Causes styes right away - avoid all ointments if possible
perhaps amazon warehouse heat impacted it, needs &lt; 25°C/77°F.  :) company doesn't reply when asked about how they make sure or if they make sure it's kept at the correct temperature in New York, UK and the amazon warehouse.  first time I used an ointment for 30 consecutive days, it was Hylo Night, and I got 2 styes; before I used them only 2-7 times a month; also all ointments cause eyelid swelling if used daily for a few weeks, even at 20% of the recommended amount.  so from 2022, I never used any ointment on a routine basis, maybe once a year max antibiotic one prescribed to remove stye created by Hylo Night.<br /><br />Our tears have a natural lipids mix that is complex, with 600+ lipids, way different than these ointments, these cheap alkane-lanolin ointments reflect our 1st century like chemical industry)<br /><br />The 5 g Hylo Night tube has 250 IU/g or 137 μg VApal (vitamin A palmitate)/g or 75 μg RAE/g or about 1 μg in a tiny 15 μL ‘drop’  (MW: retinol 286.45, retinyl palmitate 524.86, so 250 IU*0.3 μg RAE/IU=75  RAE; 75*524.86/ 286.45=137 (Wikipedia says 138 because they round up MW 525/286*75=138), thick ‘drops’, 300 applications, lasts 6 months.  Note that A can cause keratinization of meibum glands and the end of natural lipid production, styes thru blocked meibum orifice and worsening of dry eye.  They are a symptom relief method that doesn't address the cause:  blocked meibum glands blepharitis, poor eye hygiene, too much bad sleep due to stress etc.  “Vitamin A is required for the normal growth maintenance and maturation of the corneal epithelium and is effective in the treatment of xerophthalmia and experimental (rabbit) corneal epithelial wounds when applied topically as retinoic acid. The retinol concentration...in human tears was 16 ng/ml (0.5 X 10-7 M)… (or 0.5*286*10-7g/L or 0.5*15*286*10-7 μg in 15 μL tiny drop, or 4662 times lower amount than with a tiny 15 μL snake of ointment, each blinking tear has 10 μL, so 6-7 mm ointment is about the same vitamin A as in 7000 blinks, 10 hours of blinking, hence I used (before Hylo Care experience that prompted me to use as hand/foot cream the left over, since it was expiring in 20 days anyway, but I did use it 20 times 1 mm/eye to avoid overdose) vitamin A is present in the tears as retinol establishes the rationale for treatment of corneal disease with topical vitamin A” ► CER 1984;3(6):815-22. However, with vitamins, medicines, everything is about dose, 4600x higher dose may damage the meibomian glands, as IOVS 2013; 54(6):4341-50 found 13-cis-retinoic acid (acid in retinyl palmitate, metabolite of vitamin A) does. “all-trans retinoic acid decreases sebocyte growth, development, and lipid production and causes blepharoconjunctivitis. It is ... converted in sebocytes to 13-cis retinoic acid (isotretinoin, used in acne creams, Accutane, since it suppresses sebum production by 90%, so it can also suppress meibum production), which leads to thickening and keratinization of meibomian gland ducts, degeneration and necrosis of meibomian gland acinar cells, periacinar fibrosis, and reduced lipid content of meibomian tissue in animal models” and dry eyes in humans.  ►  IOVS 2011; 52(4):1938-78 (this 40 page paper has so much info on meibomian glands). Too much of a good thing can be bad, though dozens of eye drops contain vitamin A, a retinoic acid derivative that the paper claims to cause dry eye and even our tears have vitamin A; the real debate is about dose here. “Both VApal (0.05%) eye drops and topical cyclosporine A 0.05% treatments are effective for the treatment of dry eye.” ► Am J Oph 2009;147(2):206-13.e3. “VApal improved subjective symptoms, clinical symptoms, and cytological findings in dry eyes” ► Drug Des Dev The 2017;11:1871-9. VApal “and carbomer eye gel can effectively relieve dry eye” ► Glauco 2016;25(6):487-92.<br /><br />HYLO NIGHT has 1. VApal 2.  white soft vaseline (or white petrolatum in US ointments), 3. liquid paraffin (also called MO or mineral oil of US products, petroleum derived, transparent, contains mostly straight chain (pharmaceutical grade, since food grade can have branched alkanes too) C15-C40 alkanes, CnH2n+2, but may have tiny amounts of cycloalkanes and some aromatic rings which are very stable nevertheless like all benzene rings are), 4. light liquid paraffin (also called light mineral oil, ‘pharmaceutical grade mineral oil’, white soft paraffin or white petroleum jelly, also mostly alkanes, so mostly saturated), 5. wool fat or lanolin (or LA is widely used in Pharma and cosmetics) in US labels, which is a mixture of cholesterol (found in human tears), 10,000 esters of sterols (mainly), fatty acids, C18-C26, some present in natural tears; however, not all are present there, and some may cause issues explained below. Ointments contain hydrocarbons, wax esters, somewhat similar to those in the lipid layer of tears that dry eye patients secrete less of, so they can help compliment lipid tears.  Only use ointments IF moist night and dry/moist day masks and yawn tears 5x/day, saline solution (Knoxzy on amazon etc), since ointments have potentially toxic chemicals (stuff we have never placed in our eyes for billions of years, certain alkanes, lanolin alcohols, sheep sterols, wool fat, etc – so start with tiny 0.5-1 mm snake amounts first daytime, to get eyes used to it first, build up slowly over weeks, months) too that can damage eyes/body; also gels and ointments, if used in excessive amounts, can create illusion eye is wet, when it isn’t;<br />Hylo paper instructions say ointment (or eye drop) “should be applied about 30 minutes after” any ophthalmic drug (or any other eye drop medication). Hylo Gel paper instructions say “ointments should, however, always be administered after” Hylo Gel.<br />Why do they make many ointments without lanolin?  Due to reactivity of lanolin compounds, which causes eye complaints, allergies, styes. “Saponification of crude lanolin gives an alcohol fraction (lanolin alcohols or wool alcohols) containing about 34% cholesterol and 38% lanosterol /dihydrolanosterol” ► Bio Phar 2003;57(8):321-5. Refresh ointments, etc contain these lanolin alcohols and to avoid scaring people they use lanolin alcohol name instead of cholesterol and lanosterol, as that would alarm people that diffusing into vessels it could create plaque under inflammatory conditions, and with Ca from eye drops form real plaque. The level of cholesterol is low in these ointments, maybe 0.5% or so, if they use 2% lanolin alcohols and our tears do contain cholesterol too, though in a MUCH lower concentration. Plaque is made of cholesterol and hydroxyapatite crystals upon which more fatty stuff adds on. Lanosterol (lana means wool in Latin) is used to keep lens clear ATM 2020;8(22):1552 and prevent cataracts, while cholesterol makes 25% of lipids in the skin barrier (cornea is like skin). “111 mg lanosterol, 84 mg dihydrolanosterol, and 183 mg cholesterol” were obtained from 1.78 g lanolin J Sep Sci 2019;42(12):2171-8.  Walgreens PM ointment has the same ingredients as Bausch made Soothe, India made OCuSoft Retaine: 20% MO (mineral oil), 80% WP (white petrolatum, 2 ingredients present in HYLO NIGHT; white petrolatum is made mostly of microcrystalline wax (high MW) and high viscosity mineral oils (lower MW than paraffin or microcrystalline waxes), CAS # 8009-03-8, mostly alkanes > C25 called White Soft Paraffin or Vaseline in EU Pharmacopoeia or ointments, they can contain 1 ppm carcinogenic PAHs, see more on petrolatum here), minimalist, good for those worried about cross-reactions of non-hydrocarbon components, since MO/WP are very inert, good for those sensitive to lanolin LA, plant extracts, though MO/WP oils may have hydrocarbons from plants, animals living eons ago; we know cholesterol can form crystals, so we wonder if lanolin, which contains sterols, etc can also form crystals or atherogenic plaque via diffusion, enabling more crystals to form like with phosphate;  plaque is cholesterol crystals sometimes, not hydroxyapatite (calcium phosphate); it’s not clear what the long-term effects of using lanolin ointments are, so watch your eyes carefully in 20x  mirror each morning; even if tears contain sterols, they don’t contain them perhaps at the same concentration as lanolin ointments cause, so like with phosphate, even if tears contain phosphate, crystals can form if too much phosphate; as a result, some people will be sensitive to LA, since they are far more reactive than virtually inert MO or WP.  Hence, they made these LA-free lubes, like Hydramed Sensitive which has antiinflammatory vitamin A, but no irritating lanolin or petrolatum. Soothe 20% MO-80% WP expires in 40 months, since 100% hydrocarbon ointments are the most stable and least allergenic, vs 3 months Hydramed with plant extracts, lanolin, vitamin A or 6 months for HYLO NIGHT.<br /><br />What potential issues could arise with mineral oil ointments, like HYLO NIGHT, in general, besides unknown, yet obvious, chemical interactions between non-mineral oil ingredients (far more reactive) and other drops used 30 min before or after etc? Clin Med Res 2017;15(3-4):75-87 explains in Table 1 mineral oil leads to folliculitis (pimples at the base of hairs) and lanolin to contact dermatitis (red skin spots), so when mineral oil-lanolin are put on cornea, a skin like tissue, the eye can also be allergic for some and get red, inflamed, drier long-term, even if providing short-term relief. Below are some issues and benefits of ointments: they got impurities and aromatic hydrocarbons that irritate and redden the eye (all ointments at times, when used even in tiny amounts, way less than what paper says, cause some irritation). Their biophysical properties are different:  pretty solid at room temp, milky. This means, biophysically, ointments with clear liquid consistency are closer to natural and will irritate eyes less via that mechanism, but HYLO IS TOO SOLID AND MILKY.  Due to different electrostatic biophysical properties,  HYDROCARBON OILS IN HYLO NIGHT could alter the fine balance of the chemical system of the tears and disturb the homeostasis of the aqueous-lipid layer barrier (plug some outer lipid layer holes, but disturb the inner lipid layer stability where phospholipids face the water; i.e. reality being different than theory sometimes, not having such a universal ‘all good effect’ on 3rd lipid layer stability), or by facilitating certain toxic compounds to more easily cross the junction points between layers of the eye: cornea-vitreous gel, vitreous gel-retina, etc. Additionally, most hydrocarbons believed to be natural to meibum are squalene, which is similar to β-carotene, etc, vastly different than the saturated alkanes in mineral oils.  Many authors think the alkanes found in some meibum studies are due to people using face cream, makeup, etc and these entering meibomian glands (or mineral oils in every hand cream and shampoo, in food, etc), where, via different biophysical properties they can slow down certain important regenerative processes, leading to the meibomian gland lipid underproduction or even atrophy in the long-term, while offering short-term protection – just like redness reliever eye drops offer ‘white eyes’ today, but rebound redness 2 years later and damaged blood vessels (by contracting and expanding 1-2 times daily for 3 years) when eyes no longer respond well and we need 5x more of a very acidic drop to prevent redness that destroys the eye since only around pH 7.4-7.6 some eye processes of regeneration are optimal apparently in vitro, not at 5.7-6.3 of redness reliever drops.  Thus, not all is rosy just because ‘alkanes don’t chemically react with anything’, they could change electric potentials across membranes, block certain enzymes from folding, proteins, etc, slowing thus important biochemical processes. Being solid vs natural healthy meibum, they are introducing cytokine storm via the ‘foreign body’ sensation they can cause in the first minutes of application. Due to huge irritation these oils cause, you may save your eyes from huge redness if you use less than 10 mm recommended amount, maybe 1 mm, via whatever technique you can discover, like a sterile silicone tip q tip or wiping out excess after dropping some ointment using an eye guide (wipe it with eyes closed with sterile pad you opened from a packet) with an alcohol pad, don't insert so much by pulling eyelid as that will overwhelm the eye.  Always watch for ocular sensations when using any product or write them down so you recall and know when an ointment is bad. “Pharmaceutical grade mineral oil consists of a mixture of saturated hydrocarbons” ► EHJS 2020;22(Suppl J):J34-8. Vaseline, (called Petrolatum in USA) (Eur. Ph.) can have 0.67% aromatics, while medicinal liquid paraffin (mineral oil in USA) 0.05% , light liquid paraffin 0.04%► F1000Res 2017;6:682.  Paraffin comes from parum (“very little” in Latin) and “affini” (affinity), meaning little reactivity of alkane hydrocarbons it contains. It worked better for me many times than the best lipid tears; liquid paraffin can cause lipoid pneumonia if inhaled in large amounts (fire breathing) Occu Med 2010;60(3):234-5, so if via nasal lacrimal duct we inhale tiny levels, what happens? Probably not much to be worried about, since we inhale lipids (though different types of lipids) from our meibomian glands every day, as long as we don’t overdose with ointments.  “Aspiration of liquid paraffin (liquid petrolatum) used for the treatment of constipation or intranasal instillation of liquid paraffin as a component of nasal drop or petroleum jelly such as Vaseline or Mentholatum for relief of sinus congestion is the common cause of lipoid pneumonia” ► Int Med 2002;41(6):483-6. Kids using it for constipation got in trouble too, so it may be better to avoid use for constipation. Even mouth cleaning with edible oils can cause it; however, the amount we would inhale from using it on our eyes (most mineral oil would be ingested actually, as we swallow tears) is way smaller than from oil gargling to ‘clean teeth’; using lipid tears (Systane, Soothe XP, etc got mineral oil (liquid paraffin) too), we can also, in theory, get this issue, since any lipid inhaled can cause it; never heard of anyone using lipid tears getting pneumonia yet, but hey, who knows? Perhaps it’s good to be cautious with these ointment products, use carefully, keep them away from kids and try them first 3 times daytime for 1-2 hours with eyes closed to simulate part of bedtime (or even around the eye only, since many (see amazon reviews) use this as eye cream for the area around eyes, eyelids, since anything around eyelids will affect eyes since it will go inside the eye too, so you can evaluate if it makes eyes red or not; note that if you use them anywhere, they may cause pimple if it blocks pores or 10,000 esters in lanolin cause some issue), before you place them on your eyes for 8-10 hours of sleep, to make sure the 20x mirror doesn’t show anything abnormal and there is no unhealthy sensation or any itching, burning, redness, etc<br /><br /> Even if way less bioavailable than night ointment, I included some drops with vitamin A below for those interested. This ointment doesn’t need be used daily to help, even once a week may help a lot some people; it shows how useful lipid drops are. I discovered how to make a day and night time mask much better, removing the need for day drops and ointment when I have more relaxing days without trying to do a lot of computer work.<br /><br />Ointments are 30 times harder to put than drops with the eye guide and you definitely need very bright light (don’t do it in darkness), so you see the snake of paste coming down and aim it properly, otherwise you waste 80% of paste going on eyelids, eyelash or guide which is not an issue first, as vitamin A, lanolin help orbital area skin to heal, so any miss you can use it as the expensive eye cream you never used.  Vaseline is a brand or type of soft paraffin, petrolatum or petroleum jelly that allows more aromatics in than “liquid paraffin” or “mineral oil”.<br /><br />look out for wool smell in ointments and if present, don’t use, especially if red itchy eyes happen first few minutes several days in a row (some redness may be OK first time until eyes get used to it if you put too much at once; 10 mm suggested on the instructions paper is way too much for testing, only 3 mm is enough to get eyes used to it); human dermis stratum corneum lipids are similar to wool fat or lanolin lipids; lanolin is used in eye drops too).  buy ointments as you use them if they contain lanolin, vitamin A, etc since lanolin, A, polyphenols are far less stable than alkanes in mineral oils.  Lanolin provides more natural fats more like in our tears than alkanes, but quite different.  Hylo Night doesn’t indicate % of MO, WP, LA, so we need be careful with eye evaluation before and after, eliminating confounding factors. WP and MO need to be very pure to avoid impurities that can irritate the eye, so brand quality matters also. :)<br /><br />Avoid ointments they block meibum glands, cause red eyes, styes, swollen eyelids.  :)
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