The appearance of bumps around the delicate skin of the eyes often prompts a search for answers. The skin in this area is uniquely thin and susceptible to various growths, ranging from common, harmless formations to indications of underlying health conditions. Understanding the specific type of bump is the first step toward appropriate management, as they arise from distinct causes such as cellular buildup, infection, or systemic issues.
Bumps Caused By Keratin Buildup
The most frequent non-inflammatory bumps around the eyes result from a localized buildup of skin components like keratin. Milia are small, firm, white or yellowish cysts that form when dead skin cells or keratin become trapped beneath the skin’s surface, failing to shed naturally. They are often described as having a pearl-like appearance and are not related to acne, as they do not form within a pore. Primary milia develop spontaneously, while secondary milia can result from skin trauma, sun damage, or the use of heavy topical products.
Syringoma presents as small, flesh-colored or yellowish bumps, sometimes mistaken for milia. These are benign tumors arising from an overgrowth of cells in the eccrine sweat ducts. Unlike milia, which are filled with keratin, syringomas are firm and often appear in symmetrical clusters around the lower eyelids.
Skin tags, medically known as acrochordons, are common around the eyelids, especially near folds where skin friction occurs. These growths consist of a stalk of collagen and blood vessels covered by skin, and they are usually the same color as the surrounding tissue. While harmless, a large skin tag on the eyelid margin can cause irritation or potentially obscure vision.
Inflammatory and Infectious Bumps
Bumps that are painful, red, or tender often indicate an active inflammatory or infectious process involving the eyelid glands. A stye, or hordeolum, is a red, painful lump located at the edge of the eyelid, caused by an acute bacterial infection, most frequently Staphylococcus aureus. This infection occurs in an eyelash hair follicle or one of the oil-producing glands near the margin. Styes appear suddenly and can cause the eyelid to swell, sometimes presenting with a small spot of pus at the center.
A chalazion is a swollen bump on the eyelid that is typically painless once fully formed, though it may start with some tenderness. It results from a non-infectious blockage and subsequent inflammation of a meibomian oil gland, leading to a firm, chronic lump. A chalazion often develops gradually and may occur as a residual cyst after an internal stye has resolved.
Molluscum contagiosum is a viral infection that causes small, dome-shaped bumps on the eyelids and surrounding skin. These lesions are flesh-colored or pink, often featuring a distinct central dimple. The virus is contagious and is more common in children, though it can affect adults, especially those with compromised immune systems.
Bumps Related to Systemic Health
Some growths around the eyes can serve as visible markers for metabolic or systemic health issues. Xanthelasma are soft, yellowish plaques that appear near the inner corner of the upper or lower eyelids. These growths are cholesterol deposits that build up beneath the skin.
The presence of xanthelasma is linked to high blood lipid levels, specifically hyperlipidemia or elevated LDL cholesterol, in about half of affected adults. Xanthelasma can signal an increased risk of cardiovascular disease, heart attack, and atherosclerosis, even if lipid levels appear normal. This appearance suggests that a metabolic workup is prudent.
Small, itchy bumps or patches of inflamed, scaly skin on the eyelids may be a sign of allergic contact dermatitis or eczema. This condition results from an immune reaction to an irritant or allergen that has come into contact with the sensitive eyelid skin. Common triggers include components in cosmetics, sunscreens, nail polish (transferred by touch), or airborne substances like perfumes.
When to Seek Professional Diagnosis and Care
When a bump appears around the eye, it is important to avoid self-extraction, as attempting to squeeze or pop the lesion can introduce infection or cause scarring. For common inflammatory issues like a stye or chalazion, applying warm compresses several times a day can help the gland open and drain naturally. Maintaining clean eyelids by gently washing them and removing all makeup before sleep helps prevent blockages and reduces the risk of future bumps.
Certain symptoms constitute “red flags” that necessitate a prompt evaluation by an eye care professional, such as an optometrist, ophthalmologist, or dermatologist. These concerning signs include any bump that changes color or shape, grows rapidly, or does not resolve within one to two weeks. Severe pain, swelling that affects vision, or spreading redness are indicators of a potentially serious infection requiring professional care.
If Xanthelasma is suspected due to its soft, yellowish appearance, a medical provider should be consulted immediately to check cholesterol and lipid levels. A doctor can confirm the diagnosis through a visual examination and may perform a biopsy in rare cases to rule out malignancy. Treatment options for persistent, benign growths often involve in-office procedures such as sterile extraction for milia or surgical removal for skin tags and chalazia.