Itchy Eyes? Don't Rub Them: The Trouble Rubbing Causes and Safer Ways to Stop the Itch

Why does rubbing make the itch worse and hard to stop?

The conjunctiva contains large numbers of mast cells, which store itch-causing substances such as histamine. As soon as an allergen touches them, these substances are released and the itching starts. The mechanical pressure of rubbing bursts more mast cells and releases more itch-causing substances, so the itch eases briefly and then gets worse.

Rubbing also irritates nerve endings, causing local blood vessels to widen and tissue to swell. The eyelid skin is thin, so repeated rubbing easily makes it red, wrinkled and puffy. This is why many people look in the mirror the next day and find the skin around their eyes more noticeable than the eyes themselves.

So the first step in stopping the itch is to keep your hands away from your eyes. When the itch starts, close your eyes for a few tens of seconds, or press gently along the bony rim of the eye socket, instead of rubbing the eyeball directly. This takes a little practice, but it really can break the cycle of rubbing making the itch worse.

What you really need to worry about with rubbing is the cornea

The cornea is the clear tissue at the very front of the eye, and it is soft. Long-term forceful rubbing can change the shape of the cornea, causing fluctuating vision and blurry sight. These changes often progress slowly and are hard to notice early on.

Vernal keratoconjunctivitis is a more severe type of allergic conjunctivitis, seen mostly in children and teenagers who have eczema, asthma or seasonal allergies. It can itself affect the cornea, causing light sensitivity and deep eye pain in bright light. Rubbing at this point adds to the risk.

It is worth saying that these situations are not common, and most people will not have problems from rubbing their eyes a few times now and then. But children often cannot explain their discomfort clearly. If a parent notices a child rubbing their eyes often, squinting or avoiding light, it is worth taking seriously and having an eye doctor assess it.

If you don't rub, how else can you stop the itch?

A cold compress is safe and easy. Soak a clean towel in cool water, wring it out, and hold it over closed eyes for a few minutes; the coolness can ease the itch and swelling. You can also chill a clean towel in the fridge first, but do not put ice directly on the skin, to avoid cold injury to the skin around the eyes.

Artificial tears can act as a rinse, diluting and washing away allergen that has landed on the surface of the conjunctiva. Single-dose packs without preservatives are a safer choice, and you can use them as needed. They do not replace a doctor's assessment, but as a daily supportive measure they are fairly gentle.

If there is discharge or crusting on the eyelids, soak a clean cotton pad in cooled boiled water and wipe gently from the base of the lashes, using a different pad for each eye. Stop wearing contact lenses while your eyes are uncomfortable, and wait until they have fully recovered before wearing them again. If small bumps appear on the eyelid while you are wearing lenses, this may be lens intolerance, and you should have a doctor look at it.

What else can you do at home to reduce flare-ups?

During pollen season, when you get home from outside, wash your hands and face first, then change your outer clothes, to reduce the chance of bringing pollen onto the sofa and bed. Cleaning around the eyes before bed reduces the time spent in contact with allergen at night.

Wash bedding regularly in hot water with detergent, and keep pillowcases and face towels separate. House dust mite and pet dander are common triggers of year-round allergic conjunctivitis, so it helps to keep soft toys and dust-collecting ornaments out of the bedroom.

Cover your mouth and nose when you sneeze or cough, throw used tissues away promptly, and wash your hands often with warm water and soap. Allergic conjunctivitis itself is not contagious, but clean hands reduce the chance of bringing other germs into your eyes.

When should you see a doctor?

If any of the following occur, see a doctor as soon as possible rather than watching and waiting: changes in vision, such as wavy lines or flashes of light; very red eyes, whether one eye or both; marked light sensitivity, with normal light feeling glaring, and deep eye pain.

If you wear contact lenses and develop red, itchy eyes together with small bumps on the eyelid, stop wearing the lenses and see a doctor; this may be related to lens intolerance or allergy.

If symptoms last a week without easing, or the discharge becomes thick and yellow-green, you should also have a doctor assess it. If a baby under one month old has red eyes or eye discharge that sticks the eyelids shut, see a doctor as soon as possible.

One reminder: there are many kinds of anti-itch eye drops, and some ingredients are not suitable for long-term use without medical supervision; some need short-term use under an eye doctor's monitoring. Which one to use and for how long should be decided by a doctor based on the eye examination. Parents should not use drops long-term on a child based on their own experience.

This article is for general information only and is not medical advice. Please follow your doctor's instructions.