Noticing small dots or bumps under your eyes is common. These tiny formations are often benign, but understanding what they might be can help demystify their presence and guide you on when professional advice is beneficial.
Common Types of Under-Eye Dots
The delicate skin around the eyes is a common site for small bumps. Milia, xanthelasma, and syringomas are frequently observed types, each with distinct characteristics.
Milia are tiny, pearly-white or flesh-colored bumps that are firm to the touch and typically measure 1 to 2 millimeters in diameter. These harmless cysts form just under the skin’s surface and can appear individually or in clusters, often around the eyelids and cheeks. Unlike pimples, milia do not have a head, cannot be squeezed, and are generally not red or inflamed.
Xanthelasma presents as yellowish, flat or slightly raised patches, often soft or semi-solid in texture. These deposits commonly appear symmetrically on the upper or lower eyelids, particularly near the inner corner of the eye. They can range in size.
Syringomas are small, firm, rounded bumps, typically 1 to 3 millimeters in diameter, that are usually skin-colored or yellowish. They often appear in clusters, commonly found on the upper cheeks and lower eyelids. While usually asymptomatic, syringomas can sometimes cause itchiness or irritation.
Understanding the Causes and Risk Factors
The development of these under-eye dots stems from different underlying mechanisms, though they are generally harmless. Understanding their causes can provide insight into their formation.
Milia occur when keratin, a naturally occurring protein found in skin, hair, and nails, becomes trapped beneath the skin’s surface. This happens when dead skin cells do not shed properly, leading to the formation of small cysts. Factors contributing to milia can include skin trauma, such as burns or rashes, long-term use of steroid creams, or occlusive skincare products. Milia are also common in newborns due to underdeveloped sweat glands.
Xanthelasma is characterized by the accumulation of lipid-rich deposits, primarily cholesterol, within certain cells beneath the skin. While the exact pathophysiology is not fully understood, these deposits are strongly associated with elevated cholesterol levels. Genetic predisposition and certain underlying medical conditions, such as diabetes, thyroid dysfunction, and liver diseases, can also increase the risk of developing xanthelasma.
Syringomas arise from an overgrowth of cells in the eccrine sweat glands, which are responsible for cooling the body. Genetic factors play a significant role, with familial cases often showing an autosomal dominant pattern of inheritance. They commonly appear during or after adolescence and are more prevalent in women. Certain medical conditions, including Down syndrome, Marfan syndrome, and Ehlers-Danlos syndrome, are also associated with an increased incidence of syringomas.
When to Seek Professional Advice
While many under-eye dots are benign, it is prudent to seek professional medical advice in certain situations. Consulting a healthcare provider ensures an accurate diagnosis and appropriate management.
You should seek medical attention if the dots under your eyes are rapidly growing, changing in appearance, or causing discomfort. Bleeding from a lesion or any uncertainty about its nature also warrants a professional evaluation, as these changes could signal a more serious underlying condition.
Professional diagnosis is particularly important for xanthelasma due to its association with underlying health conditions. Its presence can indicate elevated cholesterol levels or other metabolic disorders, which may increase the risk of cardiovascular disease. A healthcare provider can conduct blood tests to check lipid levels and assess cardiovascular health.
Management and Treatment Approaches
The management and treatment of under-eye dots vary depending on their type and whether they cause cosmetic concern or indicate an underlying health issue. Treatment options range from at-home care to professional medical procedures.
For milia, gentle exfoliation can sometimes help encourage the trapped keratin to surface. However, self-extraction should be avoided to prevent skin damage, infection, or scarring. Professional removal by a dermatologist typically involves manual extraction. Other professional options include laser ablation, cryotherapy, or chemical peels.
Treating xanthelasma often involves addressing underlying high cholesterol levels through lifestyle modifications, such as a heart-healthy diet and regular exercise, and potentially medication as prescribed by a doctor. For cosmetic removal, various professional procedures are available, including surgical excision, laser therapy, cryotherapy, electrocautery, or chemical peels. Recurrence is common, especially if underlying lipid issues are not managed.
Syringomas are harmless and do not medically require treatment, but they can be removed for cosmetic reasons. Professional treatment options include laser therapy, electrosurgery, surgical excision, dermabrasion, and chemical peels. Topical and oral medications, such as retinoids or trichloroacetic acid, may also be used to reduce their appearance. Syringomas can recur after treatment.