Curing Blepharitis for Good

Discussion in 'Optometry Archives' started by David Halpern, Aug 21, 2003.

  1. Can any Immunologist tell me when the Pharmaceutical Industry will
    finally get to work on curing this dread disease.

    After thirteen years of torture it would be most appreciated.

    I know they say blepharitis begins at birth but guess what I never had
    *ANY* symptoms before I wore contacts for a year April 1989 - June
    As I watch my health very carefully, I think I would have noticed my
    eyes swimming with sebum and other burning oily infection in my eyes.

    I did brutalize my eyes with contacts and Visine that year and wasn't
    diagnosed till like June of 1990.

    I notice my blepharitis becomes even more painful when I use Visine,
    particularly Visine L.R.

    There has to be a way to reverse the combination of Staphylococcal and
    beneficial flora in your meibomian and Sebacceous glands.

    Or what about neutralizing the toxin the staph flora produces which
    essentially causes the blepharitis in the first place.


    David Halpern, Aug 21, 2003
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  2. David Halpern

    nipidoc Guest

    Strange. What symptoms are you having, and what treamtments have you
    tried in the past??

    nipidoc, Aug 22, 2003
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  3. David Halpern

    nipidoc Guest

    Given that it sounds like you have been able to get temporary relief
    with antibiotics, only have to have it return, I would suggest that
    you have a much deeper infection. It doesn't sound like the infection
    is being completely eliminated, and it is only smoldering, like a fire
    during the times you are getting the relief. Topical stuff isn't
    going to help. I would suggest talking with your doctor about a very
    long term course of antibiotcs, rather than the traditional 10-14

    nipidoc, Aug 24, 2003
  4. David Halpern

    drfrank21 Guest

    I agree about trying the doxycycline for a longer period but the aim
    of the long term doxycycline treatment (from what I understand)
    is more is more to "dry up" the meib. glands than to treat any actual
    infection. I've had success with 4-8 wk dosing on orals but I
    still find some recalcitrant cases that will still re-occur even
    with the longer course. I think for some people it's their
    own physiological status (similar to those who have cystic acne
    that can be very tough to "cure").

    drfrank21, Aug 25, 2003
  5. David,

    Regardless of what type of blepharitis you have, reducing SEBUM is the key.
    Too much sebum clogs the oil glands in posterior and microorganisms love to
    eat the sebum in anterior blepharitis.

    So, what to do? First, get some nizoral or coal tar shampoo. Wash your
    hair and eyebrows (NOT the eyelids) with it every day. Second, try and
    reduce sebum creating hormones. Stress increases sebum production--find a
    way to reduce it. DHT (dihydrotestosterone) is the main sebum producer in
    the body. It is also the chemical that causes balding. Find the hairloss
    newsgroups and find ways to reduce that. Xinc, B6, B5, Evening primrose oil
    may help, among other things. If there is a sebbhoreic component, then
    reducing yeast may help (this is not a candida hoax an abnormal immune
    response to tinea is part of the sebbhoreic complex). Drinking apple cider
    vinegar or probiotics may be helpful. Reduce inflammation and insulin
    resistqance any way you can.

    Treating blepahritis is a whole body apporach. It's a lot more involved
    than just lid scruibs and tetracycline.

    Go to the Rosacea and Seb Derm yahoo groups and acne newsgroup for more
    info. The acne one will not deal with the eyes, but they are related

    This post is for informational purposes only. Please see a qualified
    practitioner for treatment, I am not a doctor.

    Good luck,

    Mike \(Remove X's to reply\), Aug 26, 2003
  6. Lothar,

    Sounds like you've got Seb Derm and are overproducing sebum in your eyelids.
    Fortunately, you don't have the seborrheic blepharitis yet. You may be
    surprised how much treating the scalp, beard, eyebrows can help. Nizoral
    and caol tar shampoos are good, although only nizoral is gentle enough for
    the beard area. Some have reported great success with apple cider
    vinegar--it creates an acid environment that is hostile to the tinea yeast
    that is part of the complex. People with seb serm don't have an overgrowth
    of yeast, just an abnormal reaction to it. It is part of the problem. The
    other part is that inflammatory fatty acids are expressed in the sebum (for
    whatever reason), so reducing sebum output is important in treating it.



    This post is for informational purposes only. Please see a qualified
    practitioner for treatment.
    Mike \(Remove X's to reply\), Aug 26, 2003
  7. Thanks very much for the reply, Mike. I found your response very
    informative. I have tried all sorts of different shampoos over the
    years for my seborrheic dermatitis: coal tar, salicylic acid, zinc
    pyrithione, selenium sulfide. They all seem to do equally as good a
    job on my scalp, but I have yet found one that seems to make any
    difference on my face (eyebrows and beard)--if they are even safe to
    use there. I haven't tried Nizoral yet, but that is next on my list
    of things to attempt.

    In any case, I feel like I have done all I can think of to control
    sebum on my scalp and face (I've been at this for the 25 years or so
    since I was diagnosed), and now I have to figure out what to do to
    keep it from depositing on my contact lenses (if that's indeed what it
    is that's causing my lens problems). I have been experimenting with
    different cleaning solutions to see if one seems to remove the
    deposits better than another (I've tried 4 solutions now and have not
    noticed any difference among them, and have tried rubbing versus
    non-rubbing cleaning regimens). I've also tried lid scrubs, to no
    avail. My doctor is stumped, but he suggested that RGP lenses may be
    the next best thing to try, since he says that soft lenses (I am
    currently using Biomedics 55) are notorious for accumulating such
    deposits. I just took out and discarded my last pair of lenses after
    14 daily wearings, and they looked very oily and I couldn't see
    clearly out of them anymore.

    Any other ideas from anybody would be most welcome! I would love to
    have some other possibilities to run by my doctor for input. I would
    be especially interested in hearing if anybody can first recommend
    another brand of soft 2-week replacement lenses that are less prone to
    accumulating such deposits.

    Lothar of the Hill People, Aug 27, 2003
  8. Shawn,

    I use nizoral on my beard and eyebrows all the time. There is one
    prescription drug that seems to reduce sebum, Avodart, but it is an intense
    anti-prostate drug. The other is, of course, Accutane (tough drug). There
    are other ways to reduce sebum with different supplements. Check out the
    alt.baldspot newsgroup (while you're there, ask how to connect to
    alt.hairloss.d), since male patternbaldness and sebum are closely related.
    They know how to reduce sebum!


    Mike \(Remove X's to reply\), Aug 27, 2003
  9. Thanks for the replies, Mike. I really have a hard time though
    imagining that reducing sebum on my face even more than I have already
    been trying to do is going to prevent it from depositing on my lenses
    anymore. I think for me it's going to be a matter of either finding a
    lens type that is resistant to such deposits, or finding a cleaning
    solution that will remove them. This is all assuming that sebum is
    actually what is causing my lens problems, of which I am not certain.
    Every little bit helps though. I don't think I want to start taking
    such prescription drugs to try to help clear up my lenses, but I will
    keep trying other shampoos, soaps, etc. I will give Nizoral a try.

    Lothar of the Hill People, Aug 27, 2003
  10. David Halpern

    Diet Rich Guest

    I don't quite understand how reducing sebum in scalp, eyebrows etc will reduce
    the sebum in the meybomian glands. So what if I use special soaps that my
    oily skin is not oily anymore on the body. The oil is clogging the meybomian
    glands and it's coming from WITHIN, from the inside.

    Regarding my blepharitis I sometimes joke that even if I had $1M, I wouldn't
    be able to buy a cure...
    The only thing that helps seems to be certain anti-inflammatory eye-drops
    (Lecrolyn, Oftan Dexa-Chlora) that tend to "make the stuff in the meybomian
    glands more liquid" as one doctor put it.

    Mike, do you think it's feasible to reduce the production of oil in the skin
    (everywhere in the body, including meybomian glands) by means of hormone
    therapy or some other radical medicament approach?
    Diet Rich, Aug 28, 2003
  11. David Halpern

    Guest Guest

    Rememebr that the skin is an organ, what affects one part affects the other.
    The meibomian glands realy are not part of the eye, but actually the skin
    with oil glands secreting oil. this mechanism gets screwed up with people
    who have posterior blepharitis and the oil glands get inflamed and clogged,
    causing them to produce toxic oil to the eye. Reducing the production of
    sebum is part of the process. If you have a sebbhoreic component, then,
    improving the quality of oil is also important.

    Nizoral shampoo contatins an antifungal and an antiandrogen. The antifungal
    part helps with the sebbhoreic portion, the antiandrogen helps reduce sebum
    (more on that later). Coal tar shampoo also reduces sebum production
    through an unknown mechanism. When you use the shampoos, medicine gets
    absorbed into the skin, and also gets distributed around the body via blood
    vessels and lymph nodes. In addition, treating one portion of skin seems to
    improve the rest of the skin. It is not a total solution, but is

    Sebbhoreic blepharitis is a complex creature, believed to be caused
    partially by an abnormal immune reaction to the tinea yeast on our skin, an
    overproduction of sebum, and an abundant amount of abnormal inflammatory
    fatty acids. Essential fatty acids may help improve the oil quality.

    Rosacea blepharitis is caused by excessive facial flushing. Getting this
    under control will help the eyes. Beta blockers, antihistamines,
    antidepressants, stomach acid reducers (which are also antihistamines) all
    may help.

    Stress increases sebum production via cortisol. Reducing stress by exercise
    and antidepressants may help reduce sebum production.

    The primary method of reducing sebum is by reducing DHT, a variant of
    testosterone that controls sebum production in the skin. There are several
    hariloss and prostate drugs that do this (avodrt works better than
    propecia), and many supplements have antiandrogen properties: evening
    primrose oil, vitamin b2, b5, b6, zinc, green tea extract, saw palmetto.
    Accutane will also shrink oil glands, but shoud not be taken lightly--it may
    dry your eyes out permanently! Of course, there are the tetracyclines--no
    one I've talked to ever felt that these really did anything for them. I
    thought that they were pretty worthless.

    Sulfacetamide (bleph-10) ocular ointment (if you are not allergic to sulfa)
    seems to be better than other topical antibiotics for blepharitis.
    Sulfacetamide is also used for seb derm and rosacea which may be the reason

    If the inflammation in the eye gets real bad, than Restasis (ocular
    cyclosporin) may also be helpful, but only as a last resort. It is safer
    than ocular steroids.

    As I mentioned before, start going to the hairloss, rosacea, acne, seb derm
    newsgroups and yahoo groups. Anything that helps acne and seb derm will
    help blepharitis.

    ....and, yes, I have it too! Blepharitis can be beaten with the right
    approach. Unfortunately, most eye doctors only know about tetracyclines,
    and skin doctors don't care about the eyelids, so you are left on your own
    for effective treatment.

    This post is for informational purposes only. Please see a qualified
    practitioner for treatment.


    Guest, Aug 29, 2003
  12. Avodart is the name, and it more expensive than propecia. It is newer, but
    only approved for prostate treatment. At your age, it would probably not be
    covered by your insurance plan. If you do not have male pattern baldness,
    then it won't affect your hair.
    Avodart is the best since it blocks alpha-reductase 1 and 2. Proscar
    (another name for propecia) only blocks one of the reductases. Reductase is
    the enzyme that converts normal testosterone to it's less useful
    counterpart, dihysrotestosetrone. DHT does great things for us--it gives us
    back hair, oil, sweat stink, and baldness. Unfortunatley, it seems to also
    be intimately involved in muscle builing and umm.... erection ability. Most
    people on these drugs experience some degree of dysfuction in that arena,
    although a lucky few actually report improved muscular tone and potency.
    Saw palmetto may be helpful.
    I saw your post. Seb derm is short for seborrheic dermatitis.


    Mike \(Remove X's to reply\), Aug 30, 2003
  13. David Halpern

    Rocket man Guest

    Most of what is written below is correct, however I must take exception to
    the recommendation of using 5-alphareductase inhibitors (finasteride aka
    Propecia, or dutasteride aka Avodart) to treat blepharitis. I, and two
    other guys I know, may have developed severe dry eyes from the use of
    Propecia. Avodart could be far worse since it inhibits both type 1 and type
    2 5-alphareductase, thereby eliminating over 90% of the DHT in your body.
    Inhibiting 90% of your DHT long term can also lead to osteoporosis and may
    have an effect on brain cells. Keep in mind that these drugs were primarily
    developed for treating prostate enlargement and cancer in older men.

    The oil glands are under androgen control and you do not want to suppress
    this, trust me! There are studies which confirm that anti-androgens and
    5-alphareductase inhibitors not only affect the lipids produced by the
    meibomian glands, but also the amount of aqueous tears secreted by the
    lacrimal glands.

    Bottom line, be careful when using these hormone-manipulating drugs. They
    may not affect you as much as me, but if they do your life will be

    Rocket man, Oct 13, 2003
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