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How do I treat my stye?

I had a patient with a stye come in to see me today who had woken up three days earlier with a very sore eyelid margin and red lump that seemed to be getting bigger. It was quite tender to touch, and he had a little foreign body sensation and pus from the skin surface. He had tried hot compresses or “hot rags” to treat it. Hot rags refer to a warm compress with a flannel or small face towel using boiled water from the kettle or hot water from the tap. The hot flannel is placed over the lid for a couple of minutes two or three times morning and evening. That helps in order to quiet the stye or the acute early chalazion.

Hot rags are a very good treatment of styes. The majority of styes will go away within two to five days. My patient’s stye had not gone away, and it had got much more swollen, so I had to put him on some Augmentin antibiotics for five days and some local antibiotic ointment, Chloramphenicol four times a day onto the lid and just inside the lid margin. He will come back and see me again in five to seven days’ time. I have warned him that his stye may burst during this period and self-drain, or it may just subside and get smaller.

What I could not do was to offer an incision for the stye because it was “far too hot” and needed time to settle to get rid of the inflammation and give it time to go away by itself with a little bit of medical care and help.

He may see me in five days’ time for me to excise the stye. I will look underneath the lid and see whether there is a chalazion component that needs incision and curettage. Otherwise, it will have to be removed by direct drainage from the front of the lid and then padded afterwards overnight, followed by another five days of antibiotic ointment.

People who get styes often have the underlying cause of blepharitis promoting the acute infection and inflammation. Therefore, I advise them on how to look after their blepharitis to prevent them from getting recurrent staphylococcal lid margin disease with acute styes.

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