Removal of eyelid cysts, lumps, bumps and tumours

What is eyelid cyst, lump, bump or tumour removal?

Like any other part of your body, eyelids can develop cysts, lumps, bumps, and even tumours. In fact, they are very common. While some can disappear on their own, sometimes you need to remove them to prevent irritation, vision problems, or, in some cases, more serious consequences. This is usually done with a simple outpatient procedure, enabling you to go home the same day.

What are the different types of eyelid cysts, lumps, bumps and tumours and how are they treated?

There are many different types of eyelid growths, with individual characteristics and causes. Some common examples are included below:

Chalazion 

A chalazion cyst is a common type of cyst found on your eyelid. It’s caused by a blocked oil gland, called a meibomian gland. For this reason, it’s also sometimes called a meibomian cyst. It looks like a firm bump in your upper or lower eyelid, and may be red or tender. Sometimes it can grow large enough to interfere with your vision.

How to treat a chalazion eyelid cyst

Some chalazions go away on their own without any treatment. The usual initial treatment is a warm compress followed by eyelid massage in the direction of the eyelashes to encourage the oil to flow out of the gland. If the chalazion is not settling, then it can be drained through an incision on the inside of the eyelid to encourage it to settle more quickly.

Xanthelasma

Xanthelasma is a yellow-tinted plaque that appears on or around your eyelids. It’s caused by cholesterol deposits that collect under your skin, which can suggest that you may have high cholesterol or other health conditions. It’s usually painless and appears as flat or raised patches, usually near the inner corners of your upper eyelids.

How to treat xanthelasma

Treatment for xanthelasma can be carried out to improve the appearance of the lids. However, it is also important to have your cholesterol levels checked by your GP. Treatment of xanthelasma usually takes the form of laser therapy, cryotherapy, chemical peels or surgery. Surgical removal is usually carried out as a single procedure, whereas for other techniques sometimes several sessions are needed.

Stye

A stye is one of the most well-known types of eyelid cysts, located on the edge or inside of the upper or lower eyelid. It looks like a red lump on your eyelid, and it’s usually painful when you touch it and may even hurt when you don’t. It may have a head, like a pimple or boil, and may contain pus. It normally only affects one eye, but can affect both sides.

Styes are caused by a bacterial infection in one or more of your eyelash follicles, or in one of the small oil glands found in your eyelid. If the swelling starts to press on your eye, it could cause irritation, tearing, grittiness and mild blurred vision.

How to treat a stye

Good eyelid hygiene is crucial for treating the infection, and you should gently clean your eyelids with eyelid wipes, or a mild soap or cleanser. You should avoid wearing eye makeup and contact lenses while the stye is healing. Always use a fresh cotton pad to clean each eye, never share one between the two. Warm compresses can also help to encourage styes to settle. In some cases, you may need a course of topical or oral antibiotics to treat the infection.

Milia

Milia are tiny, white, sometimes pearlescent bumps that form under the skin around your eyes. They aren’t itchy or contagious and may form in patches. They can also be found in other areas of your body, including your forehead and chin. Milia is most common in newborn babies but can occur at any age. It’s caused by a skin protein called keratin becoming trapped and forming little cysts.

How to treat milia

Milia usually go away on their own without any intervention, although it can take several months. It’s important not to pick them or squeeze them, as this could cause an infection. If they persist, they can be removed surgically.

Papilloma

A papilloma is the term used to describe a non-cancerous, often warty growth, which can occur anywhere on the body, including the eyelids. They are typically skin-coloured and can be domed, rough, or form a ‘tag’. They are more common in middle-aged or older adults, although can also affect younger people. In some cases, they can be caused by a virus, such as Human Papillomavirus (HPV).

How to treat papilloma

Most eyelid papillomas don’t need treatment and can be safely observed, especially if they’re small and not causing any symptoms. If the bump is irritating, growing, cosmetically unwanted, or there’s any doubt about the diagnosis, an ophthalmologist can remove it in a quick outpatient procedure under local anaesthesia.

Hidrocystoma/cyst of Moll

A hidrocystoma, also known as a cyst of Moll, is a benign (non-cancerous), fluid-filled cyst that appears as a round, shiny growth. It can be flesh-coloured, clear or appear a blue-grey colour, and usually forms on the edge of the eyelid. They are caused by an obstruction of a sweat gland.

How to treat hidrocystoma

Hidrocystomas are typically removed surgically under local anaesthetic if they are causing symptoms or a cosmetic concern.

Malignant eyelid tumours

Malignant eyelid tumours are rare, but can be serious if left untreated. The most common types are known as Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC). BCC tumours often look like pearly or waxy-coloured bumps, while SCC tumours can appear as red, scaly, crusted patches. Both BCC and SCC can bleed or form ulcers.

Malignant eyelid tumours can be caused by several factors, but the most common, like other skin cancers, is cellular damage from UV radiation10. Other causes include a weakened immune system, viral infections such as Human Papillomavirus Virus (HPV) and a family history of malignant eyelid tumours.

How to treat malignant eyelid tumours

Exactly what treatment looks like for a malignant eyelid tumour will depend on your individual circumstances, including the type, size and location of your tumour, and the recommendations of your medical team. Treatment typically involves surgery to remove the tumour, but can occasionally involve radiotherapy, chemotherapy and immunotherapy.

Can eyelid lesions be cancerous?

Yes, eyelid lesions can be cancerous, although it’s relatively rare. Studies estimate that around 80- 90% of reported eyelid cysts, lumps and bumps are benign.

Can an eyelid cyst go away on its own?

Some types of eyelid cysts can go away on their own. However, since many eyelid lesions can look similar, it is important to have any unusual lump, bump or lesion on your eyelid checked by a doctor.

Who is suitable for eyelid cyst, lump, bump or tumour removal?

Most eyelid lesions can be removed, although it is important to have an assessment with a specialist to examine the lesion and discuss what removing it would involve. Lesions can be removed when they are causing symptoms, when there is a concern about eyelid cancer, or for cosmetic reasons.

Can children have eyelid cyst removal surgery?

Yes, children may be able to have eyelid cyst removal surgery. However, each case is judged on an individual basis.

How should I prepare for eyelid cyst, lump, bump or tumour removal?

As with any surgery, it’s important to follow any pre-operative instructions provided by your medical team.

You may be advised to:

• temporarily stop taking some regular medications
• stop smoking, as smoking is proven to increase your risk of complications and delay the recovery process
• limit your alcohol intake
• arrange for someone to bring you to your appointment and drive you home afterwards
• arrive at your surgery appointment with a clean face that is free from makeup
• stop eating and drinking a certain number of hours before your surgery if you have asked to have surgery with sedation or general anaesthesia.

What happens during eyelid cyst, lump, bump or tumour removal?

Exactly what happens during your removal will depend on your individual growth. Nearly all procedures are carried out using local anaesthetic, meaning you’ll be awake but won’t feel anything painful. You may also be given sedation to help keep you feeling calm and relaxed.

Typically, you’ll be given anaesthetic eye drops to numb the area, accompanied by anaesthetic injections into the eyelid. A support may be used to position your eyelid while your surgeon removes the lesion. The lesion may be sent to the lab for evaluation after it has been removed.

Stitches, if needed, are usually dissolvable. Once your surgery is complete, you’ll be able to go home the same day.

How long does eyelid cyst removal take?

It depends on the complexity of the removal, but most procedures take less than an hour, including time for anaesthetic and preparation.

Is eyelid cyst removal painful?

No, the procedure isn’t painful. You’ll be given local anaesthetic to keep you as comfortable as possible. Some people report feelings of pressure, but not pain. The local anaesthetic injections can sting, but this usually only lasts for 10-15 seconds.

Will I be awake during the procedure?

Yes, normally you would be awake during the procedure. Some patients choose to have some sedation, and general anaesthetic can be used when needed, although this is rare. Children may be given a general anaesthetic to ensure that they remain still for the duration of their procedure.

How long does recovery take after eyelid cyst, lump, bump or tumour removal?

Recovery after eyelid cyst removal surgery is usually fairly fast and straightforward, with most people able to return to their usual activities within a few days.

A typical recovery timeline looks like this:

The first 24 hours after surgery
You will experience some swelling and bruising, and may experience some mild soreness or discomfort. You may want to take some pain relief to help you manage your discomfort, although this is often not required. You’ll need to arrange for someone to drive you home after your appointment. Antibiotic ointment will be prescribed for you, and you should take this as directed.

The first week
If you continue experiencing discomfort, you can take over-the-counter pain relief to help, although most patients find that the eyelid is comfortable by this stage. You will normally be able to go back to work, and most other regular activities within a few days, but your eyelids may still appear puffy and bruised. You won’t be able to wear contact lenses or eye makeup for at least a week, and you should continue to take your antibiotic ointment for the full course. Cool compresses can help the swelling to settle more quickly, and it is best to avoid strenuous exercise until the swelling has settled. Avoid swimming for at least a week.

Two weeks and beyond
By two weeks after your surgery, most of the swelling and bruising should have subsided, and the incisions should be fully closed so you will be able to resume swimming. For chalazions, it can take several months for all the residual inflammation to go down, and you may feel a residual lump which progressively gets smaller.

Will eyelid cyst removal leave a scar?

Although eyelid cyst removal can leave a scar, it’s usually very small and typically heals well. Wherever possible, your surgeon will try to make the incision on the inner surface of the eyelid, or in a natural crease to try to hide any scarring.

What are the risks and complications of eyelid cyst, lump, bump or tumour removal?

As with any surgery, there are always some risks and potential complications that you should be aware of. For eyelid cyst, lump, bump or tumour removal they include, but aren’t limited to:

• swelling around your eyelid
• bruising
• infection at the site of the incision
• minor bleeding from your eyelid
• keloid scar formation
• temporary skin changes at the site of the incision
• loss of eyelashes
• recurrence of the cyst or lesion.

What happens if an eyelid cyst or lump is left untreated?

It depends on the type of eyelid lump you have. In some cases, an eyelid bump may disappear on its own. In other cases, such as a malignant eyelid tumour, it is essential to have it removed as soon as possible to prevent further health consequences.

How much does eyelid cyst, lump, bump or tumour removal cost at Nuffield Health?

Please select your local Nuffield Health hospital to find contact details and guide prices.

Please note that the stated guide price is only an approximate cost of treatment. You will be given a fixed all-inclusive price for treatment following your initial consultation with a consultant.

Sources

1. https://cks.nice.org.uk/topics/meibomian-cyst-chalazion/ 
2. https://pmc.ncbi.nlm.nih.gov/articles/PMC9081426/
3. https://bjo.bmj.com/content/109/3/427
4. https://pubmed.ncbi.nlm.nih.gov/26088022/
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8. https://pmc.ncbi.nlm.nih.gov/articles/PMC1781304/
9. https://www.ncbi.nlm.nih.gov/books/NBK582127/
10. https://pmc.ncbi.nlm.nih.gov/articles/PMC8339433/
11. https://www.fightforsight.org.uk/a-z-eye-conditions/eyelid-cancer/
12. https://pmc.ncbi.nlm.nih.gov/articles/PMC12144543/
13. https://www.who.int/news/item/20-01-2020-smoking-greatly-increases-risk-of-complications-after-surge...