The appearance of small, raised bumps beneath the eyes is a common dermatological concern. These lesions, which typically present as white or flesh-colored spots, are usually benign and do not pose a direct threat to health or vision. Proper identification is necessary before attempting management or removal due to the delicate nature of the skin in this area. Understanding the distinct characteristics of these bumps helps differentiate between simple skin protein accumulation and a more complex growth.
Identifying the Most Common Types
The majority of white or yellowish bumps near the eyes fall into one of three distinct categories.
The most frequently encountered are Milia, which are tiny, pearly-white cysts measuring one to two millimeters in diameter. They form when keratin, a structural protein, becomes trapped beneath the skin’s surface rather than shedding naturally, forming a small, hard capsule. Unlike acne, Milia are not associated with clogged pores or oil glands, and they do not respond to traditional spot treatments.
Another type of lesion is Syringoma, which arises from a different layer of the skin. Syringomas are benign growths originating from the eccrine sweat ducts. These tend to be slightly deeper, presenting as multiple small, firm papules that are flesh-colored, pale pink, or yellowish. They typically appear in symmetrical clusters on the lower eyelids and upper cheeks, often linked to genetic predisposition or hormonal factors.
A third, medically significant type is Xanthelasma, which manifests as soft, yellowish or whitish plaques, typically near the inner corners of the eyelids. Xanthelasma consists of fat deposits, primarily cholesterol, that accumulate beneath the skin. While harmless to the eye, their presence indicates a potential underlying lipid disorder, such as high cholesterol or dyslipidemia, which increases the risk of cardiovascular issues. Xanthelasma requires medical evaluation beyond simple cosmetic concerns due to this link to systemic health.
Professional Removal and At-Home Management
The strategy for addressing these under-eye bumps depends on their specific type and depth.
For Milia, which are superficial keratin cysts, a dermatologist can perform professional extraction. This often involves using a sterile lance or needle to create a micro-opening, allowing the trapped material to be gently removed. This precise technique, sometimes called de-roofing, is the safest way to clear the lesions without risking scarring or infection in the delicate periorbital tissue.
At-home management for Milia focuses on encouraging natural skin turnover. Topical retinoids, such as retinol or prescription tretinoin, increase the rate at which skin cells exfoliate, helping to dislodge the trapped keratin. Gentle chemical exfoliants containing alpha or beta hydroxy acids, like glycolic or salicylic acid, can also be incorporated into a routine to prevent the buildup of dead skin cells.
Syringomas are deeper growths derived from sweat ducts, making them resistant to topical creams. They require specialized in-office procedures for removal. Techniques such as electrodessication (using an electric current to destroy the tissue) or laser ablation (often using a CO2 laser) are employed to vaporize the growths. These methods target the lesion at its deeper base but require careful application to minimize the risk of scarring or pigment change.
For Xanthelasma, treatment must first address the systemic cause of fat deposition. A doctor will typically order blood tests to check lipid levels and may recommend dietary changes, exercise, or cholesterol-lowering medication. Cosmetic removal is a secondary step and can involve specialized laser surgery, cryotherapy, or traditional surgical excision. Recurrence is possible if the underlying cholesterol issue is not managed.
Prevention and Signs Requiring a Doctor
Preventing Milia involves adjusting one’s skincare regimen to promote proper skin cell shedding. This includes using lighter, non-occlusive eye creams, since heavy or oil-based products can trap dead skin cells. Consistent, gentle cleansing and the daily application of a broad-spectrum sunscreen are also important, as sun damage can thicken the skin and impede natural exfoliation.
While Syringomas are largely influenced by genetics and hormones, managing overall skin health remains beneficial. It is important to avoid attempts at squeezing or picking any bump around the eye, which can lead to inflammation, infection, and permanent scarring.
Any lesion that changes rapidly in size, becomes painful, or shows signs of bleeding or infection warrants an immediate visit to a dermatologist or ophthalmologist.
If Xanthelasma is suspected due to its yellowish, soft plaque appearance, a medical consultation is urgent, regardless of cosmetic concern. Since these deposits are a physical sign of elevated cholesterol or other metabolic disorders, seeking a doctor’s evaluation allows for a full health check-up to mitigate potential long-term risks to heart health.