relief with omega-3 fish oil, which may help the eyelid oil glands work better.
When to see a doctor
Call your provider right away if your symptoms get worse or do not improve after several days of carefully cleaning your eyelids. Also get care for eye pain that keeps getting worse. Blepharitis that continues long-term without care can scar the eyelids, so do not ignore changing symptoms.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can look at irritated eyelids, start basic lid care, and refer you to an eye doctor when drops or in-office treatment are needed.
Common questions
Can blepharitis be cured?
No. There is no cure, but symptoms can be controlled. Daily eyelid cleaning is the main habit that keeps it under control, and treatment may still be needed from time to time when it flares.
Is blepharitis contagious?
Probably not. It involves bacteria that normally live on your own skin, mites, and oil problems in your eyelids, not a bug you catch from someone else. To keep bacteria down, keep your eyelids, skin, and hair clean, and wash your hair, scalp, and eyebrows with an antibacterial shampoo.
What are Demodex mites?
Demodex are microscopic mites that can live inside the eyelash follicles. An over-population of them can lead to blepharitis. A prescription eye drop, lotilaner ophthalmic solution, is approved by the FDA to treat Demodex blepharitis.
How long does treatment take?
It varies. Warm compresses and eyelid cleaning are daily habits, not a one-time fix. The outcome is most often good with treatment, but you may need to keep the eyelids clean to stop the problem from coming back.
Sources
- MedlinePlus Medical Encyclopedia - Blepharitis
- American Academy of Ophthalmology - What Is Blepharitis?
- U.S. Food and Drug Administration - Drug Trials Snapshots: XDEMVY
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
