What are the next steps for resolving a chalazion that has been operated on twice? Is Kenalog an option for dark skin? (Photo)

Thank you for the question and photos.As you have experienced some chalazions can be very difficult to treat.I would stay away from any steroid injection at this point for concern of atrophy and depigmentIon.  I would recommend being patient and be aggressive with frequent warm compresses.  If that does not resolve then I would try repeat I&D.Make sure you are seeing someone experienced with this minor but difficult problem.Best regardsNagi T Ayoub MD, FACS

There are about 40-50 glands in the upper lid that can form a chalazion.  Sometimes when they are removed the surgeon may not have gotten the whole thing.  Or there may be a new one in an adjacent gland.  I frequently try a steroid injection first.  If done into the chalazion it should not change the color of the skin.  If that doesn't work then you would need re-excision.  The other issue is how it was "drained" - if just had a needle stuck into it from the outside, that will not work.  Need to flip the lid over to really get it out.  See an oculoplastic surgeon for proper treatment.      

Thank you for sharing your question and photos. In the hands of an experienced eyelid specialist, Kenalog injection is great treatment for many chalazions. I find it less traumatic and more successful than incision and drainage. If used inappropriately, complications (atrophy and hypopigmentation) can easily occur. See a doctor who uses Kenalog regularly. In the meantime, be very aggressive with the use of warm compresses. Good luck.

Please be careful with steroid injections as a means of treating a chalazion.  This can lead to permanent hypopigmentation in the thin skin of the eyelid which can be disfiguring.

I would recommend seeing an eyelid specialist (oculoplastic surgeon) since this is obviously not a "run-of-the-mill" chalazion.Steroid injections are certainly an option and if done properly, should not result in any unwanted effects. Repeat excision is also a possibility (since the previous 2 procedures may not have been performed adequately).As a last thought, while a chalazion is the most likely diagnosis, this could also possibly be another type of cystic growth of the lid, in which case "drainage" would not sufficiently remove it (it might require more definitive excision). All the more reason to see a specialized eyelid surgeon for formal consultation and treatment. Good luck!

Appears with recurrent chalazion you need aggressive I&D or even excision of the area................