Allergic contact dermatitis (ACD) is an immune-mediated skin reaction that causes an erythematous and pruritic rash upon exposure to a specific allergen [1,2]. Although it can occur on any part of the body, ACD of the eyelids and periorbital skin has distinct features and additional risks for patients. This interdisciplinary review serves to highlight management of this challenging disease.

The skin of the eyelids is histologically unique and the thinnest of anywhere on the body. The eyelid skin is frequently exposed to potential allergens via the application of cosmetic products and hand-to-face contact. Due the public visibility of the periocular adnexa, red and puffy skin changes are particularly distressing. Poorly controlled ACD can cause frequent eye rubbing, which can cause eyelash loss [3], damage the meibomian glands, induce mechanical dermatitis and inflammatory hyperpigmentation, and adversely affect vision [4,5]. Finally, since ACD of the eyelids is often treated by non-dermatologists who are challenged when simple avoidance strategies fail to provide improvement for the patient, an interdisciplinary approach can aid in the diagnosis and treatment of eyelid ACD.