What is the treatment for a hordeolum (stye)?

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From the Guidelines

A stye, or hordeolum, can be treated at home with warm compresses applied to the affected eyelid for 10-15 minutes, 3-4 times daily, as this helps bring the stye to a head and promotes drainage, according to the most recent guidelines on blepharitis management 1. When treating a stye, it is essential to prioritize good eyelid hygiene to prevent the spread of infection.

  • Apply warm compresses to the affected eyelid for 10-15 minutes, 3-4 times daily, to help bring the stye to a head and promote drainage.
  • Gently massage the area after applying the warm compress to help express the contents.
  • Avoid wearing eye makeup or contact lenses until the stye resolves.
  • Over-the-counter pain relievers like ibuprofen (200-400mg every 4-6 hours) or acetaminophen (500-1000mg every 4-6 hours) can help with discomfort.
  • Never squeeze or pop a stye yourself, as this can lead to further infection or complications. If the stye doesn't improve within a week, becomes increasingly painful, affects your vision, or spreads to other areas, it is crucial to see a doctor for further evaluation and treatment.
  • A doctor may prescribe antibiotic eye drops or ointment, such as erythromycin or bacitracin, for bacterial infection, as supported by the recent study on blepharitis treatment 1.
  • In persistent cases, a doctor might surgically drain the stye to prevent further complications. It is also important to note that styes occur when oil glands in the eyelid become infected with bacteria, typically Staphylococcus, so good eyelid hygiene is essential for prevention, as emphasized in the blepharitis preferred practice pattern 1.

From the Research

Treatment Options for Stye

  • A stye is a type of skin and soft tissue infection (SSTI) that can be caused by bacteria such as Staphylococcus aureus, including community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) 2
  • According to a study on SSTIs, antibiotics such as doxycycline and trimethoprim-sulfamethoxazole are effective against CA-MRSA, with all MRSA isolates found to be sensitive to these drugs 2
  • Other antibiotics, such as clindamycin and levofloxacin, may also be effective, but with lower sensitivity rates of 88% and 79%, respectively 2
  • Incision and drainage may be necessary in addition to antibiotic treatment, especially if the stye is large or does not respond to initial treatment 2

Antibiotic Resistance and Treatment

  • The study found that 48% of patients received an antibiotic that was inadequate for their specific isolate before referral, highlighting the importance of proper diagnosis and treatment 2
  • It is essential to note that antibiotic resistance profiles can vary, and treatment should be guided by culture results and sensitivity testing whenever possible 2

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Purulent skin and soft tissue infection: antibiotic selection in the community.

Journal of primary care & community health, 2010

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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