Common Eyelid Growths and Lesions

The skin on the eyelids is the most delicate and thinnest on the body, making it particularly vulnerable to sun damage. Eyelid growths and lesions are relatively common and can range from benign (non-cancerous) to malignant (cancerous). They can present in various forms, and the symptoms, diagnosis, and treatments vary depending on the type of lesion. Here’s an overview of some common types:

Chalazion

A chalazion is a small, firm, and usually painless lump on the eyelid. It occurs when one of the meibomian glands, which are responsible for producing oil that lubricates the eye, becomes blocked and inflamed. Chalazia are generally not red or tender and may persist for weeks or months. Many times they resolve on their own. However, sometimes grow large enough to press on the eyeball and blur vision. Treatments can include warm compresses, and steroid injections or surgical removal.

Stye (Hordeolum)

A stye is a red, painful bump that forms on the edge of the eyelid, typically near the base of an eyelash or inside the eyelid. It is caused by an acute bacterial infection, usually by Staphylococcus bacteria, of the oil glands in the eyelid. Styes are often swollen and can cause the entire eyelid to become tender and inflamed. Warm compresses and good eyelid hygiene are first-line treatments. Antibiotic ointments or oral antibiotics may be prescribed.

Xanthelasma

Xanthelasma is characterized by yellowish, flat, or slightly elevated plaques that typically appear on the upper and lower eyelids, particularly near the inner corners. These lesions are deposits of cholesterol and may indicate an underlying lipid metabolism disorder. Xanthelasma is usually benign and does not cause pain or discomfort but may be a cosmetic concern. Treat includes surgical excision, laser therapy or chemical peels. Managing the underlying condition is important.

Seborrheic Keratosis

Seborrheic keratosis is a benign skin lesion that appears as a brown, black, or pale growth on the eyelid. These lesions have a waxy, slightly elevated, and often “stuck-on” appearance. They are typically not painful but may become irritated if rubbed or scratched. Seborrheic keratosis is more common in older adults. They are typically harmless but can cause irritation and cosmetic concerns. Removal options include cryotherapy, laser treatment and surgical excision.

Papilloma

Papillomas are benign, wart-like growths on the eyelid, caused by the human papillomavirus (HPV). They can be skin-colored or pinkish and often have a rough or smooth surface. Papillomas are generally slow-growing and painless, though they can become irritated if they rub against the eye or are scratched. They can be removed surgically or with laser therapy, especially if they interfere with vision.

Basal Cell Carcinoma (BCC)

Basal cell carcinoma is the most common type of eyelid cancer accounting for over 60% of all eyelid cancers. It usually presents as a small, pearly or waxy bump on the eyelid, often with a central depression or ulceration. It usually affects the lower eyelids. The lesion may bleed, crust over, or develop an ulcer that doesn’t heal. BCC grows slowly and is locally invasive but rarely metastasizes. Early detection and treatment are crucial to prevent damage to surrounding tissues. Treatment involves surgical removal with MOHs surgery.

Squamous Cell Carcinoma (SCC)

Squamous cell carcinoma of the eyelid is less common than basal cell carcinoma but more aggressive. It appears as a firm, red nodule, or a flat lesion with a scaly, crusted surface. SCC can ulcerate and may bleed. This type of carcinoma can metastasize if not treated promptly, making early diagnosis and treatment essential. A biopsy is necessary for diagnosis. Treatment involves surgical excision, radiation therapy and sometimes chemotherapy.

Melanoma

Melanoma of the eyelid is a rare but serious type of skin cancer. It usually appears as a dark, irregularly pigmented lesion that can change in size, shape, or color. Melanomas can be flat or raised and may develop new colors or a spread of pigmentation around the lesion. Due to the potential for rapid spread to other parts of the body, melanoma requires urgent medical attention. A biopsy is necessary for diagnosis. Treatment involves surgical excision, and radiation or chemotherapy.

Molluscum Contagiosum

Molluscum contagiosum is a viral infection that causes small, smooth, dome-shaped, pearly lesions on the eyelid. These lesions often have a central dimple or indentation. They are typically painless and can appear in clusters. Molluscum contagiosum is more common in children and individuals with weakened immune systems. They usually resolve on their own.

Nevus

A nevus is a benign, pigmented growth or mole on the eyelid. It can be flat or raised and may be brown, black, or flesh-colored. Most nevi are harmless, but they should be monitored for any changes in size, shape, or color, as these could indicate a risk of malignancy. If the nevus changes in appearance, causes discomfort, or is of cosmetic concern, it can be surgically removed.

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Each of these conditions presents differently, and some, particularly malignant growths, require prompt medical attention to prevent complications. Regular eye exams and monitoring any changes in eyelid lesions are important for early detection and effective treatment.

Union Square Eye Care has two offices, one in Union Square and the other in Harlem for your convenience. We treat patients from Greenwich Village, Soho, and Midtown Manhattan, focusing on preserving vision and improving your quality of life through tailored treatment plans. Call us to schedule an exam today with one of our esteemed eye experts.