Small bumps under the eyes are extremely common, and in most cases they’re harmless. The skin beneath your eyes is thinner than almost anywhere else on your body, which makes even tiny changes more visible. The most likely culprit is milia, tiny white cysts made of trapped keratin, but several other conditions can cause bumps in this area too. What yours are depends on their color, texture, size, and whether they’ve changed over time.
Milia: The Most Common Cause
Milia are small, firm, white bumps that sit just beneath the skin’s surface. They form when bits of dead skin cells get trapped below the skin and harden into a tiny cyst filled with keratin, the same protein found in your hair and nails. They’re painless, don’t itch, and typically measure 1 to 2 millimeters across. You’ll often see them in clusters under the eyes, on the cheeks, or around the nose.
Milia can show up at any age. In adults, they sometimes develop after the skin heals from a minor injury, a sunburn, or a blistering rash. As the skin peels and repairs itself, small fragments of the outer layer can get trapped underneath. Heavy skincare products are another trigger. Occlusives like petrolatum, mineral oil, coconut oil, and lanolin can seal keratin beneath the surface, especially in the delicate under-eye area. The “slugging” trend of layering petroleum jelly over moisturizer is a known contributor.
Many milia resolve on their own over weeks to months, depending on your skin type and how quickly you naturally shed dead cells. You can speed the process by switching to lighter eye creams and using a retinoid on the surrounding skin. Dermatologists advise against applying chemical exfoliants directly to the under-eye area, but these products spread locally beyond where you apply them, so using them on the rest of your face can still help minimize under-eye milia.
If they don’t clear up, a dermatologist can extract them in minutes using a sterile needle or blade. Professional extraction typically costs $75 to $200 per session. Other options include cryotherapy ($100 to $250), laser therapy ($150 to $500), and chemical peels ($100 to $300).
Syringomas: Sweat Gland Overgrowths
Syringomas look similar to milia at first glance but have a different cause. They’re firm, round bumps that form from an overgrowth of cells in the sweat glands. They tend to appear in symmetrical clusters, usually on the lower eyelids, and each bump is about 1 to 3 millimeters across. Their color ranges from yellow to translucent to skin-toned.
The key difference from milia is that syringomas don’t resolve on their own. They’re benign and don’t need treatment, but if they bother you cosmetically, removal requires a dermatologist. Options include laser removal with carbon dioxide or erbium lasers ($300 to $1,500 per session), electric cauterization ($200 to $800), or cryotherapy ($150 to $500). Syringomas can sometimes return after treatment, so multiple sessions may be needed.
Xanthelasma: Yellowish Cholesterol Plaques
If your bumps are flat or slightly raised, yellowish, and soft to the touch, they may be xanthelasma. These are lipid-laden plaques that form on the upper or lower eyelids, most often near the inner corner of the eye. They tend to appear symmetrically on both sides and can grow slowly over time.
Xanthelasma gets attention because of its link to cholesterol, but the reality is more nuanced. The majority of people with these plaques do not have abnormal lipid levels. That said, some cases are associated with reduced HDL (the “good” cholesterol) or elevated LDL. A large study found that xanthelasma can independently predict increased risk of heart disease and severe atherosclerosis, even when cholesterol levels appear normal. If you develop these plaques, it’s worth getting a lipid panel done, even if you feel perfectly healthy.
Sebaceous Hyperplasia and Fordyce Spots
Two other oil-gland-related conditions can produce bumps in the under-eye area. Sebaceous hyperplasia occurs when oil glands become enlarged, creating skin-colored to yellowish raised bumps. They’re soft and often have a slightly indented center, which helps distinguish them from milia (which are firm and white).
Fordyce spots are a related phenomenon: enlarged oil glands that appear in areas without hair follicles. They look like white, yellow, or pale red bumps, usually 1 to 3 millimeters across, roughly the size of a sesame seed or smaller. They can appear as isolated spots or in clusters of 50 or more. Fordyce spots become more noticeable during puberty and adulthood as hormone levels rise. They’re completely harmless and extremely common, but the thin skin under the eyes makes them more visible than they’d be elsewhere.
Periorbital Dermatitis
Sometimes the bumps under your eyes aren’t cysts or growths but an inflammatory skin reaction. Periorbital dermatitis shows up as small red or skin-colored papules, often accompanied by redness, dryness, or slight swelling around the eyes. It can itch, burn, or both.
The trigger list is long. Hair dyes containing p-phenylenediamine are one of the most common causes. Eye makeup ingredients, including resins, solvents, preservatives, and pigments, can provoke a delayed allergic reaction. Certain antibiotic ointments (particularly those containing neomycin) cause it frequently because so many people have been exposed to them over time. Even airborne irritants like air fresheners, nail polish fumes, paint, and glues can affect the delicate skin around the eyes without direct contact.
Allergic reactions in this area tend to cause itching, while irritant reactions feel more like burning. In some cases, the rash has well-defined borders that reveal the offending product. A reaction to eyeglasses, for instance, might cause redness on the cheeks and near the eyebrows while sparing the eyelids. Chronic exposure can cause the skin to thicken and develop a leathery texture. Identifying and removing the trigger is the primary treatment.
Warning Signs Worth Watching
Most under-eye bumps are benign, but the area around the eye is a common site for basal cell carcinoma, the most common form of skin cancer. A bump that deserves a closer look has one or more of these features: it looks pearly, shiny, or slightly translucent; tiny blood vessels are visible on its surface; it bleeds or scabs over repeatedly; it grows steadily over weeks or months; or it appears as a flat, scaly patch with a raised edge. On darker skin tones, basal cell carcinoma often appears as a brown or glossy black bump with a rolled border.
A sore that heals and then returns in the same spot is another red flag. Any bump that changes in size, shape, color, or texture over time warrants a visit to a dermatologist, who can evaluate it visually or with a biopsy if needed.
Reducing Under-Eye Bumps at Home
For milia and other keratin-related bumps, prevention comes down to how you treat the skin around your eyes. Switch to lightweight, non-comedogenic eye creams and avoid layering heavy occlusives in that area. Gentle exfoliation on the rest of your face helps because the active ingredients migrate to the eye area at a lower, safer concentration.
Retinoids are the most effective at-home option for persistent milia. They accelerate skin cell turnover, which helps trapped keratin work its way out. A dermatologist can determine the right concentration for your skin. Expect the process to take weeks to months rather than days.
For bumps that are firm, symmetrical, or yellow-toned, at-home treatments are less likely to help. Syringomas, xanthelasma, and sebaceous hyperplasia generally require professional removal if you want them gone. Fordyce spots don’t need treatment at all, though laser therapy is available for cosmetic concerns.