SymptomEyes & vision
Eyelid Lesion or Rash
An eyelid lesion or rash is any bump, spot, sore, scaly patch or redness on the eyelid skin. The eyelids have the thinnest skin on the body, so they react quickly to allergens and irritants. Common causes are contact or atopic dermatitis, blepharitis, styes, chalazia, milia, xanthelasma and viral rashes. Most are harmless and treatable, but a growing lump, a sore that bleeds or will not heal, or lost eyelashes over a bump needs a doctor to rule out skin cancer.
Also called: Eyelid eruption, lid lesion, palpebral rash, eyelid bump, eyelid dermatitis
At a glance
- Rashes
- Allergic contact dermatitis (nail polish, cosmetics, eye drops), eczema, seborrheic dermatitis, rosacea.
- Bumps
- Stye, chalazion, milia, xanthelasma, molluscum, skin tags and cysts.
- Crusting at lid edges
- Blepharitis.
- Warning signs
- A pearly, bleeding or ulcerated bump, or missing lashes over a lump, can be skin cancer.
- Treatment
- Remove triggers, warm compresses, lid hygiene and short courses of mild prescribed creams.
When to get help
Call 911 or go to the ER
- Painful, red, swollen eyelid with fever, eye pain on moving the eye, bulging eye or vision changes (possible orbital cellulitis)
- Eyelid and face swelling with throat tightness or difficulty breathing
See a doctor within a day or two
- Blisters or a painful rash on one side of the forehead and eyelid, especially with blisters on the tip of the nose (possible shingles affecting the eye)
- A cold sore-like cluster of blisters on the eyelid with a red, painful or light-sensitive eye
- Rapidly spreading redness and swelling of the eyelid skin
Book a routine appointment
- A lump that is growing, bleeding, ulcerated, pearly or has caused eyelashes to fall out
- A chalazion that has not shrunk after 4 to 6 weeks of warm compresses, or one that keeps coming back in the same spot
- An itchy, scaly eyelid rash that has lasted more than 2 weeks
- Yellow flat patches on the eyelids (check cholesterol)
Usually safe to manage at home
- A small tender stye at the lash line, treated with warm compresses
- Mild itchy eyelid redness after a new cosmetic, settling once it is stopped
Eyelid rashes
Allergic contact dermatitis
The eyelids are the most common site of allergic contact dermatitis on the face. Causes are often things that never touch the eyelids directly:
- nail polish (transferred by touching the eyes)
- fragrances, hair dyes and shampoos
- preservatives in cosmetics, eye creams and eye drops
- nickel from eyelash curlers
- airborne allergens
The skin becomes red, itchy, dry, scaly and puffy, often on both eyelids. Patch testing by a dermatologist identifies the allergen. See contact dermatitis.
Irritant dermatitis
Harsh cleansers, makeup removers and rubbing cause stinging, dryness and redness without true allergy.
Atopic eczema
Atopic dermatitis commonly affects eyelids in people with eczema elsewhere, hay fever or asthma. Chronic rubbing thickens the skin and causes an extra fold under the lower lid.
Seborrheic dermatitis and rosacea
Greasy, yellowish flakes on the lids, eyebrows and sides of the nose suggest seborrheic dermatitis. Rosacea causes facial flushing, bumps and often blepharitis and dry eyes.
Blepharitis
Blepharitis affects the eyelid margins: red, crusty, greasy lid edges with flakes at the base of the lashes, gritty eyes and morning stickiness.
Infections
- Herpes simplex: a cluster of small painful blisters on the eyelid. Can affect the cornea.
- Shingles: a band of painful blisters on the forehead, upper eyelid and nose on one side.
- Molluscum contagiosum: small, shiny, dome-shaped bumps with a central dimple. On the lid margin they can cause a chronic red eye.
- Impetigo: honey-colored crusts.
Autoimmune rash
A violet or purple-red discoloration of the upper eyelids (heliotrope rash) with muscle weakness suggests dermatomyositis.
Eyelid bumps and lesions
| Lesion | What it looks like | Key features |
|---|---|---|
| Stye | Red, tender, pimple-like bump at the lash line | Painful, often points and drains within a week |
| Chalazion | Firm, painless, round lump within the lid | Blocked oil gland, develops over weeks |
| Milia | Tiny, hard, white dots | Harmless keratin cysts |
| Xanthelasma | Flat or raised yellow patches near the inner corners | Cholesterol deposits. About half have raised cholesterol |
| Skin tag | Soft, flesh-colored flap | Harmless |
| Cyst of Moll or Zeis | Clear, fluid-filled bubble at the lid edge | Harmless |
| Seborrheic keratosis | Brown, waxy, stuck-on growth | Harmless, common with age |
| Basal cell carcinoma | Pearly bump with tiny blood vessels, may ulcerate | Most common eyelid cancer, usually lower lid |
| Sebaceous gland carcinoma | Firm lump or a "chalazion" that keeps recurring | Rare, aggressive |
Signs that an eyelid lump may be cancer
- a pearly or waxy edge, with fine blood vessels
- bleeding, crusting or a sore that does not heal
- loss of eyelashes over the lump
- distortion of the lid margin
- slow, steady growth
- a chalazion recurring in the same spot, especially in older adults
Most eyelid cancers are basal cell carcinomas, which grow slowly and rarely spread but can invade nearby tissue if left. Early removal gives excellent results.
How eyelid lesions are diagnosed
A primary care doctor, optometrist, ophthalmologist or dermatologist will examine the skin and lid margins, often with a magnifier or slit lamp. They may:
- patch test for contact allergy
- check cholesterol for xanthelasma
- swab blisters for herpes
- biopsy a suspicious lump
Treatment
Rashes
- Identify and stop triggers. Use fragrance-free, simple products. Stop nail polish or eye cosmetics for 2 to 4 weeks to see if the rash settles.
- Cool compresses ease itching and swelling.
- Bland moisturizer: plain petroleum jelly is gentle on lids.
- Mild steroid creams for short periods only, under medical advice. Strong or prolonged steroid use on eyelids can thin the skin and raise eye pressure or cause cataracts.
- Non-steroid creams such as tacrolimus or pimecrolimus are often preferred for longer-term eyelid eczema.
- Antihistamine tablets may help itching.
Bumps
- Stye and chalazion: warm compresses for 10 minutes, 3 to 4 times daily, with gentle massage. Most settle within 1 to 2 weeks (stye) or a few weeks to months (chalazion). Persistent chalazia can be drained or injected.
- Blepharitis: daily warm compresses and lid cleaning.
- Milia, skin tags, xanthelasma: removed for cosmetic reasons if wanted.
- Infections: antiviral medicines for herpes and shingles, antibiotics for impetigo.
- Skin cancer: surgical removal, often by a specialist with techniques such as Mohs surgery to save healthy tissue.
Never squeeze eyelid bumps, and do not use acne products near the eyes.
Frequently asked questions
What causes a rash on the eyelids?
The most common causes are allergic or irritant contact dermatitis from cosmetics, nail polish, fragrance or eye drops, and atopic eczema. Seborrheic dermatitis, rosacea, blepharitis and viral infections such as herpes or shingles are other causes.
What is the bump on my eyelid?
A tender red bump at the lash line is usually a stye. A firm, painless lump within the lid is usually a chalazion. Tiny white dots are milia, and yellow patches are xanthelasma. A pearly, bleeding or growing lump should be checked for skin cancer.
What can I put on an eyelid rash?
Start with cool compresses and a bland moisturizer such as plain petroleum jelly, and stop any new cosmetics. Avoid over-the-counter steroid creams on the eyelids unless a doctor advises it, because eyelid skin absorbs steroids easily.
Why are my eyelids dry and flaky?
Dry, flaky eyelids are usually caused by eczema, contact dermatitis or seborrheic dermatitis. Cold weather, harsh cleansers and rubbing make them worse. Flaking at the base of the eyelashes points to blepharitis.
Can eyelid bumps be cancer?
Most eyelid bumps are harmless, but some are skin cancers, usually basal cell carcinoma. Warning signs are a pearly or ulcerated bump, bleeding, lost eyelashes over the lump, steady growth, or a chalazion that keeps coming back in the same spot.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Ophthalmology (AAO): Eyelid bumps; Chalazion and stye; Blepharitis
- American Academy of Dermatology (AAD): Eczema on the eyelids
- NHS: Styes; Blepharitis
- American Cancer Society: Basal and squamous cell skin cancer