Everything You Need to Know About Styes
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| The typical way your eyelid appears when you have a stye. There is usually no white head because most styes are inside the eyelid! via |
What is a Stye?
A stye (or hordeolum) is an acute bacterial infection of one of the oil glands found within eyelid. In its active stages, it is painful, red, and feels like a localized tender nodule within the eyelid. You may be able to see a white head, much like a pimple which is similar in etiology, but many styes form internally inside the eyelid so no head will ever develop.
What to do if you think you have a stye?
What to do if you think you have a stye?
If you have an active stye, the best thing you can do is a hot massage. Use a clean washcloth dipped in hot water, or you can get creative. Common hot massage tools are to microwave a potato and wrap it in a cloth to prevent burning the eyelid, heat a bag of rice and wrap similarly, or heat up a tea bag. All of these options retain heat better than a hot cloth will, but just be careful not to burn yourself. When you have your preferred heated item, then apply it against your closed eyelid and gently massage over the tender area. Do this as many times a day as you can. The heat will help to open the clogged oil gland, breaking down the infective materials inside.
If your stye does not resolve with a hot massage in a day, you definitely need to see a doctor. Your optometrist is trained to make sure that the pain in your eyelid is really a stye and not a different issue, like a viral herpes lesion, or a localized inflammation. If you do indeed have a stye, your doctor is going to start more aggressive treatment.
Prescription Treatment Options
Most styes are internal-- inside the eyelid, so an eye drop is not going to be a good way of delivering antibiotics to the area. An oral antibiotic will actually work much better. I typically use Augmentin or Keflex, since they are both cost effective generics, and don't cause a lot of upset stomach issues. Your doctor will discuss your medical history and any antibiotic allergies before determining the right oral antibiotic for you!
If there is discharge from the stye draining into the eye, an additional eye drop will be useful in this case. An oral antibiotic will treat the stye, but all the bacteria that your eye is now being bathed in from the drainage is putting you at risk for an eye infection (instead of just an eyelid one!). Tobramycin or Polytrim drops are a first choice for me. Again both are generics with good coverage, and tend to have very few antibiotic allergy issues.
Sometimes the eyelid is so swollen (called preseptal cellulitis) it is painful to even open the eye. In these cases, I will often couple my oral antibiotic with a topical ointment with antibiotic and anti-inflammatory properties. Tobradex ointment is excellent for this use. If finances are an issue, generic Maxitrol (neopolydex) ointment is a pretty good substitute. The added anti-inflammatory coverage can really boost comfort as the antibiotic kills the infection.
Always, always, continue the hot massages, even after you start your doctor's treatment. You can only help break down the stye faster by continuing to apply heat.
Typically a stye will take no longer than 7-10 days to completely resolve with this treatment, if it is caught early enough. If left alone too long, a scar tissue may develop inside the lid, called a chalazion. It will feel like a non-tender, hardened lump or bead inside the lid. A chalazion is not an infection, and no antibiotics will help. Keep trying your warm massages to hopefully break the scar tissue down, but in most cases the scar will have to be surgically cut out of the eye to get complete resolution.
What Shouldn't Happen
If you have a stye, there are a few quite scary changes that you need to be on the lookout for. If you see any of these, please go straight to the ER. Remember, your eye is directly connected to your brain, so if the bacterial infection breaks through past your eye you could have a life threatening problem!
It is NOT normal for you to have:
-fever
-double vision
-protrusion of the eye forward out of the socket
-vision loss
-severe pain with eye movement
If a orbital cellulitis (inflammation/infection that progresses behind the eye) develops, it requires urgent treatment -- typically injections of antibiotics straight into your blood stream. While progression of this nature is very rare, styes are common place and I have seen many patients wait until their infection is really at a dangerous point before they decide to seek medical help. Treating a stye early is key; don't wait until your eye is swollen shut to ask for help!
Do you have issues with styes over and over again? Head to my next post on the topic of styes-- how to break the cycle of recurring styes!
Prescription Treatment Options
 |
| Augmentin knocks a stye out fast. Oral medication tends to work much better than eye drops because an eye drop can't penetrate very well through the eyelid skin! Just watch out for penicillin allergies. Azithromycin is a better choice in that case; Keflex typically is fine but can have a cross-sensitivity so not worth the risk. via |
If there is discharge from the stye draining into the eye, an additional eye drop will be useful in this case. An oral antibiotic will treat the stye, but all the bacteria that your eye is now being bathed in from the drainage is putting you at risk for an eye infection (instead of just an eyelid one!). Tobramycin or Polytrim drops are a first choice for me. Again both are generics with good coverage, and tend to have very few antibiotic allergy issues.
Sometimes the eyelid is so swollen (called preseptal cellulitis) it is painful to even open the eye. In these cases, I will often couple my oral antibiotic with a topical ointment with antibiotic and anti-inflammatory properties. Tobradex ointment is excellent for this use. If finances are an issue, generic Maxitrol (neopolydex) ointment is a pretty good substitute. The added anti-inflammatory coverage can really boost comfort as the antibiotic kills the infection.
Always, always, continue the hot massages, even after you start your doctor's treatment. You can only help break down the stye faster by continuing to apply heat.
Typically a stye will take no longer than 7-10 days to completely resolve with this treatment, if it is caught early enough. If left alone too long, a scar tissue may develop inside the lid, called a chalazion. It will feel like a non-tender, hardened lump or bead inside the lid. A chalazion is not an infection, and no antibiotics will help. Keep trying your warm massages to hopefully break the scar tissue down, but in most cases the scar will have to be surgically cut out of the eye to get complete resolution.
What Shouldn't Happen
If you have a stye, there are a few quite scary changes that you need to be on the lookout for. If you see any of these, please go straight to the ER. Remember, your eye is directly connected to your brain, so if the bacterial infection breaks through past your eye you could have a life threatening problem!
It is NOT normal for you to have:
-fever
-double vision
-protrusion of the eye forward out of the socket
-vision loss
-severe pain with eye movement
If a orbital cellulitis (inflammation/infection that progresses behind the eye) develops, it requires urgent treatment -- typically injections of antibiotics straight into your blood stream. While progression of this nature is very rare, styes are common place and I have seen many patients wait until their infection is really at a dangerous point before they decide to seek medical help. Treating a stye early is key; don't wait until your eye is swollen shut to ask for help!
Do you have issues with styes over and over again? Head to my next post on the topic of styes-- how to break the cycle of recurring styes!
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31 comments
Thank you so much for your article ! It helped a lot !
ReplyDeleteThank you! I'm glad so many people have found this article helpful. When I first wrote this, I figured there were so many online resources already about stye treatment that this article might not reach many people needing help, but I've been thrilled to see it is one of the most popular articles on this website all time and that it is helping people like you find out what's really medically essential in stye treatment.
DeleteWell I have a stye for about 5 says now. My whole eye swollen big. I went to the doctor the first antibiotics they gave was an oral antibiotic name Cephalexin 500mg and my face swell do I went too the ER and the DR. Changes my antibiotic to Polymyxin B sulfate and Trimethoprim Ophthalmic solution... Is that supposed too work better? It seem really strong for me... Or do I go back taking the oral one or just neither and do home remedies.... I'm confused
DeleteIf you were allergic to the first oral antibiotic, you'll likely need a different oral antibiotic. Topical eye drops don't treat styes well at all, so I don't expect an eye drop like PolyTrim to do much of anything for you if you have a large amount of eyelid swelling. You should see an eye doctor specifically ASAP -- you'll get much more aggressive care there than at an urgent care or primary care office where the doctors aren't eye specialists.
DeleteI have had what I think is a style for 3 days now. I have kept a warm rag on it since I noticed it but it has just gotten bigger and looks like I have been punched in that eye. I have tenderness in my face almost to the corner of my mouth. I don't have the expenses to go to my regular eye doctor as my insurance won't pay for it. What should I do?
ReplyDeleteYou definitely need to prioritize seeing a doctor. Untreated styes can cause severe bacterial infections that may spread deeper from the eye into the brain. It's best to seek care right away.
DeleteI have seen people who use Vigamox for stye. But stye is treated with warm compress and with some pain killers.
ReplyDeleteI agree Nancy, I would only use an antibiotic eye drop like Vigamox if discharge from the stye was causing a secondary bacterial conjunctivitis. If hot compresses aren't working, it's time to see your eye doctor!
DeleteHi Dr.L good day!
DeleteI had this stye about 3 days now.
When i start using this Chlorsig drops every 2 hours and Chlorsig ointment before go to bed and i do this hot towel massage on my eye was really make me worried if im this is right?
I feel funny with my eye vesion,a litte bit pain wilhe i move my eyeball,i feel like cannot see clearly sometime that make me feel bout not going to open my eyes coz i feel better, and i really need your advice please if you could Dr.L thank you!
Definitely schedule to see a doctor! Sometimes styes require oral antibiotics, or in severe cases even hospitalization!
DeleteThanks for your articles! It has been extremely helpful to me. I have a stye and I wanted to know if I was following proper protocol for treatment. Basically I am. Warm/hot clothes lubricating ointment and OTC pain relievers. Just in case I have some neo/poly/dex ointment. I have a question...is it my imagination or are styes a little worse when you get them as an adult? I'm a 40something woman and I don't remember styes being this irritating and uncomfortable. IDK...maybe it is my imagination...LOL!
ReplyDeleteThanks Again!
Thanks a lot for the info. I have been getting styes off and on since i was a child. Maybe one every 2-3 yrs. They really are a pain in the neck or eye for that matter! I use the warm compress and wash my eye out with baby shampoo/wash. It usually takes a couple days to completely go away, especially the really painful stubborn ones that swell my entire eyelid. I hate them.
ReplyDeleteDo you wash the eye inside with baby shampoo or just the outside. I was sold sterilid, which is a foam. It stings if it gets inside the eye. I apply with eyes closed and keep on for one minute prior to washing off. I was put on keflex as the oil glands are blocked. I am doing the hot packs as well. The condition has been going for a couple of months but treatment only started a couple of days ago.
ReplyDeleteIs keflex going to work do you think? Thank you
Definitely only use eyelid cleansers on the eyelid. If you have an active bacterial infection, then antibiotics like Keflex could help. For chronic gland issues new treatments like Lipiflow or IPL are worth considering too!
DeleteStyes have been a recurring issue for me. I've had about 6 of them in the past two months, with varying degrees of pain and duration. I even saw an opthalmologist who performed a vision test as well, however the problem is still recurring. Please help
ReplyDeleteIf you've tried the suggestions in this article already, my best advice to you is to seek medical help! New procedures like Lipiflow, IPL, or oral medications like doxycycline may be the course you need, but your eye doctor can help find the specific treatment for your unique skin chemistry.
DeleteI have been getting recurrent styes lately. The stye I have at the moment is on my lower lid. I have been using a hot compress and Blephasol (I have Blepharitis) but it hasn't worked this time. I woke up this morning with bruising and yellow patches beneath my eye so I'm guessing that's not good! Struggling to get an appointment with mt GP but worst case scenario I will have to try A&E.
ReplyDeleteDefinitely see a doctor! There’s always a risk with styes that the infection can spread deeper behind the eye, so treatment is important!
Deletecephalexin twice or three times a day?
ReplyDeleteIt depends on your weight and metabolism factors, but for most adults twice a day dosage is most common.
DeleteIs noflux (90mg) considered to be one of the anti inflammatory as u mentioned? Thank you in advance!
ReplyDeleteI have never read a case report of anyone using this medication before for ocular inflammation.
DeleteEvery time I m going outside this happens to my eye inside the eye
ReplyDeleteI was reading that allergies could be a factor...
DeleteI have a Stye on my bottom eye lid started getting sore on my cheek first and after 4-5 days my eyelid was swollen and sore and itchy looked like someone punched me in the eye. I went to my Primary Doctor and she prescribed Erythromycin 250 MG tablets 2 x day for 7 days , and Erythromycin ointment to put in my eyes 2 x day for 7 days and said if no improvement in 2 days to see an opthomologist (Eye Doctor) and gave me a referral. My eye looks better but still swollen (localized) on my lid and not my face any more. I feel nauseated and have blurry vision in that eye because it's so big. I don't see a pimple on it and have been putting moist heat washcloth 5 times a day. When I pull my eyelid out is red underneath. Is this the best medication to use in my case? Thank-You, Linda
ReplyDeleteDefinitely follow the advice of your doctor and see an eye doctor (optometrist or ophthalmologist)! If your eye is not improving on this antibiotic, you may need a different antibiotic to fight off the infection.
DeleteWoke up with an upper eyelid stye and was prescribed Augmentin 875/125. It is really giving me a stomach ache and nausea. What would be an alternative to this antibiotic? I am allergic to sulfa drugs.
ReplyDeleteDefinitely consult with your doctor. There are a lot of alternatives even with your sulfa allergy. Azithromycin is an example.
DeleteHi, my daughter has a sizable stye on her upper left eyelid. She was prescribed Tobradex ointment for a week which has reduced its size about 75%. But it is not fully gone. Is it safe to continue the Tobradex until it disappears or does it now need to be surgically removed? It has definitely shrunk. She is 7 years old.
ReplyDeleteDefinitely call to ask your doctor! Tobradex does have a steroid as part of the medication, so your doctor may prefer limiting the use of the ointment to a certain length of time.
DeleteThank you ,and now i know...
ReplyDelete