I Think I Have a Stye!
Updated: Jun 16, 2020
What is a Stye? A stye is also called a chalazion or hordeolum. A stye is a blocked oil gland on the eyelid that traps the natural bacteria that live on our eyelids. The bacteria then multiply in this warm protected environment and cause inflammation, creating a red tender bump on the eyelid. They can occur on upper or lower lids, the inside or outside surface of an eyelid, and on the lid margin where the lashes are. Untreated they get bigger and more tender until our immune system kicks in and heals them in most cases. Although not exactly the same, styes are a bit similar to deep cystic acne (which is also caused by skin bacteria trapped in skin oil glands). A stye is not contagious and you did not get it from someone else.
How do I know if I have a stye? The stye usually begins as a small tender feeling in the eyelid. You may feel the stye several hours before you see it. Then a small red bump begins to develop. You may also feel (more than see) a tender bump inside the lid if it formed in a deeper gland farther from the surface. You might also see a red bump or area in the interior part of the eyelid. Occasionally, you might see a white bump on the margin of the lid where the eyelashes are if the blocked gland is near the lid margin surface.
What should I do, and how can I treat this at home? The best treatment is a “rice compress” (not a wet washcloth compress). Use this compress 4 times a day for 10-15 minutes. To make a rice compress, take about 1/4 to 1/3 cup of uncooked dry rice directly from the bag and put it in a small clean sock or cloth tied shut with a rubber band , string or other microwave safe closure (do not use a metal twisty tie!!). It should be golf-ball size or slightly larger. Heat this in the microwave for about 20-30 seconds depending on the size of the rice ball. Start with a smaller amount of time and add on to prevent overheating the compress. Test the compress on the inside of a wrist before putting it on an eyelid. The quicker a rice compress is started the faster the stye will get better. Continue treating until completely better; stopping early can allow the stye to return. Most styes will get better in 7-10 days, but some styes (especially those you don't treat right away) can take weeks to fully resolve.
Why does a compress work? Isn't that an old wives tale? A good hot compress can actually raise the temperature of the lid tissue and the stye. That heat signals your immune system to call in the troops to fight the bacteria and clean up the stye. Heat is a signal to white blood cells to leave the blood vessels and go into the tissue to fight infection. That is why you want to do it several times a day.
Is a stye “dangerous” to vision? Most styes are not. They can be ugly and annoying but only rarely cause serious problems. A danger signal would be a stye that grows very rapidly and occupies a significant portion of the eyelid indicating that the infection is more generalized. In this case a doctor may need to prescribe oral antibiotics and/or perform a procedure. “Styes” that are recurrent in the same area or resistant to treatment should also be evaluated by a doctor as they may not be a stye.
Do I need to see a doctor? Most small localized styes can be treated safely at home. The sooner treatment begins, the faster the stye resolves. However, if the stye is not responding to home treatment call your doctor for advice.
Can't the doctor just give me drops? Eye drops and ointments are of limited help (and expensive) because they cannot get into the blocked oil gland. Many patients request these because they feel better “doing something” to treat the stye with a medicine but the compress really is the best “medicine”.
Can't the doctor just “pop” it with a needle? No this does not work. Additionally you should never try to squeeze or open a stye yourself as you will likely drive the infection deeper into the tissue and cause a larger problem. To remove a stye we must do a larger procedure and open more fully and remove the infected material. In adults this can be done under local anesthesia in the office. However in children this requires a general anesthetic and surgery. It is very rare that we surgically remove these in children because of the added risk of general anesthesia. Some styes can also be injected with a small amount of steroid medication in cooperative adults. You can always discuss treatment options with your doctor.
What if it “pops” or ruptures on its own? That is okay. Please don't pinch or press on the stye to help it drain. This can prolong healing and drive infection deeper into the lid tissue. It is much better to keep using the compress and let nature do its work.
My stye is mostly gone but it left some scar tissue. So now what? That can be frustrating, but in most cases this improves with time. However, it can take quite a while, 3-12 months. In some cases, if you feel your lid carefully, you may always be able to feel a small nodule or dense area in the lid where the stye was. However, in the majority of cases visible scarring resolves with enough time.
I’ve had a couple of styes and don't want more. Is there anything I can do? Yes! Some people are prone to styes. So cleaning your lids regularly to reduce natural skin bacteria on the lids can help. Treating the lids once or twice a day with a product like Ocusoft foam or Ocusoft wipes can help. More stubborn cases may need a stronger product like Ocusoft Platinum. You can also use a warm compress before cleaning lids, this can help keep oil glands open and functioning better. Additionally, there is some thought that taking an Omega-3 supplement regularly may help by changing the oils in the skin. For these preventive measure to work, you need to be consistent and it can take several weeks before you see results.
This information is for general medical information only. It is not meant to diagnose or treat a particular individual and does not replace care by a doctor. If you need individual care, please contact your doctor.
©2020 Rena Stathacopoulos