Eyelid lumps are common, and can vary widely in size, position and appearance. Many eyelid lesions are benign, but it is important to rule out more serious causes such as skin cancer.
Benign eyelid lumps can also have a negative effect on quality of life, both in terms of their appearance and other symptoms such as tenderness or a tendency to catch on things.
Fortunately, most eyelid lumps can be treated successfully under local anaesthetic in a treatment room. It is important to entrust this to a surgeon with appropriate expertise in eyelid surgery for optimal results.
Common types of eyelid lumps:
Stye:
A stye is a small, typically painful abscess (a collection of pus) in the eyelid. These are often tender, and usually appear as a red lump with a yellow or white spot in the centre. There can be some redness and swelling around the rest of the eyelid, and the eye may water more than usual.
Styes form when an eyelash follicle or an oil-producing gland becomes infected by bacteria, which then causes inflammation within the eyelid.
Chalazion (plural: chalazia):
Chalazions are red or skin-coloured lumps caused by blockage of one of the oil glands (Meibomian glands) in the eyelid. The oil accumulates, causing inflammation and thickening of the surrounding eyelid tissues. They can be uncomfortable and tender, and can sometimes cause blurred vision as they press on the eye.
Papilloma:
Papillomas (sometimes called skin tags) are benign overgrowths of skin, and often have a warty appearance. They are usually skin-coloured, and sometimes have a small stalk (pedunculated). They tend to be painless, but can cause irritation, and are often removed for cosmetic reasons.
Papillomas are sometimes associated with certain viruses which can infect skin cells.
These are areas of fatty cholesterol deposits that typically develop underneath the skin around the eyelids. They can appear as flat strips or as raised bumps, and are usually yellow or cream-coloured. They are generally painless, but are unlikely to resolve without treatment and may be cosmetically bothersome.
Xanthelasma are caused by high levels of cholesterol in the blood, and therefore it is important to have a blood test to have your cholesterol levels checked and treated as needed.
Cysts of Moll/Cysts of Zeis:
These are two types of cysts which are commonly found on the eyelids, filled with either clear fluid (cysts of Moll) or thicker, pale material (cysts of Zeis).
Naevus:
These are usually round or oval, and may be pigmented with a consistent colour. They commonly appear on the edge of the eyelids.
Seborrheic keratosis:
These lesions tend to appear more commonly with increasing age, and with long-term sun exposure. They are usually raised, brownish lesions with a rough, oily surface.
Basal cell carcinoma (BCC):
Basal cell carcinomas are a form of localised skin cancer, and are sometimes referred to as a rodent ulcer. They don’t spread elsewhere in the body, but can destroy the tissues and structures where they are growing. They often have pearly edges, sometimes with a central crater or ulcer, and sometimes bleed. Early treatment is beneficial to limit the amount of normal tissue lost, and to prevent their spread into the surrounding structures.
Squamous cell carcinoma (SCC):
SCCs can have quite varied appearances, sometimes mimicking other lesions. They are much less common than BCCs, but can spread widely, including along nerves, and can metastasise elsewhere in the body. It is therefore very important to have timely treatment.
BCCs and SCCs are associated with age, sun exposure, long-term dampening of the immune system (such as with certain medications), radiation exposure (e.g. previous radiotherapy), fair skin, as well as certain genetic conditions.
While this list describes many of the more common eyelid lesions, there are many more, and assessment by a specialist will ensure you receive the appropriate treatment.
How are eyelid lumps treated?
The treatment of eyelid lumps depends on their size, type and location, but in most cases eyelid lesions are excised (surgically removed) under local anaesthetic. In the case of chalazions, surgical treatment typically involves draining the contents of the cyst to remove the source of the inflammation, followed by some ointment to help the remaining thickened tissues to settle.
A degree of bruising and swelling is common after the treatment of eyelid lumps, and can be influenced by factors such as the size and location of the lump, and whether you are on any blood thinning medications. Infection is rare, and an antibacterial cream is usually prescribed to minimise the risk of this. Scarring is limited as much as possible by careful orientation and placement of incisions and meticulous attention to technique. Some lesions can recur in the future, and careful excision of the entire lesion followed by cautery to the base of the lesion can help to reduce the chance of this.
At your consultation the treatment options for your particular lesion will be discussed, along with any associated risks.