Hi there

Hope that someone will be able to help with this and would be grateful for any help at all. To cut a long story short:
- 27 year old male. I’ve had mild acne since I was a teenager. Controlled it with Clean & Clear twice each day. Dec 10 – went to Australia (during their summer) for 4 weeks and had fewer problems. When I came back to the UK winter in January, the acne came back with a vengeance.
- Had mild dandruff since I was a teenager also. I didn’t use shampoos for a few years until Feb 11, then I started using the regular medical anti-dandruff shampoos (Nizoral, Selsun, T-Gel, H&S) and started cycling between them.
- Feb 11: think I picked up conjunctivitis from someone else’s towel, then blepharitis started shortly after.
- May 11: established with my GP that it was seborrheic blepharitis
- Later in 2011: diagnosed with meibomian gland dysfunction
- April 2012: my dermatologist diagnosed me with mild seborrheic eczema and mild rosacea. Prescribed Tetralysal antibiotics to take once a day. Stop taking them a month after ‘symptoms’ subside.
- Worth mentioning that my mother has rosacea. She has quite bad veininess on her cheeks, but she says the rosacea isn’t something she thinks about much any more (I assume it doesn’t cause her much discomfort).
To treat the blepharitis / MGD each day, I’ve been using heat bags for 10 minutes (making sure not too hot) on the eyelids, followed by massage then cleaning with Blephasol / Blephagel. In the shower in the mornings, I also let the foam from the shampoos sit on my closed eyelids for a minute or two – the dermatologist thought it would be alright to let the shampoos I get the gritty sensations in my eyes most days. I also take fish oil supplements. Here is a recent picture of my left eyelid (my left eye is my worst for eye sensations):

Points to note:
- The skin on most of my face doesn’t feel particularly greasy . But the skin around my eyes feels a little bit greasy, and the skin on my eyelids feels extremely greasy. A month ago my ophthalmologist told me that my tear film in my eyes is very oily and my meibomian glands are ‘working overtime’. I think this overproduction of oil inside the eye and on the skin around the eyes is related somehow.
- You can see the base of my eyelashes are depigmented due to blepharitis. I don’t think this is really a problem now – the bases of my eyelashes are pretty clean now.
- The eyelashes have a tendency to stick together.
- Red ‘veins’ on the eyelid due to blepharitis. There are also some more of these just below the eyebrows.
- Small white pimples on the eyelid, near the inner corner of the eye and below the eye (nearer the inner corner of the eye)
- Yellow blotches on the skin just below the eye.
- Something that I believe may be exacerbating my problems – I have quite deep set eyes so alot of the eyelid skin is hidden for virtually all the time. If I shut my eyes, there is still a fold of skin there. To get my eyelids fully stretched out (as in the picture), I have to raise my skin by using the muscles around my eyebrows. I am thinking that the oiliness of the eyelid and the fact that it doesn’t get exposed very often means it is an ideal place for bacteria / yeast to thrive.

Anything additional that you can tell me about the descriptions just above would be very useful:
- Do you think anything I am doing could be aggravating the skin around my eyes – heat bags for 10 minutes, massage, Blephasol, Blephagel, suds from medical shampoos?
- Anything you would recommend me stop doing?
- Is there anything else I can do for the skin around my eyes to help it, such as other products? In particular, is there anything I can do to reduce the oiliness of the skin around this area?

Thanks – please let me know if you need more detail to be able to help. I have more pictures of my eyelids if that would be helpful.