Chalazion vs. Stye: What’s the Difference?

A chalazion is a blocked oil gland that appears on the inside of the eyelid, usually surfacing as a bump. An eye stye (or hordeolum) is a smaller pimple-like bump that appears on the upper or lower eyelid due to a blocked oil gland. It is typically near the eyelash and lives on the outside of the eyelid.

The eyelid glands, known as meibomian glands, normally produce an oily substance that contributes to the natural tears on our eyes. If these glands become blocked, they could develop into a chalazion or a stye (i.e. hordeolum). 

What is a Chalazion?

A chalazion is a large, non-infectious cyst in the eyelid that often takes several weeks to develop.  It can be caused by either inflammation of the meibomian glands or it can start as a hordeolum. A chalazion is not painful and usually occurs on the upper eyelid. This is likely because the upper eyelids anatomically have more glands (about 50 versus only 25 glands in the lower lid). Symptoms may include eyelid drooping (ptosis), redness, and on rare occasion lid swelling.

What is a Stye?

A hordeolum, also known as a stye, is often more acute and can be secondary to a bacterial infection of the eyelid glands. Styes are contagious but tend to be smaller, more painful, and more tender to the touch than a chalazion. Symptoms can include eyelid swelling, pain, and tearing. If a stye is present for several weeks, it may develop into a chalazion.

Who is at Risk for Chalazia and Styes?

Some individuals are more prone to developing a hordeolum or chalazion than others. Common risk factors include acne rosacea, chronic inflammation of the eyelids, poor eyelid hygiene, and meibomian gland dysfunction.

How are They Treated? 

Before treatment can begin, our doctors will need to confirm that the lesion is truly a chalazion or stye and not another type of skin lesion. In general, there are several treatments available.

Warm Compresses and Antibiotics

A common home remedy is to place a warm compress over the affected area multiple times a day. This method can help melt the thickened oil gland secretions and can free the affected area, allowing it to function normally again. Our doctors will sometimes prescribe an antibiotic to the patient in order to combat the main infection. Oftentimes, these conservative treatment methods alone will allow the eyelid to heal, and no further treatment will be required.

If a patient has a recurrent chalazion or hordeolum, an extended course of low-dose antibiotic, typically a drug called doxycycline, may be prescribed to reduce chronic inflammation in the eyelids.

Steroid Injections and Surgical Removal

If a chalazion does not recede or if it continues to grow after a few weeks, either a steroid injection or chalazion surgical removal may be an option.

Steroid injections can be placed into chalazia, thereby decreasing the inflammation and leading to likely regression of the bump. This can generally be performed in the office.

Depending on the size and location of the lesion, another option to treat a chalazion would be to perform an incision and drainage procedure. If the affected area of the eye consists mostly of fluid, the bump can be punctured and then removed with pressure on the surrounding area. If the affected area is more solid, an eyelid incision will be required and the sebaceous debris can be removed through the small incision. The surgery normally requires an incision from underneath the eyelid.

Recovery time from a stye or chalazion surgery is quick for most people. Some patients report minor discomfort or pain around the eyelid margin after the procedure, but this is typically remedied easily with medication. In most cases, an eye patch is worn over the eye for a few hours after the procedure in order to apply pressure to the surgical site to help prevent drainage from the affected area.

How to Prevent Chalazion or Styes

To prevent recurrent styes or chalazion, make sure to wash your hands frequently, take control of your contact lenses by practicing good hygiene, clean your skin and take care of your cosmetics. Make sure to throw anything away that is old to prevent any chance of infection and never share cosmetics with others.

Common Questions about Styes and Chalazions

How long does a stye last?

A stye is a minor, short-term bacterial infection that will last on average one to three days. Once the stye has drained on its own, the healing phase can last approximately 7-10 days. If your stye does not begin to clear up after a few days, it may be time to see a doctor.

Is a stye contagious?

The stye itself is not contagious; however, the bacteria that caused the stye can be transferred to others where it may or may not cause an infection. Just because the stye is not contagious doesn’t mean you should not be careful – we recommend maintaining good hygiene, do not wear any contact lenses, refrain from using public showers or pools when the infection is active, as well as not sharing personal items with others such as clothes, towels, razors or cosmetics.

How long does a chalazion last?

A chalazion typically lasts longer than a stye. They can take weeks to fully develop and depending on the treatment option, they can take more than a month to go away.

How do you know if a chalazion is healing?

A small chalazion will begin to reduce in size and go away on their own over the course of a few weeks without treatment. For larger chalazion, home remedies such as warm compresses or a gentle massage of the eyelid may help facilitate the healing phase. If the chalazion is persistent and there is no visible change in size after a few weeks, it will require treatment from a physician where they will prescribe antibiotics, inject a corticosteroid to allow better drainage, or use a local anesthetic to numb the area and make a small incision to clear the contents without visible scarring.

It’s the right time for clearer vision

Do not attempt to remove a stye or chalazion yourself as it could cause the infection to spread. Schedule an appointment with one of our experienced doctors to discuss your treatment options today.

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