Treatment of Stys (Hordeolum)
For stys (hordeolum), mupirocin 2% topical ointment is the recommended first-line treatment, applied to the affected eyelid 1-3 times daily. 1
Treatment Approach
- Warm compresses should be applied to the affected eyelid as a first-line treatment to help promote drainage of the sty 2, 3
- Mupirocin 2% topical ointment should be applied to the affected area 1-3 times daily after cleaning the area 1, 4
- Treatment should continue until the sty resolves, typically within 5-10 days 1
- The affected area may be covered with a sterile bandage after application of the ointment 4
Special Populations
- For children under 2 years of age, consult a doctor before applying any topical antibiotic ointment 4
- For children with minor skin infections including stys, mupirocin 2% topical ointment is specifically recommended by clinical guidelines 1, 5
- For adults and children 2 years and older, apply a small amount (equal to the surface area of the fingertip) to the affected area 1-3 times daily 4
Alternative Treatment Options
- Triple antibiotic ointment containing bacitracin zinc, neomycin sulfate, and polymyxin B sulfate may be used as an alternative 4
- For persistent or severe stys, systemic antibiotics may be considered if there are signs of surrounding cellulitis or systemic illness 1
- Clindamycin is recommended as first-line systemic therapy for complicated skin infections if needed 5
Prevention of Recurrence
- Maintain good personal hygiene with regular hand washing with soap and water or alcohol-based hand gel 1
- Avoid reusing or sharing personal items that have contacted infected skin (e.g., towels, washcloths) 1
- For recurrent stys, consider a 5-10 day course of nasal decolonization with mupirocin twice daily 1
- Focus cleaning efforts on high-touch surfaces to prevent reinfection 1
When to Seek Further Medical Care
- If the sty does not improve within 48-72 hours of treatment 5
- If there are signs of spreading infection (increasing redness, swelling, pain) 1
- If there are signs of systemic illness (fever, malaise) 1
- If vision is affected or there is significant pain 2, 3
Common Pitfalls and Caveats
- Avoid squeezing or attempting to pop the sty, as this may spread the infection 2
- Tetracycline antibiotics should not be used in children under 8 years of age if systemic treatment is needed 1
- Cultures from purulent skin infections are recommended if there is no response to initial treatment or if there are signs of systemic illness 1
- Stys may recur or develop into chalazions if not properly treated 2, 3