Blepharitis: Symptoms, Causes, and Treatment

Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026

Quick Answer

Blepharitis is inflammation of the eyelids, typically along the edges where the eyelashes grow, usually in both eyes. It is caused by overpopulated bacteria or clogged oil pores at the lash base, and it is not contagious. It cannot be cured, but daily warm compresses, gentle massage and eyelid cleaning usually control it well, and it rarely damages vision permanently.

What the research says

• Steroid and immunosuppressant drops have limited proof behind them. A Cochrane review of 12 randomized trials (2,752 participants) found that topical corticosteroids, with or without antibiotics, and cyclosporine may make little to no difference in signs and symptoms at 4 to 12 weeks compared with placebo or antibiotics alone, based on very low-certainty evidence. The reviewers concluded that conventional lid hygiene and warm compresses remain valid treatment options (Kam et al., Cochrane Database Syst Rev, 2026) [3].

• Tea tree oil is uncertain for eyelash mites. A Cochrane review of six randomized trials (562 participants) found that the effectiveness of 5% to 50% tea tree oil for short-term treatment of Demodex blepharitis is uncertain, with very low-certainty evidence for mite counts and no clear difference in symptom scores. Lower concentrations may be preferable to avoid eye irritation (Savla et al., Cochrane Database Syst Rev, 2020) [4].

• A prescription option exists when mites are the cause. A meta-analysis of five randomized trials found that 0.25% lotilaner eye drops were associated with higher odds of mite eradication (odds ratio 6.18) and collarette cure (odds ratio 6.64; 95% CI 3.78 to 11.04) than placebo in Demodex blepharitis, though heterogeneity was high and long-term data were limited (Akhtar et al., Cont Lens Anterior Eye, 2024) [5].

What Is Blepharitis?

Blepharitis (blef-uh-RYE-tis) is a condition that causes swelling, itching, and other irritation of the eyelids. It usually affects both eyes along the edges of the eyelids, where the eyelashes grow.

The eyelid may look greasy or become crusted with scales that cling to the lashes. Some people wake with their eyelids stuck together. Others wake with dried tears around the eyes and a feeling of sand in their eyes.

Three facts matter most here. Blepharitis cannot be cured. It usually does not cause permanent damage to eyesight. And it cannot be passed from one person to another.

Blepharitis typically causes swelling and irritation along the edges of both eyelids.

What are the symptoms of blepharitis, and why are they worse in the morning?

Blepharitis symptoms are typically worse in the morning. That is why many people first notice the condition when they wake up with crusty lashes or eyelids that feel glued shut.

Symptoms may include:

• Swollen eyelids

• Changes in the color of the eyelids

• Itching or other irritation of the eyelids

• Flaking of the skin around the eyes

• Eyelids that appear greasy

• Crusted eyelashes

• Eyelids sticking together

• Tears that appear foamy

• Watery eyes

• Red eyes

• A gritty, burning, or stinging sensation in the eyes

• More frequent blinking

• Sensitivity to light

• Blurred vision that usually improves with blinking

Notice the last item. Blurry vision with blepharitis is usually temporary and clears with a blink. That is a useful clue, and it is explained in the complications section below.

Symptom guide at a glance

What you notice	What it usually means
Crusted lashes or stuck-shut eyelids on waking	Scales and dried debris collect along the lash line overnight
Greasy-looking eyelids	Oil from clogged glands mixes with skin flakes and debris
Gritty, sandy, burning sensation	The irregular tear film irritates the eye surface
Watery eyes and foamy tears	Inflammation disrupts how tears spread across the eye
Blurred vision that clears with blinking	Debris or unstable tears on the eye surface; blinking resets the tear film

When should you see a doctor about blepharitis?

Make an appointment with a healthcare professional if blepharitis symptoms do not improve with regular bathing or washing.

A few signs deserve earlier attention. Contact a professional promptly if symptoms affect only one eye and do not respond to care, if eyelashes begin falling out, or if vision does not clear after blinking, because one-sided or worsening symptoms may point to something other than blepharitis.

What causes blepharitis to develop?

Blepharitis is inflammation of the eyelids. Inflammation is the immune system's response to something it sees as a foreign substance in the body. This activity can cause swelling, irritation, and other changes in the tissues of the eyelid.

Often, one of two factors is behind it:

Bacterial overpopulation. Certain bacteria normally live on the surface of the eyelids and eyelashes. If this group of bacteria grows unusually, it may cause inflammation.

Clogged oil pores. Pores near the base of the eyelashes release oils. Clogged oil pores may be another likely cause of blepharitis.

But the cause of blepharitis might not be known.

The two most common causes of blepharitis are clogged oil glands and bacterial overgrowth on the eyelid edge.

What are the risk factors for blepharitis?

Several conditions seem to play a role or increase the risk of getting blepharitis:

Risk factor	How it connects to blepharitis
Dandruff of the scalp and eyebrows (seborrheic dermatitis)	Flaking skin spreads toward the eyelid margins and irritates them
Bacterial disease of the eyes or eyelids	Adds to the bacterial load along the lash line
Rosacea	An inflammatory skin condition that changes skin color and appearance and involves the eyelids
Allergies	Including reactions to eye medicines, contact lens solutions, or eye makeup
Excess of eyelash mites	Common and usually harmless, but an excess may contribute
Lice	Tiny insects living on the scalp or other skin
Dry eyes	Dryness and lid inflammation reinforce each other

What complications can blepharitis cause?

Blepharitis may lead to other problems near the eyes. None of these changes the basic message, since daily care keeps most of them at bay, but they explain why the routine matters.

Complication	What happens
Eyelash problems	Lashes fall out, lose color, or grow toward the eyes rather than away from them
Eyelid skin problems	Scarring from long-term blepharitis; the eyelid edges might turn inward or outward
Excess tearing or dry eyes	Excess oil, skin flakes, and debris create an irregular tear film that irritates the eye
Stye	A painful bump on the edge of the eyelid or inside the eyelid, usually from a bacterial infection at the base of an eyelash or in an oil gland, like a boil or a pimple
Chalazion	A swollen bump caused by a blocked oil gland; usually painless at first, but may become tender as it grows
Chronic pink eye	Repeated cases of conjunctivitis, which is inflammation of the film over the white of the eye
Injury to the cornea	Constant irritation or misdirected lashes can cause a sore on the cornea; too few tears increases the risk of other corneal diseases

How is blepharitis diagnosed?

Blepharitis is usually diagnosed with a careful exam of the eyelids and eyes, sometimes with lab tests, and a good response to treatment generally confirms it. Tests and procedures may include:

Examining your eyes. A healthcare professional might use a special magnifying instrument to examine your eyelids and eyes.

Laboratory tests. In certain cases, the eye might be swabbed to collect a sample of the oil or crust on the eyelid for tests of bacteria. Examination of eyelashes under a microscope can show excess eyelash mites.

Response to treatment. Response to treatments generally confirms the diagnosis of blepharitis.

One caution deserves emphasis. If there is no improvement with treatment, particularly in one eye, a healthcare professional may order additional testing to see whether the symptoms are caused by an eyelid skin cancer or an immune-system disorder. Other signs of these disorders include loss of eyelashes or scarring on the conjunctiva, the film covering the eye. One-sided symptoms that resist treatment should never be brushed off as "just blepharitis."

How is blepharitis treated?

Self-care measures, such as washing the eyes and using warm compresses, might be all that is needed for most cases of blepharitis. If self-care measures are not enough, a healthcare professional might suggest prescription treatments.

Treatment	How it helps
Antibiotics (fight infection)	Relieve symptoms related to bacterial colonies on the eyelids; available as eye drops, creams, and ointments, and as pills when drops do not improve symptoms
Steroid eyedrops or ointments (control inflammation)	Generally reserved for people who do not respond to other therapies; sometimes combined with antibiotics
Cyclosporine eyedrops (Restasis, Cequa, others)	Offer relief of some signs and symptoms of blepharitis
Treatment of underlying conditions	Controlling dandruff, rosacea, or other related conditions may control the blepharitis itself

Here is the honest long-term framing. Blepharitis rarely disappears completely. Even with successful treatment, the condition frequently is chronic and requires daily attention with eyelid cleaning. Think of it like brushing your teeth: the routine does not vanish once things feel better. It is the routine that keeps things feeling better.

What daily eyelid hygiene routine helps blepharitis?

Self-care measures are the only treatment needed for most cases of blepharitis. The routine takes a few minutes and is done 2 to 4 times a day, adjusted to your symptoms.

Use a separate washcloth or swabs for each eye.

Step	What to do
1. Warm compress	Apply a washcloth warmed with water over your closed eye for several minutes to loosen crusty deposits. Reheat the cloth with warm water as needed.
2. Gentle massage	Firmly but gently massage the eyelids with a new clean washcloth or a clean finger.
3. Clean the lash line	Immediately use a clean washcloth or cotton-tipped applicator moistened with warm water and a few drops of diluted baby shampoo or a nonprescription eyelid cleanser to wash away oily debris or scales at the base of the eyelashes. Gently pull the eyelid away from the eye to avoid contact with the eye.
4. Rinse and dry	Rinse your eyelids with warm water and gently pat them dry with a clean, dry towel.
5. Apply prescriptions	If you have a prescription ointment, cream, or eye drop, use it as directed after cleaning your eyes.

Beyond the core routine, four extras help:

Lubricate your eyes. Nonprescription artificial tears can help relieve dry eyes.

Control dandruff. If dandruff may be contributing, ask a healthcare professional to recommend a dandruff shampoo. Using one might relieve blepharitis signs and symptoms.

Address eyelash mites. If excess eyelash mites are suspected, you may be asked to use a tea tree oil shampoo or a 50 percent tea tree oil scrub, available without a prescription. Contact a healthcare professional if you do not see improvement in six weeks, and stop tea tree oil if it irritates your skin or eyes.

Avoid eye makeup during flare-ups. Makeup makes it harder to keep eyelids clean and free of debris. It is also possible that makeup could reintroduce bacteria to the area or cause an allergic reaction.

Daily eyelid care (warm compresses, gentle massage, and lash-line cleaning) is the foundation of blepharitis management.

What About Supplements and Alternative Treatments?

No alternative medicines have been proved to ease the symptoms of blepharitis.

That said, a diet rich in omega-3 fatty acids, or omega-3 supplements, might help blepharitis linked with rosacea. Omega-3 fatty acids are found in foods such as salmon, tuna, trout, flaxseed, and walnuts. More study is needed, so treat this as a reasonable addition, not a replacement for eyelid hygiene.

Conclusion

Blepharitis is frustrating but manageable. It usually strikes both eyes along the lash line, feels worst in the morning, and shows up as crusty lashes, greasy lids, a sandy feeling, and blurry vision that clears with a blink. It usually comes down to bacteria that have overpopulated the eyelid surface or oil pores that have clogged, and sometimes no cause is ever found.

The good news outweighs the inconvenience. It is not contagious. It rarely harms eyesight permanently. And a simple daily routine of warm compress, gentle massage, and lash-line cleaning controls symptoms for most people, with prescription drops and underlying-condition treatment available when needed.

Take the next step: Start the warm-compress and cleaning routine today. If symptoms persist beyond a couple of weeks of regular care, affect only one eye, or worsen, see a healthcare professional or an eye specialist.

FAQ

What is blepharitis?

Blepharitis is a condition that causes swelling, itching, and irritation of the eyelids, usually along the edges where the eyelashes grow. It most often affects both eyes and is typically caused by bacterial overpopulation on the eyelids or clogged oil glands near the lashes.

Is blepharitis contagious?

No. Blepharitis cannot be passed from one person to another, even though bacteria are often involved. The bacteria involved are ones that normally live on your own eyelids and lashes.

Is there a cure for blepharitis?

No cure exists. Blepharitis rarely disappears completely and frequently stays chronic, requiring daily eyelid cleaning even after successful treatment. But daily care and treatments usually control the symptoms well, and it usually does not cause permanent damage to eyesight.

Is a stye the same thing as blepharitis?

No, but they are related. A stye is a painful bump on the eyelid edge, usually caused by a bacterial infection at the base of an eyelash or in an oil gland, while a chalazion is a usually painless bump from a blocked oil gland. Blepharitis raises the risk of both.

Why are my symptoms worse in the morning?

Overnight, crusty deposits, dried tears, and foamy secretions collect along the lash line, so eyelids often feel stuck together and gritty on waking. The daily warm-compress routine works partly because it loosens exactly this overnight buildup.

Disclaimer: This article is for general educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for questions about a medical condition.

Related Reading

Artificial Tears: Types, Uses and How to Use Them explains artificial tears for dry eyes.

References

1. Mayo Clinic Staff. Blepharitis - Symptoms and causes. Mayo Clinic. September 20, 2025. https://www.mayoclinic.org/diseases-conditions/blepharitis/symptoms-causes/syc-20370141

2. Mayo Clinic Staff. Blepharitis - Diagnosis & treatment. Mayo Clinic. September 20, 2025. https://www.mayoclinic.org/diseases-conditions/blepharitis/diagnosis-treatment/drc-20370148

3. Kam KW, et al. Topical immunosuppressants for blepharitis in adults. Cochrane Database Syst Rev. 2026;5(5):CD013550. PMID 42153421. https://doi.org/10.1002/14651858.CD013550.pub3

4. Savla K, et al. Tea tree oil for Demodex blepharitis. Cochrane Database Syst Rev. 2020;6(6):CD013333. PMID 32589270. https://doi.org/10.1002/14651858.CD013333.pub2

5. Muhammad Muneeb Akhtar S, et al. Efficacy and Safety of Lotilaner Ophthalmic Solution 0.25% for the Treatment of Demodex Blepharitis: A Meta-Analysis of Randomized Controlled Trials. Cont Lens Anterior Eye. 2024;47(3):102148. PMID 38514290. https://doi.org/10.1016/j.clae.2024.102148