Common eyelid lesions
Benign lesions
- chalazion – a painless lump from a blocked meibomian gland; often resolves with warm compresses, but a persistent one needs incision and curettage,
- cysts – e.g. epidermoid cysts or clear sweat-gland cysts at the lid margin,
- papillomas and seborrhoeic keratoses – soft or rough skin growths,
- xanthelasma – flat yellowish deposits, usually near the inner corner; worth checking your cholesterol,
- milia – small white bumps,
- pigmented naevi (moles).
Malignant lesions
Skin cancers can also develop on the eyelids. By far the most common is basal cell carcinoma; less common are squamous cell carcinoma, sebaceous gland carcinoma and melanoma. Detected early, they can usually be removed successfully.
Warning signs
- a lesion that grows or changes shape, colour or surface,
- ulceration, bleeding, or a scab that has not healed for weeks,
- loss of lashes at the site of the lesion,
- a pearly, shiny lump with visible blood vessels,
- a “chalazion” that keeps coming back in the same place or does not respond to treatment,
- distortion of the lid margin.
Such lesions should not be removed “cosmetically” without examination – they need a medical assessment and histopathology.
How is a lesion removed?
At the consultation the doctor examines the lesion under magnification, assesses its nature and plans the procedure. Most lesions are removed under local anaesthesia in a short outpatient procedure. The goal is to remove the lesion completely while keeping the shape and function of the lid. Larger defects are reconstructed using surrounding tissue.
The removed tissue is sent for histopathology, which confirms what the lesion was and whether it was removed with a margin of healthy tissue. If the result shows a malignant tumour, we discuss the next steps with you.
Healing
After removal of small lesions the lid usually heals within 1–2 weeks. Stitches are removed after about 5–7 days. Swelling and bruising may last a few days. Eyelid scars usually heal very well, although they may be more visible after removal of larger lesions.
Frequently asked questions
Can a lesion be lasered or frozen without testing?
For lesions whose nature is uncertain, we advise against methods that destroy tissue without allowing it to be examined. Skipping histopathology can delay a cancer diagnosis.
Does a chalazion always need to be cut out?
No. A fresh chalazion often resolves with warm compresses and lid massage. Surgery is considered when it persists for weeks, is large or keeps recurring.
Will there be a scar?
Eyelid skin usually heals very well. Scar size and visibility depend on the size and location of the lesion.
This page is for information only and does not replace a medical consultation. Eligibility for any procedure is decided by the doctor after an examination.
