Stye antibiotic treatment: Is it necessary?

In this article:

• Do you need antibiotics for a stye?
• What is the best antibiotic for a stye?
• Compare antibiotics for styes
• Stye treatment at home
• Chalazion vs. stye treatment

In this article

• Do you need antibiotics for a stye?
• What is the best antibiotic for a stye?
• Compare antibiotics for styes
• Stye treatment at home
• Chalazion vs. stye treatment

A stye, also known as a hordeolum, is a common eyelid infection that occurs when an oil and sweat gland along the eyelid becomes clogged and then infected with bacteria. While most styes go away on their own, some may require medical treatment. Standard stye treatment includes applying warm compresses and keeping the eye area clean. If the stye doesn’t improve after a few days, a healthcare provider may recommend medicated eye washes, topical treatments, or oral antibiotics. In serious cases, an ophthalmologist may perform a procedure to drain the stye. 

Do you need antibiotics for a stye?

Antibiotics are medications that stop or kill the bacteria responsible for infections. They’re used when the body can’t resolve an infection on its own, and the type prescribed depends on the severity and type of infection. In most cases, you won’t need antibiotics for a stye. 

A review published in 2022 found that adding antibiotics to standard care did not increase the chances of a stye resolving. However, if a stye doesn’t go away after a few days of standard care or the infection gets worse, your healthcare provider may recommend topical or oral antibiotics. The American Academy of Ophthalmology recommends a conservative treatment of warm compresses and eyelid hygiene for uncomplicated styes, and only recommends antibiotics when necessary.

“While most styes resolve with warm compresses and lid cleanses, antibiotics are used in certain unique cases,” shares Sarah Budnick, OD, optometrist at Walmart Vision Center in St. Johns, Michigan. Redness, swelling, and discomfort around the stye are signs of infection. Sometimes, the infection can spread from the sweat and oil gland (called a sebaceous gland) into the surrounding tissue and cause cellulitis. For cellulitis around the eye (called periorbital cellulitis), oral antibiotics may be needed.

What is the best antibiotic for a stye?

Though there isn’t a single antibiotic that’s best for treating styes, healthcare providers choose from several options based on several factors. The location and severity of the infection, as well as individual factors like someone’s allergy history are all factors that can help a healthcare provider choose the best treatment for you. 

Topical antibiotics in the form of an ointment don’t have strong evidence for their benefits, but they may still be recommended. The most commonly prescribed topical antibiotic was an erythromycin 0.5% ointment, according to a 2022 review of more than 2,700 cases. This review found that topical antibiotics were prescribed 56% of the time. Bacitracin ointment is also another topical antibiotic option that may be recommended.

In some cases, healthcare providers may prescribe a combination of antibiotics and steroids to reduce both infection and inflammation. One commonly prescribed topical eye treatment is a combination of neomycin, polymyxin B sulfates, and dexamethasone. This combination comes in eye drops or as an ointment.

If the infection is spreading, worsening, or not responding to topical treatments, oral antibiotics may be used. These include doxycycline, Augmentin (amoxicillin-clavulanate), Keflex (cephalexin), and azithromycin. Doxycycline is also prescribed for underlying conditions that can increase the risk of stye formation, such as meibomian gland (oil gland) dysfunction (MBD) and ocular rosacea. 

Stye treatment at home

Most styes can be supported with at-home treatments and basic eyelid hygiene. Typical care for a stye includes washing the eyelid, keeping it clean, and using warm compresses until it resolves. If the stye doesn’t improve within a few days, it’s important to see a healthcare provider to seek other treatment options. 

Here are a few basic stye treatments that can be done at home:

• Apply warm compresses for 15 minutes at a time, three to five times a day. Make sure the cloth is warm, not hot, and that it’s clean every time you use it. You can also massage the stye gently with clean hands or a clean towel to help clear the blockage. “The heat helps to dissolve and soften the material, causing the blockage so the area can drain,” Dr. Budnick explains.
• Clean the edge of your eyelids by using diluted baby (no-tear) shampoo or an eyelid scrub such as Ocusoft Lid Scrub, available over the counter at most pharmacies. “I recommend cleansers that are specifically designed for the eyelid region rather than baby shampoo, which tends to be more irritating to the ocular surface,” Dr. Budnick says.
• Avoid touching, squeezing, or popping the stye, or else the infection could spread.
• Avoid wearing eye makeup or contact lenses to prevent further irritation and infection. 

Dr. Budnick also shares some over-the-counter supportive treatments that can make a stye more comfortable as it’s healing: “Supportive measures… include artificial tears to keep the surface of the eye well lubricated, an over-the-counter NSAID such as ibuprofen and/or an analgesic such as acetaminophen.”  

Chalazion vs. stye treatment

A chalazion is another common eyelid issue that begins with a blocked oil gland, similar to a stye. However, chalazia typically form deeper in the eyelid, are less painful, and tend to swell more than styes. While styes often resolve within a few days, chalazia can take longer to form and heal. Also, unlike styes, chalazia are typically not caused by a bacterial infection. “A chalazion is a non-infectious blockage of a meibomian gland. Unlike a stye, it’s usually painless and develops more slowly,” Dr. Budnick explains. 

Treatment for a chalazion is similar to a stye. They rarely need antibiotics and can be typically treated at home with warm compresses and basic eyelid hygiene. Chalazions may grow to affect your vision or become uncomfortable. When this happens, an ophthalmologist may administer a steroid shot to reduce the swelling. Healthcare providers may also perform surgery to drain the chalazion if it becomes too large or doesn’t go away. 

If styes or chalazia keep recurring, your healthcare provider may recommend a biopsy to rule out other underlying issues.

Bottom line

A stye is a common eyelid infection caused by a blocked and infected oil gland. Most styes resolve with simple at-home care, such as warm compresses and eyelid hygiene. In some cases, if the infection doesn’t improve or worsens, a healthcare provider may recommend antibiotics in the form of eye drops, ointments, or oral medications. The specific medication prescribed will depend on the severity of the infection and your individual health history, including any allergies. Rarely, the stye or chalazion may need to be incised and drained.