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What Doctors Don't Tell You

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July 2020 (Vol. 5 Issue 5)

Blepharitis: try these top tips
About the author: 
Joanna Evans

Blepharitis: try these top tips image

Try nutritional supplements and natural topicals to combat this common eye disorder, says Joanna Evans

If you've ever suffered from sore, itchy, red eyelids, you may have had a bout of blepharitis—inflammation of the rims of the eyelids, which can lead to irritation of the eyes themselves and sometimes an increased sensitivity to light. It's been called "the most under-diagnosed, undertreated, and underappreciated eye disease worldwide"1 and has signs and symptoms that include crusty, greasy eyelashes, a gritty sensation and bloodshot eyes.

Typically, the problem is persistent (chronic), with symptoms that tend to flare up from time to time and then subside for long periods.

Common causes include poor eyelid hygiene (not taking eye makeup off at night, for example), bacterial infection and dysfunction of the oil-producing meibomian glands in the eyelid.

Conventional treatment includes medicated eye drops and ointments, but there are several natural remedies you can try instead, some of which may even be able to prevent the problem rather than just relieve the symptoms.

Combine these with a stringent eyelid cleansing routine and you'll be well on your way to beating this common problem for good.

1) Get enough EFAs

Supplementing with omega-6 and omega-3 essential fatty acids (EFAs) may be helpful for inflamed eyelids.

In a study of patients with meibomian gland dysfunction (MGD), a common form of blepharitis, a combination of good eyelid hygiene (warm compresses, massage and cleaning) and omega-6 supplements reduced symptoms better than either eyelid hygiene or the supplements alone.2 Another study found flaxseed oil, which is rich in the omega-3 alpha-linolenic acid, to be significantly better than olive oil (the placebo) as a treatment for people with MGD.3

Suggested dosage: 28.5 mg/day linoleic acid and 15 mg/day gamma-linolenic acid (omega-6s); two 1,000-mg flaxseed oil capsules three times a day or around 3,000 mg omega-3/day (see page 76 for WDDTY's pick of omega-3 supplements)

2) Apply honey

Honey has antibacterial and anti-inflammatory properties and has been used for centuries to treat eye disorders.4 In clinical trials of 102 patients using topical honey to treat eye infections including blepharitis, improvement was seen in 85 percent of cases.5 New Zealand Manuka honey may be especially useful for blepharitis due to its high concentrations of methylglyoxal (MGO), one of the main antibacterial components.6

How to use: Use a cotton swab to apply the honey along the lash line nightly, as you would an ointment. Take care to avoid getting any honey in the eye.

3) Try tea tree oil

Another potent antibacterial, tea tree oil is showing promise for treating blepharitis and MGD. In one study, a tea tree oil formula was significantly more effective than eyelid massage and cleansing for improving blepharitis symptoms, especially light sensitivity, grittiness, soreness and discomfort during reading.7

How to use: Tea tree oil-containing wipes are available, such as Optase Tea Tree Oil Lid Wipes (, or you could try making your own completely natural formula by adding a couple of drops of tea tree oil to half a teaspoon of a carrier oil, like coconut or hemp oil, then applying it along the lash line with a cotton swab, taking care to avoid getting it in your eye. Test a tiny amount on your skin first to make sure it doesn't cause any irritation or an allergic reaction.

4) Opt for N-acetylcysteine

This amino acid appears to help prevent dry eyes—a common symptom of blepharitis. In patients with chronic blepharitis, the addition of oral N-acetylcysteine (NAC) to their conventional therapy (artificial tears along with topical antibiotics and steroids) significantly improved symptoms, possibly because of its antioxidant properties.8

Suggested dosage: 100 mg three times daily

5) Take a multivitamin

If you don't already, it's a good idea to start taking a multivitamin/mineral supplement. Low levels of vitamin B6, biotin, riboflavin and zinc have been linked to blepharitis in both humans and animals.9 Make sure you get one that supplies decent dosages of these nutrients, or take a zinc supplement and high-dose B complex vitamin separately.

Eyelid hygiene tips

Any treatment for blepharitis should always be accompanied by a strict eyelid cleaning routine. Even better, combine it with gentle eyelid massage, which can help unclog any blocked meibomian glands.1 Here are some tips:

• Clear away oil and debris from around the eyelash line by applying warm compresses (using a cloth or cotton ball warmed with hot water) to the eyelids several times a day.

• Immediately after this, use a clean finger and gently sweep the fingertip along the eyelid, starting at the inner corner and ending at the outer corner. Repeat this about five to 10 times on both the upper and lower lids while keeping the eyes closed.

• Following the massage, moisten a cotton swab with a solution of warm water and sodium bicarbonate (1 tsp in a cup of water will do), and use it to gently clean along the base of the eyelashes. Avoid touching the eye itself, and always use water that's been freshly boiled and cooled.

• If you wear eye makeup, be sure to remove it completely before going to bed (hemp seed oil makes a great natural eye-makeup remover) and then follow the above cleansing steps.




Eye (Lond), 2015; 29: 1520-1


Cornea, 2007; 26: 260-4


Trans Am Ophthalmol Soc, 2008; 106: 336-56


Iran J Basic Med Sci, 2013; 16: 731-42; Nutr Metab (Lond), 2012; 9: 61


Bull Islam Med, 1982; 2: 422-5


BMJ Open Ophthalmol, 2017; 1: e000065


Oman J Ophthalmol, 2018; 11: 11-5


Cornea, 2002; 21: 164-8


Altern Med Rev, 2008; 13: 191-204

Eyelid hygiene tips



Clin Ophthalmol, 2012; 6: 1689-98

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