Stye – Causes and treatment
A stye, also called a stye, is an infection at the base of the eyelash caused by a bacterium (staphylococcus). Much more common than a chalazion , it is nonetheless far less frequent. It appears as a bump on the edge of the eyelid accompanied by rapidly developing inflammatory swelling and a collection of whitish pus draining from the base of the eyelash. The eyelid may ooze, and the stye may rupture. Unlike a chalazion, which is a cyst, a stye is a true infection. It generally progresses more rapidly than a chalazion but is more prone to infectious complications such as cellulitis (an eyelid infection).
What is this ?
A stye is a condition that occurs on the free edge of the eyelid (where the eyelashes grow). It is caused by a bacterial infection of the hair follicle (the groove containing the eyelash root) by Staphylococcus aureus: it is the equivalent of a boil on the eyelash. It manifests as a painful, localized swelling of the eyelid, centered by a white spot topped by an eyelash.
Several glands are present in the eyelids, some producing sweat, others an oily substance, to moisturize the skin and tears. Certain conditions, such as inflamed skin (blepharitis), systemic illness (diabetes), or hormonal factors, can lead to a blockage of these glands, which line the hair follicles. This then promotes colonization of the hair follicles by Staphylococcus aureus, leading to the development of a stye.
A swollen eyelid topped with a white spot
The onset is often sudden or rapidly progressive over 1 to 2 days, with a feeling of discomfort localized to one eyelid, which quickly becomes painful and swollen. A white spot topped with an eyelash usually appears 24 to 48 hours after the onset of symptoms.
The presence of a contributing factor such as severe blepharitis or diabetes can cause very inflammatory styes, an extension of the infection to the entire eyelid (palpebral cellulitis) remains exceptional: in such cases, a chalazion or the use of non-steroidal anti-inflammatory drugs (ibuprofen) should be considered.
Why consult a doctor?
A stye usually heals spontaneously within a few days, but eyelid hygiene and the application of an antibiotic cream accelerate healing.
The main problem encountered with this condition is the frequent confusion patients make between a stye and a chalazion. Indeed, diagnostic confirmation determines the appropriate treatment and reassures the patient about the duration of symptoms, the risks of local complications, and the possibility of recurrence.
Prescribing the appropriate treatment, and identifying and treating contributing factors, warrants a specialist consultation.
Action to take and treatment
In the inflammatory phase (red, swollen and sensitive eyelid), consult urgently to begin treatment, which reduces the duration of the condition.
The treatment consists of applying an antibiotic ointment 3 to 5 times a day, anti-staphylococcal (fusidic acid), combined with eyelid care.
The pain can be relieved with standard painkillers (paracetamol), and non-steroidal anti-inflammatory drugs (NSAIDs) should be strictly avoided as they can promote the spread of the infection. In cases of extensive eyelid infection (palpebral cellulitis), oral antibiotics will also be prescribed.
Particular attention will be paid to all four eyelids to detect any predisposing factors that could lead to recurrences (chronic blepharitis). In cases of frequent recurrences, diabetes or relative immunosuppression should be investigated.
Should a stye be lanced?
No! Unlike a chalazion, a stye is not cut. It is possible to pluck the eyelash whose bulb is infected to help the pus drain.
Gently massaging the stye afterwards, respecting the pain, helps to drain it.
Evolution
A stye develops like a boil or an acne pimple. It will eventually drain and continue to ooze for a few days before disappearing.
Since the lesion usually forms on a staphylococcal infection of the eyelid, the risk of recurrence to other eyelashes on the same or another eyelid is significant.
Prevention
A stye is much rarer than a chalazion. Nevertheless, this infection at the base of an eyelash does not usually occur spontaneously; there is an underlying condition predisposing to infection of the eyelid.
Preventing styes therefore relies on treating the areas of the face infected by staphylococcus. A consultation with a dermatologist is advisable in cases of recurrent styes, in order to administer courses of topical antibiotics to the cheeks and the sides of the nose.
From an ophthalmological point of view, eyelid care will need to be carried out, in particular using disinfectant wipes such as Blephaclean®.
Complications
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Complications from a stye are extremely rare; however, it is an infection of the eyelid and can spread. This is known as preseptal cellulitis.
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If the infection continues to spread, it can affect the entire globe; this is called orbital or retroseptal cellulitis.
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This is a serious infection of the eye and orbit.