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Health condition · Clinically reviewed

Chalazion, warm compresses, injections and when incision is right.

A firm, painless lid lump that usually settles with warm compresses and better lid hygiene - and, when it doesn’t, a small in-clinic injection or minor procedure resolves it.

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Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against Royal College of Ophthalmologists, NICE CKS and peer-reviewed sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK practice including intralesional steroid, IPL and LipiFlow for meibomian gland dysfunction.

Key facts

Chalazion at a glance.

The essentials, in plain English - what it is, how it differs from a stye, and how it’s treated in the UK today.

  • What it is

    A chronic lipogranulomatous inflammation of a blocked meibomian gland, or occasionally a Zeis gland, producing a firm painless lid lump.

  • Not a stye

    A hordeolum (stye) is an acute, tender, infected lump. A chalazion is chronic, firm and usually painless.

  • Underlying drivers

    Strongly linked to blepharitis, meibomian gland dysfunction (MGD), rosacea, seborrhoeic dermatitis, Demodex and poor lid hygiene.

  • First-line care

    Warm compresses twice daily for two to four weeks, lid massage and hygiene, plus treatment of any underlying MGD or rosacea.

  • Refractory options

    Intralesional triamcinolone injection or incision and curettage under local anaesthetic if it fails to settle after six to eight weeks.

  • Red flag

    Recurrent lesion at the same site, especially in an older adult, must be biopsied to exclude sebaceous carcinoma.

Why this guide matters

Treat the lid, not just the lump.

A chalazion is usually a symptom of underlying meibomian gland dysfunction. Fixing that is what stops the next one forming.

  • Warm compresses come first

    Most chalazia settle with two to four weeks of consistent warm compresses, lid massage and daily hygiene.

  • A stubborn lump has options

    If it lingers past six to eight weeks, intralesional triamcinolone or a small incision and curettage will usually resolve it.

  • Recurrence has a reason

    Blepharitis, rosacea, MGD and Demodex drive recurrence. Treating them - with IPL, LipiFlow or oral tetracycline - breaks the cycle.

How the diagnosis is made

From lid lump to a clear plan.

The steps a UK GP, optometrist or ophthalmologist will normally follow, in order - so you know what to expect and why.

  1. 01

    Assessing

    Focused history

    How long the lump has been present, whether it is painful, previous episodes, and any rosacea, blepharitis or dry eye symptoms.

  2. 02

    Assessing

    Lid and skin examination

    A structured look at the eyelid, meibomian gland openings, tear film and facial skin for rosacea and seborrhoeic changes.

  3. 03

    Assessing

    Distinguish from a stye

    Chalazia are firm, painless and chronic. Hordeola are acute, tender and inflamed, and are managed differently.

  4. 04

    Confirming

    Slit lamp assessment

    A slit lamp confirms the diagnosis, grades any meibomian gland dysfunction and rules out other lid pathology.

  5. 05

    Confirming

    Consider Demodex and hygiene

    Cylindrical dandruff at the lash base suggests Demodex mite infestation and points to tea tree oil-based lid care.

  6. 06

    Preparing

    Oculoplastic referral

    Large, cosmetically troublesome, refractory or recurrent lesions are referred to an oculoplastic surgeon or minor operations clinic.

  7. 07

    Preparing

    Biopsy if suspicious

    Recurrent unilateral lesions, atypical appearance or older adults warrant histology to exclude sebaceous carcinoma.

Typical timeline: a first visit to a settled plan in weeks, not months.

Symptoms

What a chalazion actually looks like.

The classic firm, painless lid lump - plus the features that tell you it’s time to escalate to a specialist.

  • Firm painless lump

    A rubbery, well-defined nodule in the eyelid, most often on the upper lid, that grows slowly over weeks.

  • No acute redness

    The overlying skin usually looks normal or mildly pink, unlike the hot, tender redness of a stye.

  • Variable size

    Anywhere from a few millimetres to more than a centimetre - larger lesions can distort the lid margin.

  • Occasional astigmatism

    A large upper-lid chalazion can press on the cornea and blur vision by inducing temporary astigmatism.

  • Cosmetic and social impact

    A visible lid lump can affect confidence and photographs - a legitimate reason to seek treatment.

  • Associated blepharitis

    Crusting at the lash line, foamy tears and gritty eyes point to underlying blepharitis and MGD.

  • Rosacea features

    Facial flushing, telangiectasia, papulopustular rosacea or ocular rosacea often coexist and drive recurrence.

  • Red flag - recurrent same site

    A lump that keeps returning in the same spot, especially in an older adult, needs biopsy to exclude sebaceous carcinoma.

Treatment

How chalazion is treated in the UK.

Warm compresses and lid hygiene first, then intralesional steroid or incision and curettage - and, in parallel, treating the underlying blepharitis, MGD or rosacea.

  • Warm compresses

    Five to ten minutes twice daily for two to four weeks softens the trapped meibum and lets the gland drain naturally.

  • Lid massage and hygiene

    Gentle massage after compresses, plus daily lid cleaning, clears the meibomian gland openings and prevents recurrence.

  • Treat the blepharitis

    Managing coexisting blepharitis and MGD is the single most important step. See our blepharitis guide for the full routine.

  • Topical antibiotic or steroid

    Selective use of a combined topical antibiotic and steroid can help when there is a mild inflammatory component.

  • Intralesional triamcinolone

    A small in-clinic injection of 5 to 10 mg of triamcinolone often shrinks the lesion and avoids surgery, with a small risk of skin depigmentation.

  • Incision and curettage

    For lesions that persist beyond six to eight weeks, an oculoplastic surgeon can drain and curette the gland under local anaesthetic.

  • IPL and LipiFlow for MGD

    Intense pulsed light and LipiFlow thermal pulsation treat the underlying meibomian gland dysfunction and cut recurrence rates.

  • Systemic therapy for rosacea

    Oral tetracycline (or azithromycin if intolerant) and IPL calm ocular rosacea, a common driver of recurrent chalazia.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP, optometrist or ophthalmologist knows your eyes and history and can tell you which parts apply to you. If in doubt, get seen.

  • Royal College of Ophthalmologists. Commissioning guidance and clinical standards for oculoplastic services.

  • NICE Clinical Knowledge Summaries. Meibomian cyst (chalazion): management.

  • American Academy of Ophthalmology. Preferred Practice Pattern on blepharitis and eyelid inflammation.

  • TFOS DEWS II. Meibomian gland dysfunction and evaporative dry eye reports.

Red flags

When a lid lump needs urgent attention.

Most chalazia are benign. These are the situations that aren’t - and where a specialist opinion, biopsy or same-day review is needed.

  • Recurrent at the same site

    A chalazion that keeps coming back in exactly the same spot needs biopsy to exclude sebaceous carcinoma, a rare but serious masquerade.

  • Sebaceous carcinoma risk

    Elderly patients, unilateral progressive lesions and atypical appearances warrant urgent oculoplastic referral and histology.

  • Rapid progression

    A lump that enlarges quickly, ulcerates or bleeds is not a straightforward chalazion and needs same-week specialist review.

  • Lash loss (madarosis)

    Loss of eyelashes overlying the lesion is a warning sign for eyelid malignancy and mandates biopsy.

  • Preauricular lymphadenopathy

    A palpable node in front of the ear suggests infection or malignancy rather than a simple chalazion.

  • Visual disturbance

    Blurred vision from corneal pressure, or any true loss of vision, should be assessed by an ophthalmologist promptly.

  • Cellulitis of the lid or orbit

    Spreading redness, fever, painful eye movements or proptosis are signs of preseptal or orbital cellulitis - a same-day emergency.

  • Immunocompromise

    Atypical, multiple or persistent lid lesions in immunocompromised patients need a lower threshold for specialist review and biopsy.

  • Failure to settle

    Any lesion that has not resolved after six to eight weeks of conservative care should be reassessed and considered for intervention or biopsy.

Sebaceous carcinoma - the important masquerade

Sebaceous carcinoma is a rare eyelid cancer that can look exactly like a recurrent chalazion, particularly in older adults. Suspicious lesions are biopsied and, if confirmed, managed with Mohs micrographic surgery at a specialist ocular oncology centre such as Moorfields, Sheffield or Liverpool.

Living with it

A treatable lump, with a clear ladder.

Four things that make the biggest difference day to day - proper warm compresses, daily lid hygiene, a bit of patience and knowing when to escalate.

A quiet reminder

Consistency beats intensity, every time.

A few weeks of steady daily care usually does what one heroic day cannot.

  1. 01 Routine

    Warm compresses, done properly

    A microwavable eye mask heated for the recommended time, held over closed eyes for five to ten minutes twice daily, is the workhorse of chalazion care.

  2. 02 Hygiene

    Lid margin cleaning

    Daily cleaning with a purpose-made lid wipe or diluted baby shampoo keeps the meibomian glands open and prevents new cysts.

  3. 03 Patience

    Give it a few weeks

    Most chalazia settle within two to eight weeks of consistent conservative care. Judge progress in weeks, not days.

  4. 04 Escalate

    Don’t sit on a stubborn lump

    If nothing has changed by six to eight weeks, ask for an oculoplastic opinion for injection or incision and curettage.

Frequently asked

Everything we get asked about chalazion.

Quick answers on compresses, injections, incision and curettage, and how to stop them coming back.

  • What is a chalazion?

    A chalazion is a chronic lipogranulomatous inflammation of a blocked meibomian gland, or less commonly a Zeis gland, in the eyelid. It presents as a firm, painless, slowly enlarging lump. It is distinct from a stye, which is an acute, tender, infected lesion.

  • How is a chalazion different from a stye?

    A stye (hordeolum) is acute, painful, red and infected, and is either external (Zeis or Moll gland) or internal (meibomian gland). A chalazion is chronic, firm, painless and non-infectious. The two can overlap - a stye that fails to resolve can leave a residual chalazion.

  • How do I treat a chalazion at home?

    Warm compresses over closed lids for five to ten minutes twice daily for two to four weeks, followed by gentle lid massage and daily lid hygiene, is the first-line approach. Treating any underlying blepharitis, meibomian gland dysfunction or rosacea is essential to prevent recurrence.

  • When should I ask for treatment beyond compresses?

    If the lump has not settled after six to eight weeks of consistent conservative care, or if it is large, cosmetically troublesome or affecting vision, ask for an ophthalmology or oculoplastic opinion. Options include an intralesional triamcinolone injection or incision and curettage under local anaesthetic.

  • Is an intralesional steroid injection safe?

    Triamcinolone injection of 5 to 10 mg is a well-established, in-clinic alternative to surgery, particularly for small or awkwardly placed lesions. Risks are small but include skin depigmentation (more visible in darker skin tones), local fat atrophy and, rarely, globe puncture, so it should be done by an experienced clinician.

  • Why do I keep getting chalazia?

    Recurrence usually reflects underlying meibomian gland dysfunction, blepharitis, rosacea, seborrhoeic dermatitis or Demodex infestation. Addressing these drivers - with lid hygiene, IPL, LipiFlow, oral tetracycline for rosacea and tea tree oil for Demodex - is the key to breaking the cycle. Recurrent unilateral lesions in older adults should be biopsied to exclude sebaceous carcinoma.

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