If you’ve ever had a stye, you know how painful and inconvenient they can be. So, what happens if they keep coming back (or, don’t go away)? Chronic or recurring styes are very common, and often indicate an underlying issue that needs addressing. In this article, we’ll explore why styes recur and discuss some tips for long-term relief as well as prevention.
What Is a Stye?
A stye (or hordeolum) is an infected meibomian (oil) gland or eyelash follicle. The infection causes a red, painful lump on the eyelid. They often look like pimples and can cause swelling, tenderness, and discomfort when blinking. Larger styes can exert some mild pressure on the eyelid, even distorting your vision. Oftentimes, your body may take care of the infection but the gland itself may remain clogged, causing the redness and pain to resolve but leaves a bump on the eyelid (this is called chalazion).
Can Styes Cause Vision Changes?
Yes, although in the majority of cases this does not happen. If a stye becomes very large (especially if located on the upper eyelid), it can push on the eye itself causing astigmatic prescription changes and blurring vision. During the infection phase of a stye, persistent swelling and irritation of the eyelid can also increase tearing of the eye which also affects sharpness of vision and increases ocular discomfort. These changes in vision are usually just temporary however for some patients can significantly interfere with daily activities.
Why Do Styes Keep Coming Back?
Styes could be recurrent or chronic mainly due to poor eyelid hygiene. Bacteria accumulate along the eyelids when makeup, oils and debris are not properly removed. Other conditions like blepharitis (eyelid inflammation) which can also be caused by poor eyelid hygiene, can increase the risk of blocked glands and styes. Meibomian gland dysfunction (MGD) is a condition characterized by blocked or non-functioning oil glands; already blocked glands create an ideal environment for bacteria to replicate, which also increases the risk of developing styes and eyelid infections. Overpopulation of Demodex skin mites on the eyelids and eyelashes increases blepharitis and also leads to higher risk of stye formation. Systemic conditions like rosacea or any conditions that cause immune suppression can make styes more frequent. Effective and regular removal of any accumulated bacteria, oils, debris and excess Demodex reduces blepharitis, MGD and therefore, risk of styes.
Tips for Long-Term Relief
1. Daily eyelid hygiene:
Cleanse your skin with a gentle facial cleanser. Then, use a gentle makeup remover or micellar solution to remove excess makeup that did not come off with just your cleanser alone. Follow with an antimicrobial eyelid cleansing wipe to repel overgrowth of bacteria on the eyelid.
2. Warm eyelid compresses:
Using a warm compress for 10-12 minutes nightly can open up blocked oil glands as well as improve rate of healing by promoting more blood flow to the area.
3. Avoid touching eyes:
Our hands carry bacteria, viruses and other debris. Transferring these germs and debris to the eye area can increase risk of infection.
4. Replace makeup regularly:
Expired makeup also carries bacteria. Replacing makeup every 3 months is recommended, as well as avoiding sharing makeup products with others.
5. Address systemic and ocular diseases:
Systemic conditions like rosacea, diabetes, eczema, seborrheic dermatitis, polycystic ovarian syndrome (PCOS), psoriasis, HIV/AIDS, cancer treatment, as well as autoimmune conditions like rheumatoid arthritis and lupus can all contribute to increased stye formation. Managing these conditions is integral to reducing this risk.
6. Speak to your optometrist:
If you have tried all of these tips but not noting any improvement in your condition, it is important to inform your optometrist and have this assessed. Your eye care professional may recommend specific treatments that could be more unique to your ocular and systemic health needs. Many optometry offices also provide advanced professional treatments for stubborn blepharitis causing frequent styes as well as non-surgical treatment options to reduce persistent or recurring styes. Ask about BlephEx or Zest treatments for blepharitis, or intense pulsed light (IPL) therapy for stye reduction.
The Bottom Line
Frequent or recurring styes are usually a sign of an underlying eyelid or skin condition. Addressing underlying conditions as well as regular eyelid hygiene, regular warm compresses and seeing your eye care professional routinely can help them from coming back so often. If you seem to be struggling with this issue, book an appointment with your eye care provider for a properly tailored treatment and management plan.
References:
- Liang, Lingyi, Xiaohu Ding, and Scheffer CG Tseng. "High prevalence of demodex brevis infestation in chalazia." American journal of ophthalmology 157.2 (2014): 342-348.
- Nieves-Moreno, María, María Granados, and Susana Noval. "Primary immunodeficiency diseases presenting with chalazia as the first manifestation." Ocular Immunology and Inflammation 29.2 (2021): 257-259.
- Schear, Matthew J., et al. "The association of Demodex with chalazia: a histopathologic study of the eyelid." Ophthalmic Plastic & Reconstructive Surgery 32.4 (2016): 275-278.
- Yam, Jason CS, et al. "Ocular demodicidosis as a risk factor of adult recurrent chalazion." European Journal of Ophthalmology 24.2 (2014): 159-163.
- Arita, Reiko, and Shima Fukuoka. "Therapeutic efficacy and safety of intense pulsed light for refractive multiple recurrent chalazia." Journal of Clinical Medicine 11.18 (2022): 5338.
Contributors:
Sarah Farrag, OD
Dr. Sarah Farrag is originally from Halifax, Nova Scotia, and is happy to be practicing optometry in her hometown. She graduated with honors from the University of Waterloo Doctor of Optometry program in June 2015. In addition to routine optometric care, Dr. Farrag also facilitates an advanced dry eye clinic offering specialty consultation and treatment for severe dry eye.
