20 Recurrent Chalazia & Now in the Same Spot! - Includes Video

By Dr. Tanya Gill, Optometrist

 

If you've had a chalazion once, you're not alone. But what if you've had 20 chalazia, and now they keep coming back in the same exact spot? Is that normal? The short answer is: recurrent chalazia are common, but they are not something you should ignore. Repeated chalazia usually signal that an underlying eyelid condition has gone undiagnosed or untreated. The good news is that once the root cause is identified, many patients finally experience lasting improvement.

Why Do Chalazia Keep Coming Back?

A chalazion develops when a meibomian (oil) gland becomes blocked, trapping thickened oil inside the eyelid. While anyone can develop a chalazion, patients with recurrent chalazia often have an underlying condition that continues to clog the oil glands.

Some of the most common causes include:

• Demodex blepharitis

• Meibomian gland dysfunction (MGD)

• Chronic eyelid inflammation

• Ocular rosacea

• Poor eyelid hygiene

• Changes in oil production

Rather than treating each chalazion individually, it's important to determine why they continue to occur.

 

 

One Condition I Always Consider: Demodex Blepharitis

When I evaluate patients with numerous recurrent chalazia, one of the first conditions I consider is Demodex blepharitis.

Demodex mites are microscopic organisms that naturally live around the eyelashes. In some people, however, the mite population becomes excessive, leading to chronic inflammation of the eyelid margin.

When Demodex mites become a problem, they can contribute to:

• Recurrent chalazia

• Meibomian gland dysfunction

• Itchy eyelids

• Red eyelid margins

• Dry eye symptoms

• Eyelash shedding

Identifying and treating Demodex blepharitis can be an important step toward reducing future flare-ups.

 

What Are Demodex Collarettes?

One of the hallmark signs of Demodex blepharitis is the presence of collarettes.

Collarettes are waxy, cylindrical debris that forms around the base of the eyelashes. I often describe them to patients as tiny, tight bracelets wrapped around each eyelash.

These waxy sleeves trap inflammatory debris along the eyelid margin. Simply washing the lashes is often not enough to remove them because they remain tightly attached to the base of the eyelash.

 

 

My Typical At-Home Eyelid Hygiene Routine

For patients diagnosed with Demodex blepharitis, I generally recommend a comprehensive eyelid hygiene routine designed to remove debris while supporting a healthy eyelid skin barrier with my Demodex Mites Debris Cleansing System.

A typical cleansing routine includes:

Step 1: Loosen the Collarettes

Apply one drop of cleansing oil to Eyelid Margin Scrub Brush and gently clean where the eyelashes meet the eyelid margin to loosen the attached collarettes. Always use a 10X lighted magnifying mirror for accuracy and safety.

Step 2: Remove the Collarettes

Using In Between Eyelash Cleansing Brush and always viewing through a 10× lighted magnifying mirror, carefully work at the base of each eyelash to lift and remove the loosened collarettes.

Because collarettes behave like tight waxy bracelets around each lash, the goal is to first loosen them before gently removing them.

Step 3: Final Wash-Off

Finish with Tea Tree Eyelid & Eyelash Foaming Cleanser to remove loosened debris while helping maintain a healthy eyelid skin barrier.

Maintaining the eyelid skin barrier is an important part of long-term eyelid health.

 

Prescription Treatment May Also Be Needed

For patients diagnosed with Demodex blepharitis, your eye care professional may prescribe Xdemvy® (lotilaner ophthalmic solution), a prescription eye drop specifically indicated to treat Demodex blepharitis.

Treatment recommendations should always be individualized by your own eye care provider.

 

Why Diagnosis Matters

Patients with recurrent chalazia often have more than one condition occurring at the same time.

For example, a patient may have:

1. Demodex blepharitis

2. Meibomian gland dysfunction secondary to Demodex

3. Chronic eyelid inflammation

Treating only the chalazion without identifying the underlying cause frequently results in another recurrence.

When a Chalazion Keeps Returning in the Same Exact Spot

One situation that deserves special attention is when a chalazion repeatedly develops in the identical location.

Although recurrent chalazia are common, a lesion that continually returns to the same spot should be carefully evaluated.

One rare—but important—condition that your eye care professional may consider is sebaceous cell carcinoma, an uncommon cancer of the oil glands of the eyelid.

Fortunately, sebaceous cell carcinoma is very rare, but because it can mimic a recurrent chalazion, it is something your optometrist or ophthalmologist should rule out when the same lesion keeps recurring.

 

When Should You See a Dry Eye Optometrist?

If you've experienced:

• Multiple chalazia

• Chalazia that return after treatment

• Chronic eyelid irritation

• Recurrent styes

• Itchy eyelids

• Eyelash debris or collarettes

• Persistent dry eye symptoms

it's time for a comprehensive eyelid evaluation.

A dry eye optometrist can evaluate the health of your meibomian glands, look for signs of Demodex blepharitis, assess your tear film, and develop a personalized treatment plan designed to reduce future flare-ups.

 

Key Takeaways

• Recurrent chalazia are common, but they usually indicate an underlying eyelid condition.

• Demodex blepharitis is a common contributor to recurrent chalazia and meibomian gland dysfunction.

• Collarettes are a key sign of Demodex blepharitis and should be properly removed as part of an eyelid hygiene routine.

• Long-term success depends on treating the underlying cause—not just the bump itself.

• Chalazia that repeatedly occur in the same exact location deserve careful evaluation to rule out rare conditions such as sebaceous cell carcinoma.

 

 

Frequently Asked Questions

Is it normal to keep getting chalazia?

Recurrent chalazia are relatively common, but they are not considered normal. Repeated flare-ups usually indicate an underlying eyelid condition that should be evaluated.

Can Demodex mites cause chalazia?

Demodex blepharitis can contribute to inflammation of the eyelid margin and meibomian gland dysfunction, both of which may increase the risk of recurrent chalazia.

What are collarettes?

Collarettes are waxy cylindrical deposits that wrap around the base of the eyelashes. They are considered a hallmark sign of Demodex blepharitis.

Should I worry if my chalazion keeps returning in the same spot?

A chalazion that repeatedly returns to the same location should be evaluated by an eye care professional. While most recurrent chalazia are benign, your doctor may recommend additional evaluation to rule out rare conditions such as sebaceous cell carcinoma.

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Results may vary. This article is for educational purposes only and should not replace medical advice from your eye care professional.

 

 

Hi, I’m Dr. Tanya Gill, optometrist and founder of We Love Eyes. I started We Love Eyes in 2014 while trying to help one of my (stubborn) patients with contact lens discomfort. In 2016, I had 3 products. Fast forward to today – We Love Eyes has almost 30 SKUs. It’s been an amazing journey. Explore my life’s work at weloveeyes.com. Check out my DEMODEX COLLECTION section to find healthy eye care products for your eye problem. I also have a ton of contentat TIKTOK See the profile page and see the playlist CHALAZION DRAINING playlist. xo

 

 

 

 

 

 

 

 

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