21/07/2017 Chalazion Medication: Antibiotics, Corticosteroids

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Chalazion Medication
Updated: Apr 18, 2017
Author: Jean Deschênes, MD, FRCSC; Chief Editor: Andrew A Dahl, MD, FACS more...

MEDICATION

Medication Summary
Medical therapy for a chalazion is only rarely indicated, except in cases of acne rosacea, for which
a 6-month course of low-dose tetracycline may be of benefit. Doxycycline in dosages as low as
100 mg/week for 6 months may result in permanent biochemical change, with the sebaceous
glands producing shorter-chain fatty acids, which are less likely to congeal and block gland orifices
than longer-chain fatty acids are.

Although probably innocuous, topical antibiotics do not help this condition, which is not infectious. If
there is a question regarding the possibility of infection within the lump, topical erythromycin
ointment may be used after each application of hot compresses. Systemic tetracycline may be
beneficial, but local drops are unlikely to help and are more likely to cause a contact dermatitis-
type reaction. Long-term oral tetracycline, doxycycline, or metronidazole may be useful in the
setting of chronic, recurrent chalazia.

Topical steroids can be helpful in minimizing inflammation and in reducing edema, thereby
facilitating any drainage that may take place.

Antibiotics
Class Summary
Antibiotics are not indicated as treatment for an inflammatory lesion without evidence of an active
infection. Significant benefit may be derived from low-dose, long-term oral therapy with tetracycline
derivatives.

Tetracycline

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The useful effects of tetracycline class antibiotics in patients with chalazia include altering the skin
bacterial flora and altering lipids to produce shorter-chain fatty acids, thereby lowering the melting
point and viscosity of sebaceous secretions and possibly preventing blockage of meibomian
glands. Additional mechanisms of action may also benefit patients with acute and chronic
chalazion, and long-term maintenance therapy may prevent recurrences.

Doxycycline (Doryx, Vibramycin, Adoxa, Doxy 100)

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Doxycycline inhibits protein synthesis and thus bacterial growth by binding to 30S and possibly
50S ribosomal subunits of susceptible bacteria. It alters lipids to produce shorter-chain fatty acids,
thereby lowering the melting point of sebaceous secretions and possibly preventing blockage of
meibomian glands.

Minocycline (Minocin, Solodyn)

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Minocycline alters lipids to produce shorter-chain fatty acids, lowering the melting point of
sebaceous secretions and possibly preventing meibomian gland blockage.

Metronidazole (Flagyl, Metro)

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When taken orally, metronidazole may benefit patients who are unable to take tetracyclines.

Bacitracin
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Bacitracin prevents transfer of mucopeptides into the growing cell wall, which causes inhibition of
bacterial cell wall synthesis.

Polymyxin B/bacitracin topical (Double Antibiotic, Polysporin)

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Bacitracin prevents transfer of mucopeptides into the growing cell wall, which causes inhibition of
bacterial cell wall synthesis. Polymyxin B damages bacterial cytoplasmic membrane and alters
permeability, causing intracellular constituents to leak. Used to treat open excoriations and
erosions.

Corticosteroids
Class Summary

Corticosteroids have anti-inflammatory properties and cause profound and varied metabolic
effects. In addition, these agents modify the immune response of the body to diverse stimuli.
Cicatricial complications may be avoided with judicious use of topical or injected corticosteroids.

Triamcinolone (Aristospan Intra-Articular, Kenalog)

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The advantages of triamcinolone over other depot corticosteroids are decreased discomfort and
reduced cost. Triamcinolone is used for inflammatory dermatoses responsive to steroids. This
agent decreases inflammation by suppressing migration of PMNs and reversing capillary
permeability. It acts to minimize scarring and inflammation. Injection of depo-steroids into the lid
may raise intraocular pressure (steroid glaucoma) in susceptible individuals (steroid responders).

Methylprednisolone (DepoMedrol, Medrol, Solu-Medrol, A-Methapred)

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Methylprednisolone decreases inflammation by suppressing migration of PMNs and reducing

capillary permeability.

Dexamethasone (Baycadron, Dexamethasone Intensol)

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Dexamethasone is used for various inflammatory diseases. It decreases inflammation by

suppressing migration of PMNs and reducing capillary permeability.

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