The most common reason for a bump on your eyelid is a blocked oil gland, which can show up as either a stye or a chalazion. These two conditions account for the vast majority of eyelid bumps, but smaller white cysts called milia, yellowish cholesterol deposits, and rarely, skin cancers can also appear on or near the eyelid. The type of bump you’re dealing with depends on where it sits, whether it hurts, and how it looks.
Styes: Painful Bumps Near the Lash Line
A stye (also called a hordeolum) is a small, painful bump that forms right at the edge of your eyelid, usually near your lashes. It’s caused by a bacterial infection in an oil gland or hair follicle. Staphylococcus aureus, a common skin bacterium, is responsible for 90% to 95% of cases. Styes look and feel a lot like a pimple: red, swollen, tender to the touch, and sometimes filled with pus.
Within one to two days of appearing, a stye typically comes to a head at the eyelid margin. Most rupture and drain on their own within two to four days, and the pain eases once that happens. You can speed things along by holding a clean, warm compress against your closed eyelid for about five minutes, several times a day. Avoid squeezing or popping it, which can spread the infection deeper into the lid.
Less commonly, a stye can form on the inner surface of the eyelid rather than the outer edge. These internal styes tend to be deeper and more painful, and you might notice them more when you flip your eyelid or feel a sensation like something is rubbing against your eye.
Chalazia: Painless Lumps in the Eyelid
A chalazion starts when an oil gland in the middle of the eyelid gets blocked but not infected. Unlike a stye, it sits in the body of the eyelid rather than at the lash line, and it’s typically painless. It grows slowly over days to weeks, eventually forming a firm, round nodule you can feel under the skin. Some chalazia are barely noticeable. Others grow large enough to press on the surface of your eye and cause blurred vision.
About 25% of chalazia resolve on their own, but this can take an average of six months. Warm compresses are the first-line treatment here too: five minutes, several times a day, to help soften the blocked oil and encourage drainage. Chalazia that respond to conservative treatment tend to clear up faster when they’re caught early. In one study, bumps that fully resolved had been present for an average of 1.5 months, while those that didn’t resolve had been around for 2.2 months before treatment started.
If warm compresses don’t work after several weeks, there are two main office procedures. Surgical drainage (a small incision made from the inside of the eyelid) has a success rate of about 78% with a single procedure and 87% with a second attempt if needed. Steroid injections into the bump are less invasive, with a success rate of about 60% after one injection and 73% after two. Neither procedure carries significantly more complications than the other, so the choice often comes down to the size of the chalazion and your comfort level.
Milia: Tiny White Bumps
Milia are very small, white or skin-colored bumps, usually only 1 to 2 millimeters across. They’re caused by tiny cysts of trapped skin cells just beneath the surface. On the eyelid, they look like hard little pearls and don’t hurt, itch, or become red. They’re extremely common and completely harmless.
Primary milia can show up for no obvious reason, especially on the eyelids, forehead, and cheeks. Secondary milia form after skin damage from sunburn, rashes, blisters, or heavy skin creams. In most cases, no treatment is needed because they go away on their own over several weeks. If they persist and bother you, a dermatologist can remove them with a simple extraction.
Xanthelasma: Yellowish Patches Near the Nose
If the bump is more of a flat, yellowish patch sitting on the inner corner of your eyelid near your nose, it could be xanthelasma. These are deposits of cholesterol-laden cells under the skin. They’re soft or slightly firm, usually appear on both sides of the face, and grow slowly over time. They’re most common in middle-aged and older adults.
Xanthelasma itself is painless and not dangerous to your eye, but it can signal something important about your overall health. Roughly 50% of people with xanthelasma have abnormal lipid levels, and the associated cholesterol problems raise the risk of heart attack, stroke, and artery disease. If you notice these yellowish patches developing, getting your cholesterol checked is a worthwhile step. The patches can be removed for cosmetic reasons, but they tend to come back if the underlying lipid issue isn’t addressed.
How to Tell a Stye From a Chalazion
Since these two are by far the most common eyelid bumps, here’s how to distinguish them:
- Pain: A stye hurts. A chalazion usually doesn’t, or only hurts mildly in the first day or two before settling into a painless lump.
- Location: A stye sits right at the eyelid margin, near your lashes. A chalazion forms deeper, in the center of the lid.
- Timeline: A stye comes and goes within about a week. A chalazion can linger for weeks or months.
- Appearance: A stye looks like a red, swollen pimple. A chalazion looks like a smooth, round nodule under the skin.
Sometimes a stye that doesn’t fully drain turns into a chalazion. If your painful bump stops hurting but doesn’t go away, that transition has likely happened.
When an Eyelid Bump Could Be Serious
Eyelid cancer is rare, but it does happen. The warning signs look different from a typical stye or chalazion. Be alert for a bump that keeps growing over weeks or months, bleeds or crusts repeatedly, causes your eyelashes to fall out in the area around it, or has an unusual color like pearly white or pink. A discolored, firm lesion that doesn’t respond to warm compresses and doesn’t behave like a normal bump warrants a closer look from an eye care specialist.
You should also have a persistent chalazion evaluated if it hasn’t improved after several weeks of warm compresses, if it’s large enough to blur your vision, or if you keep getting eyelid bumps in the same spot. Recurring bumps in the same location can occasionally mimic a chalazion while actually being something else, so a biopsy may be recommended to rule out other conditions.