Does Skincare Affect Your Eye? Let's Talk Ocular Surface Health!

I say over and over on this channel: what goes AROUND your eyes, ends up IN your eyes. And skincare is NO DIFFERENT! So today, let’s discuss the implications of the skincare you’re using AROUND your eyes on your OCULAR SURFACE HEALTH.

Welcome back to the eye school blog, with me Dr. D, where I teach you about products and treatments related to dry eye syndrome and eye beauty so you can have healthy, beautiful, comfortable eyes. The migration of cosmetics and skincare products across the lid margin and into the tear film has long been observed by eye doctors in day to day practice, and recently there have been articles published to back up what we’re seeing clinically.


The migration of these products is thought to exacerbate tear film instability and symptoms of dry eye syndrome. In addition, numerous adverse events have been reported with the use of cosmetics around the eye. Prospective studies have demonstrated that eyeliner application at the inner eyelash line is associated with higher levels of tear film contamination and ocular discomfort than application at the outer periocular skin.


Why I always say to NEVER EVER apply eyeliner to your “waterline”. But first what the heck is a waterline? Well nursa.org, an independent organization not funded by the pharmaceutical industry defines it as, “The medical term for waterline is “horizontal line on the body.” This line represents the point at which the body’s water content is equal to the amount of water in the surrounding environment. The waterline is used to help determine the body’s hydration status and can be used to monitor changes in body water content over time.


In aesthetics or medicine, this is a term that refers to a line between the eyelashes and the eyes. It does not make you look different or make your eye look different in any way because it touches your eye just like you would eyeliner.

There is a gelatin protein in your eyelid that acts as a lining. If you want your eye to have color, you must first see a white outline of your eye, known as the sclera. Swelling or dilated blood vessels are the most common causes of eye redness. If you want the eyeliner to sit properly near your eyes, you can get it into the waterline, but you must do this before applying it.”

A recent randomized trial also highlighted the potential for eye cosmetic wear to compromise the efficacy of lipid-based dry eye supplements.


Ocular Surface Health Begins With Tear Film


The most superficial layer of the tear film is composed of a complex mixture of lipids secreted by the meibomian glands,23 and a continuous surface lipid layer is required to inhibit tear evaporation.24


It has been suggested that the migration of cosmetic products across the eyelid margin may potentially contribute toward an increase in debris within the surface tear film lipid layer, in meibomian gland blockage, and in meibum contamination.11,12,15


The resulting destabilization of the lipid layer can lead to increased tear evaporation and reduced tear film stability.6,7,14,24 Complications of skin and eye products can be related to allergy or toxicity, often attributable to perfumes.


Preservatives - The potential role of preservatives used within eye cosmetic formulations has also been raised. A review suggested that benzalkonium chloride (BAK), a quaternary ammonium preservative, may contribute toward lipid layer destabilization through its detergent-like tensioactive effects.7


However, it is noted that BAK is no longer widely used in eye cosmetic products, partly due to its reduced preservative efficacy within formulations containing solid particulate matter or ionic emulsifications.29 Nevertheless, the review also proposed a model by which lipophilic constituents of cosmetic formulations may disrupt the integrity of the tear film lipid layer.7


The model suggests that the lipophilic substances may initially diffuse through the surface lipid layer. However, their inability to dissolve within the aqueous phase of the tear film could lead to their accumulation at the lipid-aqueous interface, compromising the stability of the overlying tear film lipid layer.


Skincare Ingredients That May Be Affecting Your Ocular Surface Health


Actives - Skincare actives are often recommended by dermatologists as a way to exfoliate the skin, promoting collagen formation and skin regeneration. Many of these are acids, and have the potential to cause acidic cornea and/or conjunctival burns. There are anecdotal cases of glycolic acid doing just that - getting in the eyes and causing redness and irritation.


Retinols - The effect of tretinoin and retinol derivatives on the meibomian glands is well documented in the literature as well as on my channel. I’ll link videos I’ve done on the negative impact retinoids have on the meibomian glands here as well as my advice on how to apply retinol if you must use it.


Dyes and Fragrances - Another component of skin care that is undoubtedly migrating to the ocular surface as the rest of the cosmetic migrates to the ocular surface are the dyes and fragrances that are contained within the product itself. Like preservatives fragrances and dyes have the potential to alter tear film chemistry and stability and potentially cause irritation as well as dry eye symptoms.


Conclusions About Skincare and Ocular Surface Health


There are a number of the components of your skin care that could be affecting your eyes, your tear film and therefore dry eye symptoms. You want to watch out for preservatives, dyes, fragrances as well as acid based actives. And remember, anything you put around your eyes will migrate to the ocular surface.


Therefore, it is incredibly important to flip over those labels and analyze all the components of the skin care and cosmetics that you were placing around your eyes. Think critically about how it will impact your tier film. And if you have any questions don’t hesitate to comment below contact me and I will help you find out if those preservatives or other components are affecting the front of your eye.



Reference Links:

Eye Makeup and Dry Eye https://www.tandfonline.com/doi/abs/10.1080/02713683.2021.1966476

Retinol and MGD https://www.pjo.org.pk/index.php/pjo/article/view/866

https://www.ingentaconnect.com/content/wk/ecl/2016/00000042/00000004/art00002

https://www.sciencedirect.com/science/article/abs/pii/S1542012412700319

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6118859/

https://www.sciencedirect.com/science/article/abs/pii/S1367048412000811