Recurrent styes: why they keep coming back and what helps

A stye is a small, painful lump on or inside the eyelid or around the eye. The NHS says the skin around it may be swollen and red, and the stye may be filled with yellow pus. The eye may be red and watery, but vision should not be affected. A stye usually affects one eye, but it is possible to have more than one at the same time and in both eyes.

Having an occasional stye is common and there is nothing to investigate. People usually describe their styes as recurrent when they come back repeatedly over months, appear in clusters, or return in the same spot. That pattern is a sign that something is keeping the eyelid margin inflamed, and it is more useful to look for that underlying driver than to treat each stye as a one-off.

The NHS says styes are often caused by bacteria infecting an eyelash follicle or an eyelid gland. Anything that makes the edge of the eyelid more prone to infection or blocked glands makes a repeat more likely.

• Blepharitis, a long-term inflammation of the eyelid margins. The NHS says it causes swollen, itchy eyelids, sore or gritty eyes, flakes or crusts at the roots of the lashes and eyelids that stick together in the morning, and its symptoms often come and go.

• Rosacea, which the NHS names alongside blepharitis as a reason that styes are more likely.

• Skin conditions such as seborrhoeic dermatitis, which the NHS lists as one cause of blepharitis.

• Glands in the eyelids not producing enough oil, another cause of blepharitis listed by the NHS.

• Hygiene habits around the eyes, such as leaving eye make-up on overnight, touching the eyes with unwashed hands or sharing towels and flannels.

The NHS says it is probably not a stye if there is no lump, in which case a swollen, red, watery eye or eyelid is more likely to be conjunctivitis or blepharitis. It also says that if the lump is hard but not very painful it is more likely to be a chalazion. A chalazion is a lump in the eyelid that is typically firm and not very painful, and the NHS points to Moorfields Eye Hospital for more information about it.

The distinction matters for recurrent problems, because someone who keeps getting lumps may be experiencing a mixture of the two. A GP or eye specialist can usually tell the difference by looking at the lid.

To reduce swelling and help a stye heal, the NHS suggests soaking a clean flannel in warm water and holding it against the eye for 5 to 10 minutes, repeating this 2 to 4 times a day. Painkillers such as paracetamol or ibuprofen can ease the pain, and aspirin should not be given to children under 16.

The NHS advises avoiding contact lenses and eye make-up until the stye has burst and healed, and warns not to burst a stye or remove an eyelash yourself. Squeezing can push the infection deeper or spread it to the surrounding eyelid.

The NHS says you can help avoid styes by keeping your eyes clean. In practice, for people who get them repeatedly, that means building a short, consistent routine rather than reacting only when a lump appears.

• Wash your face and remove eye make-up before bed.

• Keep your eyelids and eyelashes clean, especially if you have blepharitis. The NHS describes holding a warm flannel on the closed lid for 5 to 10 minutes, gently massaging the lids for around 30 seconds and then wiping along the lid edge with cotton wool or a cotton bud to remove flakes and crusts.

• Continue the lid cleaning even when symptoms settle, because the NHS notes that blepharitis symptoms come and go.

• Wash your hands before putting contact lenses in or taking them out.

• Do not share towels or flannels with someone who has a stye, and do not rub your eyes unless your hands are clean.

• Discuss rosacea or a scalp and skin condition with a GP if you have one, because treating it can calm the eyelid margin.

The NHS says to see a GP if a stye does not get better within a few weeks. It advises asking for an urgent GP appointment or getting help from NHS 111 if a stye is very painful or swollen, affects your vision, your eye is producing pus or the infection has spread to your eye or eyelid.

For recurrent styes, it is reasonable to see a GP even if each one clears up, particularly if they are frequent, tend to appear in the same place or come with symptoms of blepharitis or rosacea. The NHS says that if blepharitis does not clear up with regular cleaning a GP might suggest an antibiotic cream or ointment for the eyelid, and that severe blepharitis or additional eye symptoms may lead to referral to an eye specialist.

The NHS says a GP may burst a stye with a thin, sterilised needle, remove the eyelash closest to the stye or refer you to an eye specialist in hospital. For people with a persistent lump, the NHS points to the Moorfields Eye Hospital information on chalazia, which are usually managed by a specialist team when they do not settle.

If blepharitis has caused other problems such as a cyst, antibiotic eyedrops or tablets may be recommended, according to the NHS. The long-term aim for recurrent styes is usually to control the eyelid inflammation so that fewer lumps form, rather than to treat each lump in isolation.