Can Face Wash Make Dry Eye Worse? What Eye Doctors Should Know

What this episode covers

A patient comes in with red, irritated eyes. Their eyelids are swollen. Maybe they have recurring styes, or perhaps they have tried several contact lenses and insist that every one of them feels dry. For an eye care professional, the natural response is to start thinking about treatment. But Amy Gallant Sullivan , executive director and co-founder of the Tear Film & Ocular Surface Society (TFOS), suggests starting somewhere much simpler. “What do you wash your face with?” It was a question Sullivan returned to throughout her conversation with Dr. Jennifer Lyerly on the Defocus Media Podcast. As skincare routines become more complicated, the products patients use every day may be an overlooked part of the dry eye conversation. Topics Covered : Dry Eye Is Increasingly a Lifestyle Conversation The Problem With Some Familiar Recommendations When “Natural” Does Not Mean Eye-Friendly Skincare May Be Hiding Behind Contact Lens Intolerance A New Question for the Dry Eye Exam Dry Eye Is Increasingly a Lifestyle Conversation Dry eye was once commonly associated with aging, particularly menopausal women. That picture no longer reflects what clinicians are seeing. Teenagers are showing up with irritated eyes. Young adults are struggling with contact lens comfort. Men and women across generations are dealing with redness, inflammation and eyelid problems.At the same time, skincare has changed dramatically. Patients may use cleansers, acne treatments, serums, retinols, makeup removers, eyelash growth products and multiple creams without ever considering them relevant to an eye exam. They are also unlikely to volunteer that information. As Lyerly pointed out, patients generally do not consider a face wash, retinol cream or lash serum a “medication.” Asking what medications they take may therefore completely miss an important part of their daily routine.That changes the conversation in the exam room. Instead of only asking what a patient is taking, clinicians may need to ask what they are putting on their face. The Problem With Some Familiar Recommendations Baby shampoo remains one of the most recognizable recommendations for eyelid hygiene, but Sullivan argues that its reputation deserves reconsideration. A product being designed for babies does not mean it was designed for the ocular surface. Some formulations can contain fragrance, formaldehyde donors and other ingredients that may irritate the delicate skin surrounding the eyes. Lyerly also noted that baby shampoo may strip oils without delivering the antibacterial benefit many patients and clinicians assume it provides. Oil-based products create a different concern. Petroleum jelly, coconut oil and similar products may seem appealing because they feel moisturizing and can loosen makeup. But around the eyelids, Lyerly and Sullivan discussed the possibility of trapping makeup residue, bacteria and oils against the skin while potentially contributing to meibomian gland obstruction. Micellar water also received scrutiny. Despite the name, Sullivan noted that it is not simply water.

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