Stye: causes, duration, treatment and when to see a doctor

A stye (hordeolum) is a small infection at the root of an eyelash, most often caused by Staphylococcus aureus: a red, painful lump appears on the edge of the eyelid, then drains and heals on its own in about a week. Warm compresses and simple hygiene support this healing. A topical antibiotic is not routinely needed, a cortisone ointment is only used on prescription, and a stye must never be pierced. A whole eyelid that swells, fever, an eye that moves poorly or vision that drops mean you should see an ophthalmologist the same day or, failing that, go to the eye emergency department.

RECOGNISING IT

What is a stye?

Each eyelash grows from a small follicle, alongside tiny glands. When bacteria settle there, the follicle becomes infected and forms a small abscess: this is a stye, or “hordeolum” to doctors. It appears as a red, warm, tender lump on the free edge of the eyelid, often centred on an eyelash. After two or three days, a yellow or white head appears at its tip, then the lump drains and the swelling goes down.

The start of a stye is recognisable: localised tenderness on the edge of the eyelid, redness, then a swelling that concentrates on one point. The pain stays centred on the lump, and vision does not drop.

Stye or chalazion: how to tell the difference

This is the most common mix-up, and it changes what to do. A stye is an acute infection of the edge of the eyelid. A chalazion is the inflammation of a meibomian gland, deeper in the lid: the gland becomes blocked, its oily contents build up and a firm lump forms, without infection. A review written for general practitioners (Carlisle, 2015) gives the main rule of thumb: a well-defined lump on the edge of the eyelid is most often a stye; a lump in the middle part of the eyelid is most often a chalazion. Redness, swelling and pain are the three criteria that specialists consider most useful for telling them apart (Shin, 2025).

The two can overlap: a stye that does not fully resolve can leave a chalazion behind once the infection has cleared. The pitfalls of telling them apart: stye or chalazion, the difference.

The internal stye: a special case

When the infection affects not an eyelash follicle but a meibomian gland, within the thickness of the eyelid, it is called an internal stye: the eyelid is swollen and painful as a whole, with no visible head on the edge, it takes longer to settle and more often turns into a chalazion. We have a dedicated article on it: the internal stye.

CAUSES

What causes a stye?

A stye is a bacterial infection (Lindsley, 2017), most often caused by Staphylococcus aureus, a germ that normally lives on the skin and in the nose of many people without causing disease. It occurs when this germ gets into an eyelash follicle, helped by a weakened eyelid margin or by hands brought to the eyes. A one-off stye can happen to anyone; styes that keep coming back almost always point to an underlying predisposition:

• Blepharitis, a chronic inflammation of the eyelid margins, with crusts at the base of the lashes and glands that do not work properly. The large chalazion series place it at the top of the risk factors: in an Israeli study of 9,119 patients (Nemet, 2011), it multiplied the risk by 6.2, and an American study of 134,959 patients (Kim, 2024) found it, along with rosacea and smoking.
• Rosacea, a skin condition in which the face flushes easily, often affects the eyelids; it multiplied the risk of chalazion by 2.9 in Nemet’s study.
• Demodex, a microscopic mite that lives in the eyelash follicles. A 2021 Korean study of 250 patients (Jun) found it in 59.5% of people with recurrent styes, compared with 17.5% of controls. Its presence can be recognised by the small sleeves (collarettes) that sheathe the base of the lashes (Rhee, 2023).
• Hands brought to the eyes, old or shared make-up, contact lenses handled without washing your hands. Itchy eyes that get rubbed keep the cycle going.

Is a stye linked to tiredness?

It is the explanation most patients give, and it has not been demonstrated: we found no published study establishing a link between tiredness and styes. What is documented are the predisposing factors above. Diabetes is traditionally mentioned, but the two large chalazion series (Nemet, 2011; Kim, 2024) do not find it to be a risk factor; a 2023 review (Rhee) lists it, along with age and rosacea, among the factors for Demodex blepharitis. A weak statistical association with anxiety has been described for chalazion (Nemet, 2011), with no demonstrated cause-and-effect link. If a period of tiredness coincides with a stye, it is more likely because you rub your eyes more and neglect eyelid hygiene.

Is a stye contagious?

Only slightly, and not in the way viral conjunctivitis is. Staphylococcus aureus is present on the skin of a large part of the population: it is not contact with the germ that causes a stye, but its entry into a weakened follicle. In routine practice, a stye does not require keeping a child off school or isolating yourself. The pus that drains does, however, contain bacteria: washing your hands after each treatment, using your own towel and pillowcase, and throwing away the mascara used during the episode protect those around you as well as the other eye.

TREATING

How long does a stye last?

About a week. The 2017 Cochrane review (Lindsley) points out that, in many cases, the lesion drains spontaneously and heals without treatment; another Cochrane review (Cheng, 2017) gives the benchmark of “about a week”. The pain is at its worst in the first two or three days, then the white head appears, the lump drains and the redness fades. A stye that is unchanged after one to two weeks, or that grows instead of draining, is no longer an ordinary stye: it should be examined.

How to treat a stye: what works

We need to be honest about the level of evidence. The 2017 Cochrane review (Lindsley) looked for every trial comparing warm compresses, eyelid cleaning, antibiotics or corticosteroids with no treatment in acute internal stye, the form it studies: it found none, and concludes that there is no evidence either for or against these treatments. They rest on clinical experience. Here is what is advised in routine practice.

• Warm compresses, several times a day, for a few minutes each time: a clean towel or flannel, soaked in hot water, wrung out and folded into several layers, placed on the closed eyelid and rewarmed as soon as it cools. The heat helps the stye come to a head and then drain, and it needs to reach the inside of the eyelid: in a small study comparing eight methods (Murakami, 2015), only a warm damp towel, folded into several layers, managed this.
• Gentle cleaning of the eyelid margins, once or twice a day, with a clean compress and lukewarm water or a dedicated wipe, to remove crusts and secretions at the base of the lashes. In blepharitis, a Cochrane review of 34 trials (Lindsley, 2012) concludes that this can relieve symptoms.
• Clean hands before and after each treatment, and no fingers on the eyelid in between.
• No make-up and no contact lenses while the stye is there: make-up keeps the infection going and contaminates the products; a lens, handled close to an infected eyelid, puts the eye at risk.

Is an antibiotic needed? When yes, when no

Not for an ordinary stye. The Cochrane review devoted to internal stye (Lindsley, 2017) found no trial showing that an antibiotic ointment speeds up the healing of a stye that is progressing well, and the same caution is applied to styes on the edge of the eyelid, even though this prescription is very widespread: in a 2025 survey of 80 Korean oculoplastic surgeons (Shin), 73.8% prescribed a topical antibiotic for a stye. In blepharitis, topical antibiotics reduce the bacteria on the eyelid margin and give partial relief (Lindsley, 2012). A topical antibiotic may therefore be considered, on prescription, in cases of marked blepharitis, repeated styes or heavy discharge. An oral antibiotic is reserved for cases where the infection spreads beyond the eyelid: a medical decision, not self-medication.

Sterdex and corticosteroids: on prescription only

Sterdex is an eye ointment that combines a corticosteroid, dexamethasone, and an antibiotic, oxytetracycline. Many patients have a tube of it in a drawer and apply it themselves to a stye. This is a mistake: a corticosteroid calms the redness, but it dampens the local defences against the infection; in an eye affected by herpes, a fungal infection or a corneal wound, it can seriously worsen the situation, and it can raise the pressure in the eye without any symptoms. This medicine is dispensed only on prescription, it is restricted to adults and children over 8 years of age, and it is prescribed for a short period, after an examination. Never with an old prescription, never on a stye that nobody has examined. The details of the ointments, from those that make sense to those that do not, are in our article ointment for a stye: what really works.

What not to do

Never pierce or squeeze the stye with a needle or your fingernails: this pushes the infection deeper and risks eyelid cellulitis or a scar. Do not pull out the eyelash at the centre of the stye yourself, and do not apply eye drops or an ointment that have not been prescribed. Home remedies (tea bag, chamomile, gold ring, saliva) have not been evaluated by any study, none of them is sterile and some expose you to an allergy or a secondary infection.

A stye that does not heal or keeps coming back

Two situations call for an examination. The first is the stye that does not drain: after one to two weeks, the lump persists, less red but still there. It has often turned into a chalazion, and the treatment changes: warm compresses and eyelid massage morning and evening for ten days to a fortnight or so; if the lump remains, an incision and curettage can be scheduled once the eyelid is no longer inflamed (see a chalazion that won’t go away).

The second is the stye that comes back several times a year. The Cochrane review (Lindsley, 2017) notes that recurrences are common; they almost always reflect an underlying predisposition: blepharitis, ocular rosacea, Demodex. The examination looks for crusts and collarettes at the base of the lashes, blocked glands and redness of the eyelid margins. It is treating this predisposition, with long-term daily eyelid hygiene and, depending on the case, treatment of the rosacea or the Demodex, that makes recurrences less frequent, not the ointment applied to each stye.

When to see an ophthalmologist

An ordinary stye, painful but limited to the edge of the eyelid, can be treated at home. Certain signs indicate that the infection is spreading to the tissues around the eye: this is periorbital cellulitis and, more serious, orbital cellulitis. In a Taiwanese series of 224 adults hospitalised for one or the other (Shih, 2023), a stye was the second identified cause, accounting for 15.5% to 24.8% of cases depending on the decade. What distinguishes the two forms (Carlisle, 2015): in orbital cellulitis, the eye moves poorly and vision changes. You should see an ophthalmologist the same day or, failing that, go to the eye emergency department if you have:

• a whole eyelid that is red, warm and swollen, or swelling that spreads towards the cheek or forehead;
• fever or a feeling of being unwell;
• an eye that moves poorly or seems to be pushed forward;
• a drop in vision or double vision.

Without these signs, it is usual practice to book a non-urgent consultation when the stye has not changed after one to two weeks of compresses, when it comes back, or when the lump is not on the edge of the eyelid. An eyelid that swells with no lump and no pain has other causes (swollen eye), as does a red eye with no lump on the eyelid (red eye: the causes). In a contact lens wearer, a red, painful eye means removing the lens and seeing an ophthalmologist the same day or, failing that, going to the eye emergency department. The warning signs are brought together on our page eye emergencies.

Styes in children

Styes are common in children, who rub their eyes with hands that are not always clean. A Japanese study of more than one million reimbursed chalazion or stye incisions between 2014 and 2022 (Kido, 2026) shows that stye incisions are most frequent between the ages of 10 and 14, in boys and girls alike. The treatment is the same as in adults: warm compresses, clean hands, no pressure on the lump. A child’s eyelid swells easily: a whole eyelid that is red and warm, fever or a child who seems listless and unwell mean you should see an ophthalmologist the same day or, failing that, go to the eye emergency department. Children are seen at the Cachan practice from the age of 3; below that age, the consultation falls within paediatric ophthalmology. Between the ages of 3 and 8, care is limited to warmth and hygiene, and any medication is decided at a consultation.

What Dr Tourabaly does

Dr Tourabaly, former chef de clinique at the Quinze-Vingts hospital (Sorbonne University), sees patients for consultations in Cachan, in Paris 13 and at the Cabinet ophtalmologique Sorbonne Saint-Michel (Paris 5th). The consultation confirms the diagnosis, rules out cellulitis and looks, with the slit lamp, for the predisposition behind recurrences. As a general rule, a stye is not operated on: it drains on its own, and at most the doctor can help a stye that has come to a head to drain. When a stye has given way to a chalazion that persists despite a fortnight or so of compresses and massage, an incision and curettage under local anaesthesia can be scheduled at the practice, in Cachan or at the Cabinet ophtalmologique Sorbonne Saint-Michel, once the eyelid is no longer inflamed. In children, a chalazion is treated medically; if an incision becomes necessary, Dr Tourabaly refers the child to a suitable team.

Frequently asked questions

Consultations in Cachan, Paris 13 and at the Sorbonne Saint-Michel practice (Paris 5th) · Tel. +33 1 45 47 08 11

Scientific sources

• Lindsley K, et al. Non-surgical interventions for acute internal hordeolum. Cochrane Database Syst Rev. 2017. PMID 28068454
• Cheng K, et al. Acupuncture for acute hordeolum. Cochrane Database Syst Rev. 2017. PMID 28181687
• Lindsley K, et al. Interventions for chronic blepharitis. Cochrane Database Syst Rev. 2012. PMID 22592706
• Carlisle RT, Digiovanni J. Differential diagnosis of the swollen red eyelid. Am Fam Physician. 2015. PMID 26176369
• Shin HJ, et al. Management practice for hordeolum and chalazion: a survey of the Korean Society of Ophthalmic Plastic and Reconstructive Surgery (KSOPRS) members. Korean J Ophthalmol. 2025. PMID 40267992
• Jun SY, et al. Clinical characteristics of Demodex-associated recurrent hordeola: an observational, comparative study. Sci Rep. 2021. PMID 34725365
• Nemet AY, et al. Associated morbidity of chalazia. Cornea. 2011. PMID 21993469
• Kim DH, et al. Risk factors for chalazion diagnosis and subsequent surgical excision. Ophthalmic Epidemiol. 2024. PMID 37032590
• Rhee MK, et al. Demodex blepharitis: a comprehensive review of the disease, current management, and emerging therapies. Eye Contact Lens. 2023. PMID 37272680
• Shih EJ, et al. Differences in characteristics, aetiologies, isolated pathogens, and the efficacy of antibiotics in adult patients with preseptal cellulitis and orbital cellulitis between 2000-2009 and 2010-2019. Br J Ophthalmol. 2023. PMID 34607790
• Murakami DK, et al. All warm compresses are not equally efficacious. Optom Vis Sci. 2015. PMID 26164316
• Kido M, et al. Sex differences and age distributions in invasive treatments for chalazion and hordeolum in Japan: a 9-year nationwide claims study. Ophthalmol Sci. 2026. PMID 41675090

This article is intended for information only and does not replace a medical consultation. Indications, expected benefits and risks depend on each individual situation. For any question about your vision, consult an ophthalmologist.