Understanding Retinoids and Meibomian Gland Dysfunction

felicia Goualin
Jun 3
3 min read

Updated: Jul 2

Meibomian glands are specialized sebaceous glands located within the tarsal plates of the eyelids. They release meibum, a lipid-rich substance essential for several functions:

Prevents the evaporation of the tear film
Maintains a smooth optical surface
Reduces shear forces on the conjunctiva and cornea

When these glands do not function properly, the condition is termed Meibomian Gland Dysfunction (MGD). This dysfunction is one of the leading causes of dry eye disease, particularly evaporative dry eye.

Common Causes of Dry Eyes

Many people blame various factors for their dry, irritated eyes, such as excessive screen time, allergies, or poor sleep. However, one significant yet overlooked cause may originate in your skincare routine. Specifically, the oil glands along your eyelids can be affected by your choices in skincare.

The Impact of Retinoids on Eye Health

Welcome to the discussion on Meibomian Gland Dysfunction (MGD) — an overlooked condition affecting millions. It is closely connected to our ocular surface health and our skincare choices, particularly the use of retinoids.

🔬 Retinoids & Meibomian Gland Atrophy: The Link

Retinoids are derivatives of Vitamin A, popular in dermatology for treating acne, aging, and pigmentation issues.

Key Effects of Retinoids on Meibomian Glands:

Induce Acinar Atrophy: Retinoids can decrease the size and function of meibomian acinar cells.
Cause Ductal Keratinization: This can lead to duct blockage, inflammation, and ultimately gland loss.
Reduce Lipid Synthesis: This creates an unstable tear film and results in increased evaporation.
Alter Ocular Surface Immunity: Retinoids may disrupt local cytokines and mucins, worsening dry eye symptoms.

📚 Studies:

Stern ME et al. (2004) opened discussions about the inflammatory cycle in dry eye, which can worsen with retinoid-induced gland changes.
Draelos ZD (2006) discovered that topical retinoids can penetrate periocular tissues, influencing gland function—even when not directly applied to the eyelids.
Donnenfeld et al. (2003) identified meibomian gland dysfunction as a dose-dependent side effect of systemic isotretinoin therapy.
Harvard Medical School (2025) under the guidance of Dr. David A. Sullivan noted that 13-cis retinoic acid (isotretinoin) can disrupt meibomian gland activity, affecting tear production and leading to dry eye symptoms.

UK-Based Insights

John Rose Eyecare (2025): Reports indicate that retinoids present in anti-aging eye creams can adversely impact meibomian gland functioning, advocating caution and consultation with eye care professionals.
Dry Eye Zone UK (2025): An article underscored that even over-the-counter retinol products can pose risks for dry eye when applied near the eyes.

👁️ Symptoms of MGD & Retinoid-Associated Dry Eye

Individuals with MGD may experience various symptoms, which include:

Burning, stinging, or gritty sensations
Redness or a foreign body sensation
Increased reflex tearing (also known as paradoxical tearing)
Blurred vision that improves with blinking
Discomfort while using contact lenses

💊 Management Tips (Clinical & Patient Self-Care)

🔹 For Patients on Retinoids:

Use preservative-free artificial tears (e.g., Systane®, Hylo-Forte).
Apply warm compresses daily for gland secretion support.
Avoid applying topical retinoids near the eyelids.
Consider omega-3 fatty acid supplements to enhance meibum quality.
Use lid hygiene wipes (e.g., Blephaclean® or Ocusoft®).
Topical azithromycin or low-dose doxycycline can help manage inflammatory MGD.

🔹 For Aesthetics & Skincare Professionals:

Educate clients about the risks associated with periocular retinoid use.
Offer non-retinoid alternatives for eye-area rejuvenation (e.g., bakuchiol, peptides).
Exercise caution when recommending retinoids to clients with pre-existing dry eye.

📌 Clinical Takeaway

Meibomian glands are crucial for maintaining ocular surface integrity. Retinoid-induced MGD often goes underdiagnosed, especially among those using anti-aging skincare products. Regular application of Systane or other lubricants can help, but it's important to identify and manage the underlying dysfunction.

📌 Clinical Implications

These recent findings emphasize the necessity of careful use of retinoid products, particularly around the eye area. Healthcare professionals need to educate patients about the possible ocular side effects of retinoids, recommending alternative treatments where suitable.

📌 Additional Considerations

In our ever-evolving skincare landscape, awareness is key. Both patients and professionals should be informed about the impact of skincare ingredients on eye health.

📌 Medical Disclaimer

This content provides general information and is not a substitute for professional medical advice. For personalized recommendations, please consult your GP, dermatologist, or medical aesthetician before using active skincare ingredients near the eyes or adopting management tips outlined above.