My 4 Step Daily Blepharitis Treatment Routine (also helps as a Dry Eye Treatment)

Update on 12 November 2025: 5 years since I wrote this blog post to help others, this routine is still working amazingly for me. My eyes gradually became so naturally hydrated that I now only do this routine once daily in the morning instead of twice, and I no longer need to follow step 4 (eye drops). I hope you find this routine as useful as I have. Leave a comment if you have any questions, and I'll do my best to answer you.

Original Blog Post:

By doing this blepharitis treatment routine daily, I was able to get rid of my most frustrating symptom (sand in eyes sensation) in just 2 weeks. My other symptoms of dryness, redness, and constant infections were also alleviated. I don't offer medical advice - as a fellow sufferer I'm sharing the routine that's worked wonders for me for the last 5 years!

I used to do this 10-15 minute ritual twice daily – after waking up, and before going to bed. As my condition is now controlled, I do the full 4 steps in the morning, and at night I only do Step 3 (lid hygiene) as minor maintenance. 
The general idea is to heat and massage the glands to remove any blockage and promote natural lubrication of the eye, and then clean the eyelids to tackle bacterial sensitivity and remove debris.

The 4 Steps Are:
Step 1: Warm Compress
Step 2: Lid Massage
Step 3: Lid Hygiene
Step 4: Apply Preservative Free Eye Drops

Now to the specifics!
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STEP 1: Warm compress with a face cloth (7-10 minutes)

My choice of a face cloth is old school but deliberate. A major reason is hygiene as I just keep a big stock of face cloths that I can alternate frequently, and at low cost! Different compress methods work for different people, but either way, do a warm compress somehow, it's essential! I also listed the other options here, maybe you can experiment with a couple.

Heat one cup of water in a microwave or a kettle (do not use boiling water! Aim for very warm/ just above warm, if you find it uncomfortable mix in more cool water). I then fold my face cloth in half, and then a quarter, and dip two corners into my cup of warm water. I then apply the each warm corner on each eye and relax. When the face cloth cools all I have to do is quickly dip the corners again in the cup of water immediately in front of me. By using a big enough cup or mug, I can heat a big enough body of water to make sure it's warm throughout. I do this for 7 to 10 minutes or until the water cools.

​Be careful not to make the water too hot and burn yourself.

Update: Electric Eye masks like this one are fairly new and A LOT of people seem to be having positive results with them! I bought this one and I'm super excited to try it out, expecting benefits to be:

-  a removable cover that's washable (hygiene is key)
- constant heat through constant power
- no prep, just flip the switch

I wrote a post for my unboxing of this eye mask, and look forward to sharing my thoughts from using it in a later post! Still I recommend you to try different compress options and see what works for YOU! ​
 
STEP 2: Gentle massage of the eyelids (30 seconds)
​
Now that you’ve heated the oil in your glands, a gentle massage will move it around and help your glands to express excess oil. Here’s what I do:
a. I start with brief gentle circular moments with my index figure on each upper and lower eyelid.
b. then I make gentle stroking motions downwards on the upper eyelids, and a rolling motion upward on the lower eyelids. As I’m doing this I imagine that I’m gently squeezing the oil out of the glands.
​Remember to be GENTLE! 

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​STEP 3: Lid hygiene (2 minutes)
 
The aim of this stage is to clean the bacteria that can cause inflammation and constrict glands, as well as remove excess oil and debris from steps 1 and 2. To do this you need a solution and cotton, the solution is key to effective cleaning as it helps to kill bacteria

The solution I use is Blephasol eye hygiene solution. Around 2005, there were no eye hygiene solutions and baby shampoo + water was the recommended way. I’m surprised to see that some people still use this but I would not recommend it. It’s a huge effort for daily treatment and I didn’t find it comfortable. Buying a solution is definitely the way forward. I’ve used Blephasol for the last 5 years and have zero complaints. It's preservative free, lasts for 2 months, and as long as I don't put too much it causes me no irritation. It's shown here (Amazon UK link on the left, Amazon US link on the right):

Amazon UK - Blephasol Lotion

Amazon US - Blephasol Lotion

Now ​I take a cotton bud, and a cotton pad to clean the eyelids as below:
a.     Take cotton bud, and dab some Blephasol on each end. After this I carefully run the cotton bud along the inside margin of the eyelids, top and bottom.
b.     Take cotton pad, dab some Blephasol on and wipe the outsides of the eyelids and eye lashes. I either use a different cotton pad for each eye, or the other side of the same pad. Either way, don’t use the same surface area on both eyes! This can result in the spread of infections.
I’m always surprised how much dirt I see coming off on each of these stages.
 

Why do lid hygiene in two ways? I do this in order to deal with both anterior and posterior blepharitis. I used to only clean the inner margins of my eye lids, however, when I learned about anterior blepharitis caused by bacteria on the skin of the eye lids, I added Step B with the cotton pad, and my rate of getting eye infections went right down! I figure I must have a combination of the two main types of blepharitis, which is why I could never shake all my symptoms. As simple as it sounds, just adding that extra cleansing to my blepharitis treatment has made my condition very stable.

Eyelid wipes/ scrubs like below are also sold as an alternative. These are pre-packed pads soaked in the same solution as you get in the bottles. I've used them and they're ok for emergencies (e.g. when travelling light) but personally find a cotton bud much easier to manoeuvre for eye lid cleaning, and also more cost effective. That said, links are below if you want to try this option for yourself (Amazon US , followed by Amazon US link):

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Amazon US - Blephaclean Wipes

Amazon UK - Blephaclean Wipes (sold as duo with bottle)

​STEP 4: Preservative Free Eye Drops
 
If it’s morning time I put one drop of Hycosan preservative-free eye drops in each eye, to wash away any debris, hydrate, and because it just feels good! At night I don’t do this as I find the eye drop liquid dries on my lashes over night, but that’s just me.

I've been using Hycosan drops for over 6 years now. I highly recommend them as they give great hydration.  Other benefits of Hycosan:
- Awesome Bottle: The bottle is syringe-like, and pushing down releases one perfect drop! So no waiting around for the drop to fall or accidentally getting a stream of fluid!
- Long Life: After opening, the drops can still be used for 6 months (per the packaging)!

In addition to normal Hycosan Original (in a blue bottle) there is now Hycosan Extra. I honestly cannot tell the difference having used both for long periods, but I just go with Extra as the price isn't that much more. These drops, used once or twice a day tend to last me about 2-3 months. 

Hycosan is less available in the US, but Systane is a comparable alternative.

Again, links to where you can find these are below (Amazon UK links are on the left, Amazon US link on the right):

Amazon UK - Hycosan Original

Amazon UK - Hycosan Extra

Amazon US - Systane Eye Drops

​Before I started doing this treatment I would use hydration drops throughout the day to combat dryness. Since this method I find the glands express so well that I'm getting enough natural hydration to not need constant top ups. Sometimes I can actually FEEL the expressed oil in my eyes when doing Step 3, which is amazing.

In Closing

It can be hard to stay motivated and keep up with a new routine. I found keeping a diary at first helped me stay accountable and track changes - you're welcome to print this free 14 Day Checklist Diary, if you want to try this habit.

This blepharitis treatment routine has changed my life and I no longer obsess about my eyes during the day. Some days are still better than others, but my core symptoms are definitely controlled and in my grasp. I recommend to continue this ritual daily even when your eyes are great, always remember that Blepharitis is chronic and what we do is MANAGE the condition! Good luck!

What's worked or not worked for you? Or do you have a question, or just want to say hi? Drop a comment below!!

(Purchasing the stuff I use from the links shown here means, at no extra cost to yourself, you get to support me keeping this site running for others to also get advice and help. Thanks for your support!)

Note: I’m not a medical doctor, and so none of my content including that shown here is to be taken as medical advice. I’m a fellow sufferer sharing what has worked for me! Please speak to your doctor or other appropriate medical professional for medical advice.