Eyelid hygiene (with lid scrubs) is very important in preventing eyelid infection and maintaining a healthy eyelid margin. Without proper cleaning of the eyelids, lid margin disease can develop. Lid margin disease involves overgrowth of bacteria, thickening and accumulation of oily secretions, accumulation of dead skin cells, and inflammation at the base of the eyelashes. This eyelash debris can lead to the problems of blepharitis, meibomitis, dry eyes, Staphlyococcal hypersensitivity, and ocular infections. Demodex folliculorum is a skin mite that causes one type of blepharitis and is commonly seen in patients that do not adhere to a regimen of eyelid hygiene. We know that most serious intraocular infections following surgery come from the patient’s own eyelashes. So, eyelid hygiene is particularly important before and after eye surgery. Lid scrubs should be performed daily, either at the time of washing your face, or when taking a shower or bath.
How Should I Perform Lid Scrubs?
Cleaning the eyelashes and lid margins should be thought of in the same way that we think of brushing our teeth. We don’t think of plaque on our teeth as an infection, yet it does involve bacteria. And in order to reduce the bacteria that cause plaque, we don’t wash our mouths out with antibiotics every day, we brush. Similarly, we should all carefully clean the eyelid margin and eyelashes to reduce bacterial overgrowth. We know that soap can reduce the growth of bacteria. However, both kids and adults are reluctant to get soap in their eyes because it burns. Therefore, I recommend thorough cleaning of the base of the eyelashes and eyelid margins with a non-stinging, gentle cleanser called Cetaphil on a cotton swab. Cetaphil is not a soap. It comes in cleansers and moisturizers. I feel that the best product for cleaning the eyelids is called Cetaphil Gentle Skin Cleanser For All Skin Types.
This cleanser is not actually soap so it does not burn. Other types of Cetaphil may burn, so stick with the one For All Skin Types. It is not dangerous or damaging if it gets into the eyes. It can be used to reduce mattering and debris on the eyelids and around the eyes. Moisten the cotton swab with water. Apply the Cetaphil to the swab and clean the base of the lashes as if you were applying eyeliner or masquera. Then, rinse with water. Even if you feel uncomfortable about using a cotton swab, Cetaphil can be applied with the hands and fingers around the eyes and still be very effective. You can wash your whole face or entire body with Cetaphil. Because it is so gentle and hypoallergenic, it can be used once or many times daily without stinging, drying, or cracking the thin delicate skin of the eyelids. I believe in it so much that I myself have been using it every day for years. PLEASE DO NOT USE BABY SHAMPOO! Eye care providers have been advocating the use of baby shampoo on the eyelids for years because better products were not available. But because baby shampoo is a soap, it is not good for the ocular surface. Baby shampoo can still burn the eyes and be somewhat drying to the skin. Other products exist for cleaning eyelids and can also work well, but Cetaphil still remains my favorite.
