From: Linda Sy MD
Date: Fri, 12 Nov 1999 14:46:19

Shelley Spencer wrote:

Hi, Can any of the ocular rosacea sufferers let me know what they use to remove mascara/clean their eyes?

Hi Shelley,

Sorry for the delay in responding to you. I am replying here for the benefit of others who have also e-mailed me privately re the subject of mascara for rosaceans and a safe way to remove it. I don’t use mascara myself; therefore had to do some research about it. I am also not an ophthalmologist and therefore, try to refrain from acting as an expert on eye products/rx’s.

I would like to reiterate the wisdom of Alexandra’s message re how she handled her ocular rosacea problem. The key to her message is patience & perseverance. For those who have missed this message, I have pasted it below mine.

I wish to emphasize that my credo in treating patients has always been: It’s better to prevent than to treat. Therefore, if you can go without mascara – then don’t use it.

However, being a woman who values her appearance, I empathize with your desire to look your best. I have some helpful advice from Dr. Zoe Draelos, a dermatologist with special interest in cosmetics, re mascara and here’s what she said:

Mascara for Rosacea Sufferers

“Of all pigments used in mascara, black is the least irritating.

Select water resistant rather than waterproof formulations because you want something that can be washed away with just soap & water.

If patients with very sensitive skin insist on wearing mascara, have them apply it only to the eyelashes. A lot of mascara flakes into the eye.

For patients with bad rosacea who can’t wear mascara but still want to highlight the lashes, I recommend that they buy a black eye shadow and actually brush the eye shadow onto the lashes. To do this, you simply wet the eye shadow brush, run it over the eye shadow, and then brush it onto the eyelashes.

Black eye shadow is nothing but powder. It has no emulsifiers and preservatives. You can mix it with water.  I’ve not found a patient yet who can’t tolerate plain black powder.”

Linda Sy M.D.

Alexandra’s message to the group:

Hi all,

I haven’t written forever because I’ve been very busy. But, I do want to share something with this wonderful group.  My eyes have gotten a lot better (It has taken about 6 months for them to get better, but they have). Here is what worked for me. And its not guaranteed to work for all, I imagine, but maybe it will help some. I will also describe the symptoms I had as that may make a difference to people.

Symptoms:

• inflamed lid margins (people would ask if I had allergies)
• red eyes
• eyes HURT and sometimes stung
• eyes felt swollen
• gummy feeling
• sometimes felt like there was a foreign object in there.

What helped:

• Wash eyelids with dilute solution (50/50) or Johnson and Johnson baby shampoo and warm water. Its cheap, and for me, it works and doesn’t irritate either my face or eyelids. I do this RELIGIOUSLY AT NIGHT AND IN THE MORNING, EACH AND EVERY DAY. If I get lazy, my eyes start getting bad again.  Also, after I wash my eyes with the solution, I rinse them with just plain warm water. I press my warm (clean) hands against my eyes for a couple of minutes as well. This, I have heard, helps loosen the crud that builds up.
• When I get flareups I use an erythromycin antibiotic gel on the lid margins overnight (there is a special gel your ophthalmologist can prescribe. Mine is some generic made by Fougera). It clears up the inflammation in 1-2 days.  (I had tried a sulfate gel before with awful results. My eyelids got purple.  It was horrible, so I chucked that ASAP)
• I was on oral erythromycin for about a month and a half. I believe it helped a lot. Tetracycline, the drug of choice for rosacea, did nothing for me. So, I insisted my doc put me on erythro. And, I was right.
• I put Refresh preservative drops in my eyes at night and in the morning.
• I gently swab the inner and outer corner of my eyelids each night with
  cotton swabs to remove any “crusts” that may have built up.
• I don’t wear any eye makeup. Yes, I look “bland” without it, but you know what, I would rather look “bland” than be in excruciating pain. And, I think that when I wear eye makeup little bits fall of and irritate my eyes and I pay for it the next day with red eyes and swollen eyelids.
• Don’t rub your eyes. No matter what. If they feel bad, run to the bathroom, wash your hands, and rinse your eyelids with some warm water. Put in Refresh drops. Don’t rub. If it doesn’t get better, try to accept that you are having a bad eye day, and that tomorrow will hopefully be better. Put in the gel at night.
• Don’t ever touch your eyes with dirty hands. If you think you have something in there, use a clean cotton swab to get it out of the corner of the eye. (This seems like kindergarten advice, but when my eyes hurt like hell, i used to rub them all the time..the impulse to rub and poke got worse as my anxiety level rose, so actually these last two pieces of advice were actually pretty difficult for me to follow).

That’s all folks. cheap, simple and not a magic “make it all go away” potion, but it has really improved my quality of life. I hope that it helps some of you. Be patient. It took me about 6 months of using this regimen for my eyes to get better. Especially important is, don’t get lazy on washing your eyes with Baby shampoo. Its’ easy to get lazy once your eyes start improving, but you pay for it a couple of weeks later.

Results: I’m not cured, I still have both facial and ocular rosacea, BUT

(a) my eyes don’t hurt anymore

(b) they look close to normal (though I still have some telegencias) and most of the time I can’t even feel that I have ocular rosacea.

My ophthalmologist agrees that they have gotten better and she also says that my tear film is better than before. (I think she feels grateful for this because when they were bad, I used to run to her crying practically every week crazed with pain) I feel lucky for this and I hope that it continues. My eyes have been good like this for several months now and I feel I owe it to my regimen.  Before they hurt so bad that it would trigger migraine headaches and my head and jaw would hurt.

Take care, and a wonderful holiday season to all of you. I couldn’t have made it without the support of all the great people in this group. So, to all a sincere and heartfelt thanks. ”

–Alexandra.

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