Blepharitis is inflammation of the eyelid margins — the edges of the lids where the eyelashes grow. It can affect one or both eyes, the upper lids, lower lids, or all four.

It's a chronic condition, meaning it tends to come and go rather than resolve completely on its own. Flare-ups are common, particularly during periods of stress, illness, or when lid hygiene lapses.

Blepharitis is broadly divided into two types, though many patients have elements of both:

Anterior blepharitis affects the outer front edge of the eyelid where the lashes are attached. It's often associated with a bacterial overgrowth — typically Staphylococcal species — or with Demodex mite infestation of the lash follicles.

Posterior blepharitis affects the inner edge of the lid, where the meibomian glands open onto the lid margin. This type is closely linked to meibomian gland dysfunction (MGD) and is extremely common in patients with dry eye disease.

What causes blepharitis?

Several factors can contribute to or trigger blepharitis:

• Bacterial overgrowth on the lid margin, most commonly Staphylococcal species
• Demodex mites — microscopic mites that live in eyelash follicles and are a common and underrecognised cause, particularly in older patients
• Meibomian gland dysfunction — poor quality meibomian oil creates an environment where bacteria thrive
• Seborrhoeic dermatitis — a skin condition causing flaking of the scalp and face that frequently involves the eyelid margins
• Rosacea — a significant proportion of rosacea patients develop posterior blepharitis and MGD
• Contact lens wear — increases bacterial load on the lid margin
• Reduced immune response with age

What are the symptoms?

Blepharitis symptoms overlap significantly with dry eye disease — the two conditions frequently coexist and drive each other.

Common symptoms include:

• Red, sore, or inflamed eyelid margins
• Crusting or flaking at the base of the lashes, particularly on waking
• Gritty, burning, or stinging eyes
• Eyelids that feel stuck together in the morning
• Watery eyes
• Sensitivity to light
• Eyelashes that grow irregularly or fall out over time
• A feeling that something is in the eye
• Blurred vision that varies through the day

Symptoms are often worse in the morning and may improve as the day goes on — though for many patients with associated dry eye, they worsen again by the afternoon.

How is blepharitis diagnosed?

Diagnosis is made through careful examination of the eyelid margins, lashes, and meibomian gland openings at the slit lamp. At our clinic we look for:

• Lid margin redness and thickening
• Crusting, scaling, or collarettes at the lash base — collarettes are a specific sign of Demodex infestation
• The quality and flow of meibomian gland secretions
• Signs of associated MGD, rosacea, or seborrhoeic dermatitis
• Corneal involvement in more advanced cases

We combine this with meibomian gland imaging and tear film assessment to build a complete picture of what's driving your symptoms.

How is blepharitis treated?

Blepharitis can't always be cured, but it can be very effectively controlled. Treatment is aimed at reducing bacterial load, clearing blocked glands, managing any Demodex infestation, and establishing a sustainable lid hygiene routine.

Lid hygiene Regular, effective cleaning of the lid margins is the foundation of blepharitis management. We'll show you the right technique and products — not all lid wipes and cleansers are equally effective, and poor technique can make things worse.

Warm compresses Gentle warming of the lids softens meibomian secretions and improves gland function. Consistency matters more than intensity here.

In-clinic treatments

For patients with moderate to severe blepharitis, or where self-care alone isn't controlling symptoms, we offer:

• ZEST (Zocular Eyelid System Treatment) — a deep professional clean of the lid margins using okra-based gel. Highly effective for removing biofilm and Demodex debris that home cleaning can't reach
• LLLT (red and blue light therapy) — blue light has documented antimicrobial properties at the lid margin, making it particularly useful where bacterial load or Demodex is a factor. Red light addresses the associated inflammation
• IPL therapy — where rosacea or significant lid margin inflammation is driving the blepharitis, IPL can reduce the inflammatory burden and improve meibomian gland function
• NuLids — a gentle micro-exfoliation device for home use between clinic treatments, helping maintain the results of professional treatment

Demodex-specific treatment Where Demodex mites are identified as a significant contributor, treatment is tailored accordingly. We'll explain this in detail — see our dedicated Demodex blepharitis page for more information.

Blepharitis and dry eye — the connection

Blepharitis and dry eye disease are closely linked. Lid margin inflammation disrupts meibomian gland function, which destabilises the tear film. A disrupted tear film creates conditions where bacteria thrive, worsening the blepharitis. It becomes a self-reinforcing cycle.

Treating one without addressing the other rarely produces lasting results. Our approach looks at the whole picture — lid health, gland function, tear film stability, and any underlying skin conditions — and treats accordingly.

Frequently asked questions

Is blepharitis contagious? No. Blepharitis is not infectious and cannot be passed to other people.

Will it go away on its own? Blepharitis tends to be a chronic, recurring condition. Mild cases may settle with consistent lid hygiene. More established blepharitis usually needs a structured treatment approach and ongoing maintenance to keep symptoms controlled.

How long will treatment take? This depends on the severity and type of blepharitis. Most patients notice meaningful improvement within four to eight weeks of starting a proper treatment programme. In-clinic treatments accelerate this significantly.

Can I wear eye makeup with blepharitis? We'd advise against eye makeup during active flare-ups. When symptoms are controlled, hypoallergenic products and thorough removal each evening are important. We'll advise you on what's appropriate for your situation.

Do I need to see a GP first? No referral is needed. You can book directly with us for an assessment.

Get your eyelid health assessed

If you've been managing sore, crusty, or uncomfortable eyelids on your own, a proper assessment will tell you exactly what's going on and what will actually help.