Compared to our mother’s and grandmother’s generations, menopause symptoms are now better documented than ever before from hot flushes, to mood swings and vaginal dryness, most women today are better prepared about what to expect as they reach menopausal age.
But what about if there are still so some common symptoms that experienced by large numbers of menopausal women, yet doctors are still not so familiar with?
Blepharitis, a type of eye eczema, that causes inflammation of the eye lids and the skin around the eyes, as well as neck eczema could be one of the unknown yet common symptoms of menopause and for many women often its one of the first and most difficult symptoms to deal with.
‘Women entering perimenopause are more prone to developing dry itchy skin around the eyes and conditions like blepharitis,” says Dr Eva Melegh M.D. consultant dermatologist.
“The reduction in the hormone oestrogen is what can trigger eye eczema and facial eczema in peri menopausal women as oestrogen is a major factor for collagen production which keeps skin flexible and moisturised. The skin around the eyes, and on the fae and neck is particularly susceptible to dryness from a drop in oestrogen as its very thin and so isn’t able to retain much moisture.”
So what can be done about this common and very uncomfortable condition. According to doctors not a lot as normal prescription steroids are not generally recommended for use around the eye area and should only be considered as a last resort.
“Typical first point of call treatment for atopic skin flares is steroids, they bring fast and spectacular improvement, but for this very delicate area around the eyes steroids are not recommended, which leaves relatively few alternatives,” says Dr Melegh.
However, there are some effective alternatives to steroids and one of those is phytosterols (which are plant-derived steroid-like components) which are structurally similar to the basis of steroids.
“Unlike prescription steroids, phytosterols are natural and gentler and offer anti-inflammatory effects without the undesirable side-effects, which makes them suitable for use around the delicate eye area.
“The physosterol Cardiospermum halicacabum is particularly useful for atopic skin around the eye area as it has been widely studied for its beneficial effect for use on atopic and reactive skin. It’s extracted from a vine grown in Sri Lanka, and offers an effective anti-inflammatory action and is gentle enough to use around the eye area,” says to Dr Melegh.
Here four women discuss their menopause-triggered blepharitis and how Hydrosil Dry Eye Gel, which contains the physosterol cardiospermum halicacabum, helped relieve their symptoms.
‘I was offered cosmetic surgery instead of HRT for damage due to menopausal linked blepharitis as none of the doctors made the link between the two’
Katherine, 57, a mum of three and full -time carer for her son who suffers from autism lives in Lavenham in Suffolk.
Katherine says;
“When I first developed inflamed sore eyes in the Spring of 2018 I thought maybe I had developed late onset allergy.
Around this time my skin has also become quite dry and I would get a flushed face now and then and had started to get more disturbed sleep. I figured that I was probably entering the menopause as these were common symptoms I’d read about but I didn’t have them that badly so I thought I’d just let nature take its course.
The symptoms started off with itching and swelling on my eyelids. The irritation became increasingly worse and it got to the point where by I would wake up most mornings with red swollen eyes glued together and like the eyelids were being stabbed with sharp needles.
It was agonising and I felt quite scared because as I gradually pulled at my lashes to ease my eyes open, everything was a blur and I feared that I was losing my eyesight.
My eyelids started to crack and weep and then crusted over. They looked bruised as if I had been in several rounds of a boxing ring, with bruised shadows underneath. When I wiped the crust away it left a shiny surface which felt like burns in the creases.
But it wasn’t until I read a health article about a lady with symptoms just like mine whose doctor had told her that the symptoms were associated with menopause that it ever occurred to me that two things could be linked. None of the doctors or consultants I saw about my eyes ever suggested it was due to menopause and I never saw it listed on any of the menopausal symptoms to look out for.
I used whatever I could find in the house to calm the swelling, paracetamol, anti-wrinkle night creams and moisturisers. Even olive oil and coconut oil. Nothing worked.
I asekd the pharmacist what to use and she suggested allergy tablets, but they knocked me out even more and did nothing for my eyes. Everything I tried seemed to further trigger the pain and itching.
My eyes started to affect my overall health. The swelling and pain triggered migraines and light sensitivity. The skin started to sag heavily above my eyes and underneath.
I bought an air purifier for my bedroom and a humidifier to keep the air moist. I found that everything seemed to trigger the swelling and even the dust on the floor of the gym which I attended. People kept asking me if I was ok as they could see my acute discomfort.
I couldn’t bear the stares or the stinging when sweat ran into my eyes so I stopped going to the gym. I felt depressed as I had gone quickly from being an active women who I’d say looked good for her age to looking and feeling years older than I was. My confidence plummeted but I couldn’t even cry to relieve my misery as the tears burnt my eyes.
My GP told me she wasn’t sure what I had and that there was little she could prescribe as even low-dose steroids for eczema are not really recommended for use around the eyes.
She referred me to an eye consultant at the hospital. After an eye examination I was told to return in six months to be reviewed. In the meantime, the consultant sent me to have an allergy test and see a dermatologist. I was hoping the allergy test would give me the answers but to my surprise, nothing conclusive was determined.
A dermatologist then reviewed my condition without telling me what it was and prescribed a topical steroid treatment gel. Seconds after use, the skin around my eyes became so bright red and swollen, I couldn’t open them and the burning pain was horrific. It felt like both my eyes were being gouged out with red hot pokers. As much as I tried to wash the gel off, the pain just got worse. I called the dermatologist in a panic but she was adamant that I continue to use the gel and said my skin would become used to it. However, I simply couldn’t continue as it was just too painful.
I returned to the eye specialist and she suggested that maybe what I had was blepharitis, though it was more severe than most cases she had seen.
I told her that my mental health was suffering greatly because of how awful my eyes looked and she said she could refer me for cosmetic surgery to remove the excess skin, once the Blepharitis had calmed down.
Surgery seemed rather extreme but then Covid hit and my medical case was closed as it was a non-emergency situation.
Over lockdown I was left to cope with the agony on my own. I decided to do some much deeper research into blepharitis causes and treatments and that is when I discovered Hydrosil Dry Eye Gel after reading about the lady with similar symptoms to me and she had used the eye gel with incredible results. I couldn’t believe that there was actually a product out there that targeted the very problem I had that did not contain steroids and no one had told me about it. I immediately researched it and found lots of reviews from women with similar symptoms as me saying the eye gel had really helped calm down their symptoms.
Needless to say I ordered some immediately. I was scared to apply the gel as by this stage everything stung my eyes, even water. As instructed I carried out a patch test and was not even a tingle so I applied the gel to my eyes and the relief was instant!
Not only did the manufacturers make the eye gel but they also made an under-eye concealer to use over the eye gel which was designed to be used on eyes like mine. Every eye concealer I’d tried before burned but I had zero reaction to this one and it immediately brightened up my dark circles and covered a lot of the redness on my eye lids and around my eyes.
My daughter spotted the improvement immediately when I collected her from school later that day. After a few weeks of using the eye gel my eyes had calmed right down and most of the redness had gone. The dry cracks gradually healed up and once I put the concealer over the top you could barely notice my eye condition at all.
I now use the gel religiously both at night and under make up during the day along with the concealer. My eyes have stayed calm for almost eight months now and are more or less back to normal.
I feel it’s given me back a quality of life and my self-confidence. I can sleep better, I’ve returned to the gym and I no longer feel worried about facing people as my eyes feel normal again and I’m not in constant pain.
While I’m beyond delighted that I’ve found something to control my blepharitis I do feel that if at least one of the doctors I saw had made the link with menopause and maybe prescribed me something for that rather than topical creams that burned my eyes or even cosmetic surgery, I may have been spared years of both physical and mental suffering. It’s definitely something that more doctors really need to be aware of as there must be a lot of women out there going through the same agony as I did.”
‘The dryness was so bad around my eyes from my blepharitis it looked like I had two black eyes.’
Lisa, 54, from Bideford in North Devon is a retired bank manager and lives with her partner John, 55, a retired black cab driver. Lisa has two adult daughters aged 27 and 23 and is shortly about to become a grandmother for the first time.
Lisa says;
“The first sign of my menopause triggered eczema was a small rash on the side of my neck at the start of this year. I thought I’d had a reaction to wearing a new perfume I got for Christmas so I wasn't too worried.
But as the weeks progressed, the rash spread all over my neck and chest and then to my face and eyes.
It was red raw and itched like crazy. The dryness was so bad around my eyes, it looked like I had two black eyes. My skin was flaking off. It got so bad that I was eventually too upset to look in the mirror. I stepped up my cleansing and moisturising routine but nothing seemed to give me any relief from the itching or clear up the furious rash that seemed to be spreading and intensifying.
I was really worried and became quite depressed about the state of my skin. I had never had any skin problems before like this and eczema did not run in my family.
I knew I was a bit stressed as I was going through some big life changes. I was made redundant from my job of 32 years due to Covid, I met my new partner who had also had to take early retirement due to covid and then both of us re located from London to Devon to start a new life away from the city.
However, I was mostly positive about these changes, the main stress was the organisation of it all so it didn’t feel right that my skin was reacting so badly.
I started to research my symptoms online to try and work out what was causing it. I even thought it may have been shingles but realised the symptoms didn't match up.
In all the research I did, which was a lot, there wasn't anything online suggesting it was caused by the menopause. The first time I made the link was after reading an article online about a lady who had similar symptoms to me, face eye and neck eczema, which had been triggered by the menopause. I had started to develop some menopausal symptoms last year, but they were not too bad.
I watched 100's of YouTube videos on beauty skincare for very dry skin around the eyes and on the face and began ordering various products in desperation as by now I felt anxious even leaving the house.
I literally tried everything to try and alleviate my skin, and by everything I mean everything. The list of what I tried calm my skin down ran into hundreds of pounds.
Results varied but in all honesty none of them really worked and some made my skin even worse and I’d spent a small fortune.
I decided I needed medical help and booked an appointment at the doctor, but it was months to get an appointment. Meanwhile instead of beauty advice I started reading health advice articles about eye eczema and facial eczema and quickly discovered that the use of steroids on the face and around the eyes is not advised and that doctors don’t have many options in terms of prescription products for this issue, which filled me with panic as I got the feeling a doctor’s appointment wasn’t going to help me much either. It seemed there was nothing out there to help me.
It was then that I discovered my salvation - Hydrosil Dry Eye Gel that contained a natural plant steroid that claimed to reduce redness, inflammation and itching around the eyes but didn’t carry the same dangers as medicated steroids.
I went straight into the website and found that they also made a Hydrosil Turmeric Butter & Hypoallergenic Milk Salve with the same ingredient in it plus turmeric butter and hypoallergenic milk that I could use on my neck so I ordered both.
Thank goodness I did. The results were quick and frankly amazing. I had taken photos of the state of my skin before in case I needed to send them to a doctor. I then took some after a few weeks of using the Hydrosil eye gel and salve just to see for myself the difference as sometimes it’s hard to believe your own eyes after all the ups and downs I have been through with my skin.
I think the photos speak for themselves about the incredible difference these products have made to my skin.”
‘The first symptom of my menopause was not hot flushes but very red, inflamed and sore skin around my eyes.’
Sherry, 55, a customer service manager from New York is married Tim, 57, a mechanic and they have four grow up children.
“The pain and discomfort of my inflamed eyes was awful. The first flare up lasted nine months and I made it worse by crying most days because of how awful looked.
Some days I felt like I really was the demon monster that my friends and co-workers used to joke I looked like. It was embarrassing as I worked in customer service. The state of my eyes really effected my confidence because it was impossible for people not to stare at my eyes as they were livid and so sore.
I tried multiple cleansing regimes and did hot compresses, which only made my eyes worse. Almost every over-the-counter product I tried stung like hell and dried my skin out, making my eyes even redder and more sore.
Eventually I went to the eye doctor who misdiagnosed me with an allergy and then eventually I was sent to a specialist who diagnosed me with blepharitis. I was prescribed steroids and multiple rounds of antibiotics which only worked for a while but stopped working the minute the course ended. You’re not allowed to use steroids around the eye area for long as they can permanently damage the skin.
It was only after the flare up of blepharitis that my doctor tested me for menopause which had of course begin and he thought was what had triggered my blepharitis. I also had very dry red eyes, and have since also been diagnosed with ocular rosacea, which is probably what then caused the blepharitis.
When the medications for the blepharitis stopped working I started researching alternative treatments on the internet and joined several Facebook groups of other sufferers from this condition which I discovered was far more common than I realised. It was from one of these groups that I read a review of Hydrosil Dry Eye Gel
I ordered some immediately as it was clear from the review that the lady who has written it had something similar to me and had also tried all treatments available from her doctor with no decent results. If someone like that was recommending this eye gel then I believed her as I know myself I would never suggest anything to anyone for this condition unless it really worked. She also said it didn’t sting her yes, which for me was the crucial as by now I was very cautious to try anything new o my eyes due to the intense stinging that was often triggered.
The eye gel began to take effect almost immediately! Within days the swelling and hotness reduces and within a week dry flaking around the eyes and on the my eye lids had noticeably improved. It’s hard to explain the relief I felt from this. Just having something that calmed the hot itchy irritation that was almost always around my eyes felt miraculous after months of nothing working.
After six months of use of the eye gel twice a day I would say my blepharitis has improved by about 90%. I still get some irritation if I’m not super careful about cleansing my eyes every day and I have to be very strict about what make up I wear. I don’t dare wear any ‘normal’ concealers or eye creams around my eye area, instead I used the Hydrosil Dry Eye Concealer around my eyes after using the eye gel underneath. The concealer has some of the same ingredients in it as the eye gel and also has a prebiotic which helps heal dry broken skin. As long as I use the gel twice a day (especially overnight ) and cleanse well every evening my eyes have stayed more or less back to normal
There is no way I would stop using this eye gel ever, it’s been a life saver for me. The fact you can use it every day and don’t have to stop like with steroids is the best thing about it as it constantly keeps working.”
‘The skin around my eyes was so sore, hot, swollen and itchy, I didn’t think I could go through the Christmas dealing with the pain.’
Natasha, 50, is an office administrator from Hampshire
Natasha says;
'Blood tests confirmed I was pre-menopausal at the end of 2019. I was 48.
'In September 2020 I developed a furious red dry and itchy rash on my neck, which then spread around the corners of my mouth and then to around my eyes. It began with a small section on the back of my neck, which I thought at the time was caused by a fashion necklace I'd been wearing.
I’ve always had very oily skin and was even prone to spots as an adult but one thing I never had was dry or itchy skin. Yet all the research kept indicating I had eye eczema which they said could be brought on by stress or diet but nowhere mentioned menopause so I never made the connection.
I had never had anything to indicate that I was prone to eczema before and I had been stressed several times in my life and also changed my diet a lot so it didn’t make sense. Covid lockdown wasn’t easy for anyone and amongst it all I started a new job, but I handled it as well any anyone, albeit with a few wobbles.
By December my skin around my eyes was so sore, hot, swollen and itchy, I could no longer bear it and didn’t think I could go through Christmas dealing with the pain.
I was unable to sleep very well and became embarrassed of my looks and very unsociable. I’d started saying I was busy or not well so as not to appear in public. I do a lot of shopping online, and at one stage I was only going to work which was hard as I see customers and delivery drivers every day. I felt I was starting to lose my confidence and becoming very introverted.
At first as I didn’t want to be a burden, so I tried lots of over the counter lotions, creams purchased on the internet, nothing worked, in fact my eyes were getting worse.
Eventually I got an appointment at the doctors and after four more visits over several months I was finally referred to a dermatologist in April. They just said it was eczema.
I was prescribed a hydrocortisone cream but was warned I could only use the cream for a very short period of time around my eyes as steroids are not advised for use around the eyes as they can cause long term damage to the skin there.
I was so desperate that I was willing to take the risk, but I also knew I had to find an alternative for my eyes as I didn’t want to cause any permanent damage.
I began to do more in-depth research on alternative treatments for eye eczema and that is when I came across Hydrosil Dry Eye Gel and Dry Eye Concealer, which had been used by a lady who was also going through menopause who had symptoms just like mine and was diagnosed with blepharitis. It was only then that it occurred to me that it was linked to my menopause. Looking back it seems obvious but back then no one told me it was a possibility the two are linked so you don’t make the connection yourself.
After I’d managed to calm my eyes down enough with the prescription cream to bare it, which took about two weeks, I stopped using it and started using the Dry Eye Gel and experienced instant relief. I wanted to try something more natural as using the steroids on my eyes really worried me.
I have been applying the eye gel and concealer daily ever since and my eyes are hugely improved and I have not had a flare up like the one I had before since.
It’s been really helpful as my go to product to help keep my eyes under control. They got so bad during the initial flare up that I think only a prescription cream would have done the job at the time, but its really not ideal to be using these types of medicated creams around the eyes especially for more than a few weeks so it puts my mind at ease that I can use a safer alternative now.
Only a few people saw what I was going through due to Covid restrictions and also because I choose not to see people so they didn’t have to look at me.
But I’d like as many women to be made aware of this condition as possible so that they can get help as early as possible and not go through the months of torment and discomfort I did and by also getting doctors to spot the condition sooner as its clearly linked to menopause, HRT will almost certainly help it and everyone should be more aware of that.”
What is blepharitis (eye eczema) and how can menopause trigger it?
Blepharitis is an inflammation along the edges of the eyelids. The eyelids can become irritated itchy and inflamed and appear greasy and crusted with scales that cling to the lashes.
Some things can lead to the development of blepharitis. Some causes include excess bacteria, blocked oil glands, allergies. The condition can also be due to other skin conditions like rosacea, seborrheic dermatitis, and eczema.
Female sex hormones, namely oestrogen, influence production of all components of the tear film including aqueous layer, lipid, and mucin. A drop oestrogen can cause changes in the ocular surface and cause dryness and irritation both in and around the eyes. It can change in the oil gland production which can trigger blepharitis in much the same way that can cause menopausal acne.
Ocular rosacea can also be triggered much like normal rosacea by the disturbance in hormone levels during menopause and blepharitis can then develop as a secondary condition to ocular rosacea.
Blepharitis cannot be cured, but treatment can successfully manage symptoms.
Antibiotics applied to the eyelid have been shown to provide some relief of symptoms and resolve bacterial infection of the eyelids. Topical corticosteroids may also be prescribed in severe cases although need to be used with extreme caution around the eyes and should only be used for very limited periods.
In addition to treatments, people should avoid using cosmetics such as eyeliner, mascara, and other makeup around the eyes unless they are free from chemicals and perfumes and are designed for use on sensitive and atopic skin.
