What is a stye?
A stye is an inflamed lump in the eyelid caused by a blocked Meibomian gland.
The eyelids contain Meibomian glands that make sebum, an oily/waxy material that lubricates the eyes in conjunction with the tears.
These Meibomian glands are situated in the cartilage of the eyelid and drain out of the small ducts you can see on the edge of the eyelid just inside the lashes. This is why it is not a great idea to use eyeliner on the actual lid margin, as you can block these duct openings.
If the ducts are blocked, by mascara, eyeliner, dirt, dust, or just dried sebum, then the gland keeps making sebum, but it cannot drain out. So it builds up causing a collection, which can become inflamed or infected.
When it is acutely inflamed or infected, we call it a stye or Meibomian cyst.
When it is just a collection, which often remains after the acute inflammation has resolved, or been treated, it is called a chalazion.
Most of these lumps, although unsightly, will resolve with conservative treatment and a little patience.
How to treat a stye at home
These are the things you can safely try at home to treat your stye:
· Warm compresses. The easiest and cleanest way to do this, is to take a clean face washer and run it under the hot tap until it is warm and damp and then roll it up, lie down and place it on your closed eyelids for a few minutes. Do this as often as you feel to. The warmth will help to make the secretions more fluid and to open up the gland ducts so that the glands can drain spontaneously.
· TheraTears Sterilid spray or cleanser. There is often an underlying blepharitis or inflammation of the lids and lashes. It is important to treat this so that any infection settles and does not recur. The spray contains dilute hypochlorous acid, which is the substance that our bodies own white cells use to treat infection, and can be safely sprayed directly onto the closed eyelids and massaged into the lash follicles, which is where the microbes live. The foam is a cleanser which contains tea tree oil and needs to be washed off after use. If you need ongoing treatment with this, it can be great to use the foam in the shower and then spray the spray on the lids when they are clean.
· Chloramphenicol ointment. This powerful antibiotic is now available over the counter at chemist shops. It can help treat the stye if it has become infected, which will manifest as redness and sometimes pain of the skin directly over the lump. Use the ointment 2-3 times a day for a week. The safest way is to wash your hands, apply 1 cm of cream to your fingertip and gently massage it into the skin.
Medical treatment of a stye (things you cannot do at home)
· Antibiotics. If the skin of the lid is very red and the redness is spreading, it is important to get checked by a doctor promptly in case you are developing cellulitis of the eyelid skin (peri-orbital cellulitis). If you are, you will need oral antibiotics. Rarely, the cellulitis can spread deeper into the eye socket (orbital cellulitis) and this is a medical emergency that requires hospitalisation and intravenous antibiotics. This is very rare, but important to be aware of. Cellulitis can also develop after an injury with anything that breaches the skin. The infection can also be spread from elsewhere in the body through the blood.
· Steroids. Once any acute infection has been treated and settles down, some steroid cream may help to reduce the residual swelling and inflammation. This treatment needs to be prescribed and monitored by a doctor, as steroids can cause high pressure in the eye, or glaucoma, which is a potentially blinding eye disease. They also increase the risk of getting other infections around and in the eyes.
· Surgery. Definitely do not try this at home! Do not try to squeeze, pop or needle your own eyelid stye or anyone else’s. Things can go terribly wrong in unprofessional hands.
· Surgery may be required acutely if the stye is very large and tense, to drain the collection and prevent it rupturing through the skin. We drain the collection from the inside of the eyelid so it does not leave a weeping sinus or a scar. Surgery may also be needed once the acute swelling and inflammation settle down to drain any chronic residual collection. Mostly, conservative treatment will work, but it can take some time and patience.
· Styes are very common and usually they settle promptly and without any problems. Occasionally the more intense measures are required to treat them, but it is important these are undertaken by trained professionals (ophthalmologists) who know how to treat them and to care for the underlying eye.
How to prevent a stye from occurring or recurring
· Keep the gland openings open. Keep the lids clean by washing the face, especially after any dirty or dusty work. Do not use mascara, lid liner or makeup near the openings of the Meibomian glands on the edge of the eyelids, and carefully wash off all makeup at the end of the day.
· Keep the lash follicles clean by using Theratears Sterilid spray or cleanser to sterilise the lash follicles where bugs can take up house and cause blepharitis. Blepharitis is not an infection that can be caught or passed on, but is an overgrowth of your normal skin flora, often because there is an underlying dry eye condition.
· Keep the eyes moist. Treat any underlying dry eye condition with preservative free tear drops such as Evolve.
· Don’t feed the bugs! Bugs love sugar, which is in sweets, carbs (all the white stuff), dairy and its substitutes, and alcohol. A low carb, low sugar, low alcohol diet will support your health in all sorts of ways, including your eye and eyelid health.
· A stye is ‘in your face’ and is sometimes your body’s way of bringing to your unavoidable attention the fact that something in your life needs to change, be that your diet, the stress you are under, or some other aspect of your lifestyle that needs to be addressed. We always know what that is, we just don’t always want to look at it, but the body has a sense of humour and it can have a way of showing you what you need to see and doing in a way that can no longer be avoided!
· Embrace the offering to clean up your diet and lifestyle, to rest if needed, to address any underlying stress, and generally make room for a more joyful, loving, magnificent you that you can look in the eyes and love.
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