Stye and Chalazion
Also known as Hordeolum, External Hordeolum, Internal Hordeolum, Eyelid Cyst, Meibomian Cyst, Tarsal Cyst
Bottom Line
A stye is a painful red bump on the edge of the eyelid caused by an infected oil gland. A chalazion is a slow-growing, usually painless bump from a blocked oil gland. Most clear up with warm compresses, but some need a doctor's care.
A stye (hordeolum) is a tender red bump on the edge of the eyelid. It happens when a tiny oil gland or eyelash root gets infected, usually with the common skin bacterium Staphylococcus aureus. Most styes come to a head in a few days and drain on their own 1.
A chalazion is different. It is a slow-growing, firm bump that forms when an oil gland inside the eyelid (a meibomian gland) gets blocked. The trapped oil triggers chronic granulomatous inflammation, but there is no active infection. Chalazia are usually painless once they form, but they can stay for weeks or months 2.
Most styes and small chalazia get better at home with warm compresses and gentle lid hygiene. Studies on antibiotic efficacy show antibiotic drops help only when there is true infection of a stye, not for chalazia. Larger or stubborn chalazia often need a small in-office procedure — incision and drainage or a steroid shot — by an eye doctor 3.
Stye vs. Chalazion: How to Tell the Difference
Styes and chalazia are often mixed up, but they are not the same problem and the treatment is different.
- A stye (hordeolum) is an active infection of an oil gland or eyelash root. It is tender, red, and grows fast — usually over a day or two. Most styes come to a head and drain.
- A chalazion is a blocked, inflamed oil gland with no real infection. It grows slowly, sits deeper in the lid, and is usually firm and painless once it has formed.
An external hordeolum sits right at the lash line and looks like a pimple. An internal hordeolum sits inside the eyelid (you can see it when the lid is flipped). An internal hordeolum that does not fully clear can turn into a chalazion 1.
Other bumps that can look like a stye or chalazion include allergic swelling, a small eyelid cyst, or — rarely — a skin cancer of the eyelid. Any lump that does not get better in 4-6 weeks, grows back in the exact same spot, or changes the eyelashes should be checked by an eye doctor.
Treatment
What you can do at home (most styes and small chalazia):
- Warm compresses. Soak a clean washcloth in warm (not hot) water, wring it out, and hold it against the closed eye for 10-15 minutes, 3-4 times a day. Reheat as it cools. This softens the trapped oil and helps the bump drain.
- Gentle lid massage. After the compress, use a clean finger to lightly massage along the eyelid toward the lash line.
- Lid hygiene. Wash the lid edges daily with diluted baby shampoo or a commercial lid wipe.
- Hands off. Do not pop or squeeze the bump. Squeezing can spread the infection.
- Stop eye makeup and contact lenses until the stye or chalazion is gone.
What an eye doctor can add:
- Topical antibiotic drops for an infected stye (a true hordeolum). The efficacy of antibiotic drops for chalazia is poor, since chalazia are not active infections 3.
- Oral antibiotics if redness spreads into the surrounding skin (preseptal cellulitis).
- Incision and drainage (I&D) for a chalazion that has not shrunk in 4-6 weeks. The doctor numbs the lid, makes a small cut on the inside of the lid, and drains the contents.
- Steroid injection into the chalazion as an alternative to surgery for some bumps. Mixed evidence on which works better; many doctors offer either.
- Intense pulsed light (IPL) is being studied for chronic chalazia and may help in selected cases 5.
When to See a Doctor
Book a regular eye doctor visit if:
- A stye does not start to improve after 5-7 days of warm compresses.
- A chalazion has not gone away after 4-6 weeks of warm compresses.
- You get more than 2-3 styes or chalazia a year.
- The bump keeps coming back in the exact same spot, or it changes the eyelashes (eyelashes fall out or grow in odd directions).
- You have rosacea, severe blepharitis, or dry eye that is making things worse.
A bump that grows back in the exact same spot, especially in an adult over 60, needs a careful look. A rare eyelid skin cancer can be mistaken for a chalazion. An eye doctor or oculoplastic surgeon can biopsy the lump if the appearance is unusual.
Preventing Styes and Chalazia
Once you have had one stye or chalazion, you are more likely to have another. Daily habits help:
- Wash your face and lid edges every day. A short, gentle lid scrub with diluted baby shampoo or a lid wipe keeps the meibomian glands clear.
- Treat blepharitis and rosacea. These are the biggest reasons styes and chalazia come back. Daily warm compresses, lid hygiene, and any prescribed treatments make a real difference.
- Replace eye makeup every 3-4 months. Old mascara and eyeliner grow bacteria. Never share eye makeup.
- Remove eye makeup before bed every night.
- Care for contact lenses well. Wash hands before touching lenses, do not sleep in them, and follow the cleaning routine the eye doctor recommends.
- Manage dry eye. Treating dry eye usually treats the meibomian gland problem that causes chalazia.
Common Questions About Styes and Chalazia
Next Steps
- 1Start warm compresses (a clean warm washcloth on the closed eye for 10-15 minutes, 3-4 times a day) as soon as you notice a stye or chalazion.
- 2Stop wearing eye makeup and contact lenses until the bump is gone.
- 3Wash your eyelid edges daily with diluted baby shampoo or a commercial lid wipe.
- 4Book an eye doctor visit if a stye has not improved in 5-7 days or a chalazion has not gone away in 4-6 weeks.
- 5Go to the emergency room or call 911 right away if you get spreading redness, fever, pain with eye movement, a bulging eye, double vision, or sudden vision loss.
- 6If you keep getting styes or chalazia, ask your eye doctor about treating blepharitis, rosacea, or meibomian gland dysfunction.
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