Small bumps under the eyes are a common concern. While often benign, understanding their nature provides clarity. This article explores their types, causes, and management approaches.
Common Types of Bumps
Small bumps under the eyes can stem from various benign skin conditions. Milia are tiny, white or yellowish cysts, typically 1-2 millimeters in diameter, resembling small, firm beads under the skin. They are smooth to the touch, usually appear in clusters, and are often mistaken for whiteheads, though they are not acne blemishes.
Syringomas appear as small, skin-colored or yellowish firm papules, often in clusters, creating a cobblestone-like texture. These benign growths frequently occur on the lower eyelids and can be mistaken for milia, though they originate from deeper skin structures. Syringomas are generally painless and do not itch.
Xanthelasmas are soft, yellowish, raised patches or plaques that form on or around the eyelids, often near the inner corners closer to the nose. These deposits can vary in size and may appear as single growths or clusters, creating a bumpy, textured appearance. Unlike milia or syringomas, xanthelasmas have a distinct yellow hue due to their composition.
Sebaceous hyperplasia manifests as small, soft, often shiny bumps that are typically flesh-colored or slightly yellow. These bumps usually have a central indentation, resembling a tiny donut or crater, which helps distinguish them. While they can appear anywhere on the face, including under the eyes, they are an overgrowth of oil-producing glands in the skin.
Causes and Risk Factors
Milia develop when keratin, a skin protein, becomes trapped beneath the skin’s surface, forming small cysts. This occurs if dead skin cells do not shed properly, leading to their accumulation and hardening. Risk factors include skin damage from injury or sun exposure, long-term use of corticosteroid creams, and heavy oil-based makeup or skincare products that impede normal skin exfoliation.
Syringomas arise from an overgrowth of cells in the eccrine glands, which are sweat glands. While the exact reason is not fully understood, genetic predisposition plays a role. They may become more noticeable in warmer, more humid months due to increased sweat gland activity. Syringomas are more common in females and tend to appear after puberty.
Xanthelasmas are caused by deposits of cholesterol or other lipids accumulating beneath the skin. These yellow patches often indicate underlying lipid disorders, such as high cholesterol. Conditions like diabetes, high blood pressure, obesity, certain liver diseases, and smoking can increase the risk of developing xanthelasma.
Sebaceous hyperplasia results from an overgrowth of sebaceous glands, the oil-producing glands surrounding hair follicles. When these glands produce too much oil or cell turnover slows with age, dead cells can become trapped, causing the glands to enlarge. This condition is often seen in middle-aged and older individuals, with genetics, chronic sun exposure, and certain medications contributing factors.
When to Seek Professional Advice
While many small bumps under the eyes are benign, consult a healthcare professional, such as a dermatologist, if a bump exhibits rapid growth, changes in color, shape, or texture. Also seek advice if it begins to bleed, itch, or cause pain. These changes could indicate a more serious condition, making an accurate diagnosis crucial.
Professional advice is also recommended if bumps cause significant cosmetic concern, discomfort, or affect vision, or if self-care measures are ineffective. A medical professional can diagnose the type of bump through visual examination or, if necessary, a skin biopsy. Early diagnosis ensures appropriate management and prevents complications.
Management and Treatment Options
Addressing small bumps under the eyes involves various approaches, from at-home care to professional medical procedures, tailored to the specific type. For milia, which often resolve on their own, gentle skincare practices are beneficial. Regular cleansing and mild exfoliation may help the skin shed trapped keratin, but harsh scrubbing or attempts to “pop” them should be avoided to prevent irritation or scarring. Topical retinoids, derived from vitamin A, can encourage skin cell turnover and are sometimes used for milia. Professional treatments for persistent milia include deroofing or laser ablation.
Syringomas, while harmless, can be treated if cosmetically bothersome. Professional removal options include diathermy, which uses heat to cauterize the tissue, laser therapy, or dermabrasion. Excision is another method. It is generally not recommended to attempt to remove syringomas at home.
For xanthelasmas, treatment is typically sought for cosmetic reasons, as they do not usually disappear on their own and may grow larger over time. Options include cryotherapy, which freezes the deposits with liquid nitrogen, laser surgery, or surgical excision. Electrocautery is also a method. Managing underlying high cholesterol levels through diet, lifestyle changes, or medication may help prevent new xantanthelasmas but typically does not eliminate existing ones.
Sebaceous hyperplasia can be managed with topical retinoids, which may reduce the size of the bumps, though recurrence is possible if treatment stops. Professional treatments include electrocautery, where an electrically charged needle heats and vaporizes the bump, laser therapies, or cryotherapy. It is important to note that home squeezing of sebaceous hyperplasia bumps is ineffective and can lead to inflammation or bleeding.