Mass on Eyelid: What That Lump Could Be

Common causes of a lump on the eyelid

Stye (hordeolum)

A stye is a bacterial infection of an oil gland at the edge of the lid or inside it. It comes on over a day or two as a tender, red swelling, often with a yellow head of pus near the eyelashes. The whole lid can swell. Most drain and heal within 7 to 10 days. Warm compresses 3 to 4 times a day speed this up. Do not squeeze it.

Chalazion

A chalazion is a blocked oil gland deeper in the lid. It develops over weeks, sits a few millimeters back from the lash line, and is usually painless and firm, like a small pea under the skin. It is the most common cyst of the eyelid. Large ones can blur vision. Many settle in 2 to 8 weeks with compresses. Others can be drained.

Milia and small cysts

Milia are tiny, hard, white dots from trapped keratin. Sweat gland cysts look like small, clear, water-filled bubbles at the lid edge. Both are harmless and can be removed for cosmetic reasons.

Xanthelasma

Xanthelasma are soft, flat, yellow plaques, usually near the inner corners of the upper and lower lids. They are cholesterol deposits. About half of people who have them have raised blood cholesterol, so a lipid blood test is recommended. They can be removed by laser, surgery or chemical peel, but often return.

Benign skin growths

• Skin tags and papillomas: soft, skin-colored, finger-like or stalked growths, common on the lid margin.
• Seborrheic keratosis: a brown, waxy, "stuck-on" spot in older adults.
• Molluscum contagiosum: small, pearly bumps with a central dimple, common in children. Near the lashes they can cause red, irritated eyes.
• Moles: pigmented or skin-colored, stable over years.
• Syringomas: small, firm, skin-colored bumps on the lower lids, often several.
• Hemangioma: in babies, a red or bluish soft lump that grows in the first months. Lid hemangiomas need prompt assessment because they can block vision.

Skin cancers of the eyelid

Eyelid cancers are uncommon but important, because early treatment protects the eye and lid function.

• Basal cell carcinoma: accounts for around 9 in 10 eyelid cancers. A pearly, shiny or waxy lump with tiny surface blood vessels, often on the lower lid, that may have a central sore that bleeds and crusts.
• Squamous cell carcinoma: a scaly, crusted or ulcerated growth that grows faster.
• Sebaceous gland carcinoma: a firm, yellowish lump that can look like a recurrent chalazion or one-sided chronic blepharitis, more often in older adults.
• Melanoma: a changing pigmented spot. Rare on the lid.

Telling eyelid lumps apart

Signs an eyelid lump may be cancer

See a doctor rather than waiting if the lump:

• bleeds, crusts or forms a sore that does not heal
• causes eyelashes to fall out over it
• distorts the shape of the lid margin
• grows steadily over weeks to months
• comes back in the same spot after a chalazion was drained
• is firm and fixed rather than soft and movable

Older age, fair skin and a lot of past sun exposure raise the risk.

How doctors evaluate an eyelid mass

The doctor will ask how quickly the lump appeared, whether it hurts, and whether it has changed, then examine the lid under magnification, turning it out to see the inside. Vision is checked if the lump is large. Most lumps are diagnosed by appearance. A biopsy is taken from any suspicious, recurring or unusual lump. Blood cholesterol tests are offered for xanthelasma. Imaging (CT or MRI) is used only if a mass seems to extend behind the eye.

Treatment and home care

• Warm compresses: 5 to 10 minutes, 3 to 4 times a day, followed by gentle massage, help styes and chalazia drain.
• Lid hygiene: clean the lash line daily with lid wipes or diluted baby shampoo if you have blepharitis.
• Avoid eye makeup and contact lenses until a stye or chalazion settles.
• Do not squeeze any eyelid lump.
• See a professional for antibiotics if infection spreads, drainage of a chalazion that persists, removal of tags, papillomas or xanthelasma, and surgery (often Mohs surgery) for skin cancers.

Frequently asked questions

What is a bump on the eyelid that is not a stye?

A painless, firm bump that has developed over weeks is most likely a chalazion, a blocked oil gland. Other possibilities include milia, skin tags, papillomas, xanthelasma, molluscum and, less often, a skin cancer. A doctor can usually tell which by looking.

When should I worry about a lump on my eyelid?

Get it checked if it lasts more than 4 to 6 weeks, keeps coming back, bleeds, ulcerates, causes eyelash loss or keeps growing. Seek urgent care for a swollen red lid with fever, eye pain on movement, a bulging eye, or vision changes.

Can an eyelid lump affect my vision?

Yes, if it is large. A big chalazion on the upper lid can press on the front of the eye and cause blurred or distorted vision. In young children, a lid lump that covers the pupil can cause a lazy eye, so it needs earlier treatment.

How do you get rid of a lump on your eyelid?

For styes and chalazia, use warm compresses and gentle massage several times a day for a few weeks. If a chalazion persists, a doctor can drain it or inject it. Skin tags, papillomas, xanthelasma and cancers are removed by a dermatologist or eye surgeon.

Are yellow bumps on the eyelids a sign of high cholesterol?

They can be. Yellow, flat plaques called xanthelasma are linked to raised cholesterol in about half of people who have them. Ask your doctor for a lipid blood test. They can also occur with normal cholesterol levels.