Seeing a small, unfamiliar bump under the eye can be concerning. These tiny growths are common and can appear suddenly or develop slowly. While many look similar—often small and white—their underlying causes vary, ranging from protein buildup to blocked oil glands. Understanding the specific type of growth is important because it dictates the correct approach for care and potential removal. This guide covers the most frequent culprits for a white bump under the eye.
Milia: The Tiny Keratin Cyst
The most frequent identity for a small, hard, white bump under the eye is a milium, a miniature cyst filled with keratin. Keratin is a strong protein found naturally in skin, but in milia, it becomes trapped just beneath the surface. These bumps appear as pearly white or yellowish, dome-shaped lesions, typically measuring one to two millimeters in diameter. Unlike a pimple, milia are firm and cannot be squeezed or “popped” because they lack an opening.
Milia are classified as either primary or secondary, based on their cause. Primary milia develop spontaneously when the body fails to naturally shed dead skin cells, leading to trapped keratin. Secondary milia, which appear identical, form after some kind of skin trauma, such as a burn, a rash, or long-term sun exposure.
The delicate skin around the eyes is particularly prone to milia due to a slower cell turnover rate. Using heavy, occlusive eye creams can also contribute by trapping dead skin cells beneath the surface. To manage milia at home, focus on gentle cleansing and avoiding harsh scrubbing. Incorporating mild exfoliating ingredients like glycolic or salicylic acid can help encourage the natural shedding process.
Inflammatory Bumps: Styes and Chalazia
Bumps that are tender, red, or swollen often indicate inflammation or infection, pointing toward a stye or chalazion. A stye, medically known as a hordeolum, is an acute bacterial infection of an oil gland or an eyelash follicle at the edge of the eyelid. Styes appear suddenly as a painful, red, and swollen lump, sometimes with a pus-filled white center near the lid margin.
A chalazion is visually similar to a stye but represents a chronic, non-infectious blockage of the meibomian oil glands within the eyelid. It often begins as a stye that has resolved its infection but leaves behind a firm, painless lump of trapped oil. Chalazia tend to be located farther back on the eyelid than styes and lack tenderness upon touch.
Home management for both involves the frequent application of warm compresses. Applying a clean, warm compress for 10 to 15 minutes, three to four times a day, helps liquefy thickened oil secretions. This heat promotes natural drainage and reduces swelling. Attempting to squeeze or drain these inflammatory bumps is not advised, as this can spread infection and potentially cause scarring.
Other Chronic Skin Bumps
Other chronic, non-infectious growths can manifest as a white or yellowish bump near the eye. Syringoma are benign tumors originating from the eccrine sweat ducts. These growths appear as small, flesh-colored, or slightly yellowish dome-shaped bumps, often grouping in clusters on the lower eyelids and upper cheeks.
Xanthelasma presents as yellowish plaques or patches on the eyelids, rather than a singular bump. It is caused by deposits of cholesterol crystals under the skin, and its presence may indicate a need for a lipid profile evaluation. Sebaceous hyperplasia appears as yellowish-white bumps that are slightly larger than milia and often have a small indentation in the center, representing an enlarged oil gland.
These growths are chronic and do not resolve with typical skin care or warm compresses. A professional visual assessment is necessary to identify these less common bumps and rule out other conditions that can mimic them.
Diagnosis and Professional Treatment
Consulting a dermatologist or ophthalmologist is necessary if a bump grows rapidly, causes pain, affects vision, or fails to resolve with home care after several weeks. A professional diagnosis is important to distinguish between benign growths and rarer, more serious conditions. A medical professional can accurately determine the nature of the bump based on its appearance, texture, and location.
For milia that do not clear spontaneously, the most common professional treatment is manual extraction, often called “deroofing.” A sterile needle or lancet is used to create a tiny opening in the skin, allowing the trapped keratin core to be gently removed. Chalazia that persist despite warm compresses can be treated with a steroid injection to reduce inflammation or, if large, surgically drained by an ophthalmologist.
Less common growths like syringoma and sebaceous hyperplasia are often removed for cosmetic reasons using minimally invasive techniques. These methods include laser ablation, which precisely vaporizes the tissue, or electrocautery, which uses a fine needle to destroy the growth with heat. Xanthelasma may also be removed using these techniques, though addressing any underlying high cholesterol is also important for long-term management.