Can Accutane Cause Styes? Understanding Eye Issues During Treatment

Starting Accutane is an exciting step toward clearer skin, but it can come with unexpected side effects that catch you off guard. If you've developed a stye (also called a hordeolum) while on isotretinoin, you might be wondering whether your medication is to blame.

The short answer is yes, there is a connection. Accutane affects oil-producing glands throughout your body, including the specialized glands in your eyelids. Understanding this relationship can help you take preventive steps and know when to seek care.

At Honeydew, we've helped over 100,000 patients through their Accutane journeys, and eye-related concerns are among the questions our dermatologists hear regularly. In this article, we'll break down exactly how Accutane can contribute to styes, what you can do about it, and when it's time to see an eye doctor.

What Is a Stye?

Before diving into the Accutane connection, let's clarify what a stye actually is. A stye (hordeolum) is a painful, red bump that forms on or near the edge of your eyelid. It looks similar to a pimple and occurs when one of the small oil glands in your eyelid becomes blocked and infected, usually with Staphylococcus aureus bacteria.

There are two types of styes:

• External stye (external hordeolum): Forms at the base of an eyelash follicle or in a Zeis or Moll gland. This is the most common type and appears on the outer edge of your eyelid.
• Internal stye (internal hordeolum): Develops inside the eyelid when a meibomian gland becomes infected. These tend to be more painful and take longer to heal.

Styes typically resolve on their own within one to two weeks, but they can be quite uncomfortable during that time. Symptoms include:

• A red, swollen bump on the eyelid
• Pain and tenderness
• Swelling of the entire eyelid
• Crusting along the eyelid margin
• A feeling like something is in your eye
• Light sensitivity
• Tearing

How Accutane Affects Your Eyes

Accutane (isotretinoin) works by dramatically reducing the activity of sebaceous glands, the oil-producing glands in your skin. This is why it's so effective for acne. However, the effect isn't limited to your face: isotretinoin affects oil glands throughout your entire body, including a special type of gland in your eyelids called meibomian glands.

The Meibomian Glands

Your eyelids contain approximately 25-40 meibomian glands in the upper lid and 20-30 in the lower lid. These glands produce meibum, an oily substance that forms the outermost layer of your tear film. This oil layer serves crucial functions:

• Prevents tears from evaporating too quickly
• Keeps your eyes lubricated between blinks
• Creates a smooth optical surface for clear vision
• Helps maintain eye comfort

When Accutane reduces the activity of these glands, less meibum is produced, and the oil that is produced may become thicker and more prone to clogging the gland openings.

Research on Accutane and Meibomian Gland Dysfunction

Studies have documented the impact of isotretinoin on meibomian glands. A study published in Cornea found that patients taking isotretinoin showed significant changes in meibomian gland function, with reduced tear break-up time and changes in the quality of meibum secretions.

Research in the British Journal of Ophthalmology demonstrated that isotretinoin treatment leads to morphological changes in the meibomian glands, including gland dropout (loss of functional glands) that may persist even after treatment ends in some patients.

A comprehensive review in Survey of Ophthalmology confirmed that ocular surface disease is a well-documented side effect of isotretinoin, with meibomian gland dysfunction being a primary mechanism.

The Pathway from Accutane to Styes

Understanding how Accutane can lead to styes involves tracing a chain of events:

Step 1: Reduced and Altered Meibum Production

Isotretinoin causes the meibomian glands to produce less oil. Additionally, the oil that is produced tends to be thicker and more viscous than normal, making it harder to flow freely from the gland openings.

Step 2: Meibomian Gland Dysfunction (MGD)

With altered secretions, the meibomian glands can become obstructed. This condition, known as meibomian gland dysfunction, is characterized by blocked gland openings, irregular or reduced oil secretion, and inflammation of the gland tissue.

Step 3: Blepharitis

MGD frequently leads to blepharitis, an inflammation of the eyelid margins. Symptoms include red, swollen eyelid edges, crusty or flaky debris at the base of eyelashes, itching and burning sensations, and increased susceptibility to bacterial overgrowth.

Step 4: Stye Formation

When a blocked gland becomes infected with bacteria, usually Staphylococcus aureus, a stye develops. The combination of blocked glands and chronic eyelid inflammation creates an environment where styes are more likely to form.

How Common Are Eye Problems on Accutane?

Eye-related side effects are among the more common issues patients experience during Accutane treatment. Here's what the research tells us:

Eye Side Effect	Approximate Frequency
Dry eyes	20-50% of patients
Blepharitis	20-40% of patients
Meibomian gland dysfunction	Variable, may affect most patients
Styes (hordeolum)	Less common, but increased risk
Contact lens intolerance	Common during treatment

While styes themselves aren't as frequently reported as dry eyes, the underlying conditions that lead to styes (MGD and blepharitis) are very common during isotretinoin treatment.

Preventing Styes While on Accutane

The good news is that with proper eye care, you can significantly reduce your risk of developing styes during Accutane treatment. Here are evidence-based strategies:

1. Warm Compresses

Applying warm compresses to your closed eyelids for 5-10 minutes once or twice daily can help keep meibum flowing. The warmth helps liquefy thickened oil secretions, making them easier to express from the glands. Use a clean, warm (not hot) washcloth and reheat as needed to maintain warmth throughout the treatment.

2. Eyelid Hygiene

Keeping your eyelid margins clean is essential for preventing bacterial buildup that can lead to styes:

• Use a gentle, preservative-free eyelid cleanser or diluted baby shampoo
• Clean along the lash line with a cotton swab or clean fingertip
• Remove all eye makeup thoroughly before bed
• Avoid rubbing your eyes with unwashed hands

3. Artificial Tears

Preservative-free artificial tears can help maintain moisture and flush away irritants. Look for products specifically designed for dry eyes, and use them throughout the day as needed. Some patients find thicker gel drops helpful at night.

4. Omega-3 Fatty Acids

Some research suggests that omega-3 supplements may help support healthy meibomian gland function. A study in Ophthalmology found that omega-3 supplementation improved symptoms of meibomian gland dysfunction. Consider discussing this option with your dermatologist.

5. Stay Hydrated

Drinking plenty of water supports overall hydration, which can help with dry eye symptoms. While hydration alone won't prevent MGD, it's part of a comprehensive approach to managing Accutane side effects.

6. Avoid Eye Irritants

During Accutane treatment, your eyes may be more sensitive than usual. Try to minimize exposure to smoke and air pollution, avoid windy or very dry environments when possible, take breaks during prolonged screen time (follow the 20-20-20 rule), and consider using a humidifier in dry indoor spaces.

How to Treat a Stye While on Accutane

If you do develop a stye during your Accutane treatment, don't panic. Most styes resolve on their own with conservative home care. Here's what to do:

Home Treatment for Styes

1. Warm compresses: Apply a warm, damp cloth to the affected eye for 10-15 minutes, 3-4 times per day. This is the most important home treatment, as it helps the stye drain naturally.
2. Keep the area clean: Gently clean the eyelid with diluted baby shampoo or an eyelid cleanser. Don't try to squeeze or pop the stye.
3. Avoid contact lenses and eye makeup: Until the stye has completely healed, avoid wearing contacts and eye makeup to prevent further irritation or spreading bacteria.
4. Use artificial tears: Continue using preservative-free artificial tears to keep the eye comfortable.
5. Don't squeeze: Resist the urge to pop or squeeze the stye. This can spread the infection and lead to more serious complications.

Most styes improve significantly within a few days and resolve completely within one to two weeks with consistent warm compress application.

When to See an Eye Doctor

While most styes are harmless and self-limiting, certain situations warrant professional evaluation. You should see an eye doctor (ophthalmologist or optometrist) if:

An eye doctor may prescribe antibiotic ointment or drops if there's significant bacterial infection. In rare cases, a persistent stye may need to be surgically drained under local anesthesia. They can also evaluate you for underlying conditions like chronic blepharitis that may need ongoing treatment.

Should You Stop Accutane if You Get Styes?

In most cases, developing a stye is not a reason to stop Accutane treatment. Styes are typically manageable with conservative care, and the benefits of completing your Accutane course usually outweigh the temporary inconvenience of a stye.

However, if you experience:

• Frequent, recurring styes
• Severe or persistent eye problems
• Significant impact on your quality of life from eye symptoms

You should discuss these concerns with your dermatologist. In some cases, adjusting your Accutane dosage may help reduce eye-related side effects while still maintaining treatment effectiveness. Our providers at Honeydew can help you weigh the options and make the best decision for your individual situation.

Will Eye Problems Go Away After Accutane?

For most patients, eye-related side effects improve significantly after completing Accutane treatment. As isotretinoin leaves your system and your meibomian glands resume more normal function, symptoms like dry eyes and blepharitis typically resolve within a few weeks to months.

However, some research suggests that prolonged isotretinoin use may cause structural changes to meibomian glands that persist longer. A study in British Journal of Ophthalmology found that some patients showed evidence of meibomian gland dropout even after treatment completion.

If you continue to experience eye problems after finishing Accutane, consult an eye care professional. They can evaluate your meibomian gland function and recommend treatments like in-office thermal pulsation therapy or other interventions for persistent MGD.

Other Eye-Related Side Effects of Accutane

While this article focuses on styes, it's helpful to be aware of other eye issues that can occur during Accutane treatment:

Condition	Symptoms	Management
Dry eyes	Grittiness, burning, fluctuating vision	Artificial tears, warm compresses
Blepharitis	Red, crusty, itchy eyelid margins	Eyelid hygiene, warm compresses
Contact lens intolerance	Discomfort wearing contacts	Switch to glasses during treatment
Light sensitivity	Increased sensitivity to bright light	Sunglasses, avoiding bright screens
Chalazion	Painless lump in eyelid (blocked gland)	Warm compresses; may need medical treatment

Note that a chalazion is different from a stye. While a stye is an acute infection, a chalazion is a non-infectious blockage of a meibomian gland that forms a firm, painless lump. Chalazia are also more common during Accutane treatment and are managed similarly with warm compresses, though they may take longer to resolve.

Working with Your Care Team

Managing eye-related side effects is an important part of your Accutane journey. At Honeydew, our board-certified dermatologists are experienced in monitoring for these issues and can help you develop a proactive eye care routine.

If you're experiencing eye problems during treatment, don't hesitate to reach out to your care team. We can:

• Assess whether your symptoms are typical or need further evaluation
• Recommend specific products for dry eyes and eyelid care
• Adjust your treatment plan if needed
• Coordinate with an eye care professional when appropriate

Remember, most eye-related side effects are manageable and shouldn't prevent you from achieving the clear skin you're working toward. With proper care and monitoring, you can navigate these challenges successfully.

Key Takeaways

• Yes, Accutane can contribute to styes by affecting meibomian gland function and promoting conditions like dry eyes and blepharitis.
• Prevention is key: Daily warm compresses, good eyelid hygiene, and preservative-free artificial tears can significantly reduce your risk.
• Most styes resolve on their own with warm compress treatment within 1-2 weeks.
• See an eye doctor if a stye doesn't improve within a few days, spreads, or is accompanied by fever or vision changes.
• Eye side effects usually resolve after completing Accutane treatment, though some patients may have lingering symptoms.
• Developing a stye rarely means stopping Accutane, but discuss any concerns with your dermatologist.