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That Little Pouch or Bump on Your Eyelid Could Be a Papilloma

Anytime you notice a change around your eye, you might worry about whether it might affect your appearance or even your vision. If you develop something on your eyelid that looks like a small bump, raised lump of skin or pouch of skin, it’s possible that you have an eyelid papilloma.

Daniel Twelker, OD, PhD, an optometrist with Banner Health in Tucson, said, “Eyelid papillomas are one of the most common benign eyelid tumors.” They are usually one to six millimeters in diameter and could be red, brown or the same color as your skin. You’re more likely to develop them if you are middle-aged or older.

What are the signs of an eyelid papilloma?

You might notice a raised lump on the skin or a pouch of skin on the eyelid that looks like a skin tag. Depending on what causes them (more on that later) their appearance can vary. Some seem to be attached to the eyelid by a stalk, while others appear as multiple small bumps. Some feel greasy or waxy. They don’t generally cause symptoms, though in some cases, they may make your eyelid feel itchy or irritated.

What are the different types and causes of eyelid papillomas?

There are several different forms of eyelid papillomas and they all have different causes:

  • Squamous papilloma, or a skin tag, is the most common type. It looks like a smooth round lesion and is caused by age-related skin degeneration.
  • Seborrheic keratosis is a slightly raised area that looks like it is stuck on the eyelid. It may look pink, brown or the color of your skin and may feel greasy. It’s not clear what causes them.
  • Ophthalmic molluscum contagiosum is caused by a virus, and with it you’ll see one or more small, solid, raised bumps. It may feel waxy and release a discharge. It can spread through skin-to-skin contact or sexual contact and it’s more common in children and people who have either AIDS or allergies.
  • Sebaceous cysts are smooth, round, raised lesions. They can develop when the meibomian glands in your eyelid become blocked.
  • Verruca vulgaris is a rare type that’s caused by the human papillomavirus (HPV). It can develop when the virus is on your finger and you touch your eye. It may look like a squamous papilloma.

Eyelid papillomas are not the same as milia, which are tiny cysts. Milia generally appear on your nose and cheeks but can sometimes show up on your eyelids.

How can you prevent eyelid papillomas?

Sun exposure can trigger the development of eyelid papillomas. So, the best way to prevent them is to protect your skin from the sun by using a hat and sunglasses whenever you’re outdoors. “Maintaining a healthy diet with plenty of whole grains, fresh fruits, and vegetables can also help,” Dr. Twelker said. Viruses can also cause some eyelid papillomas, so it’s best to avoid contact with raised skin bumps on other people.

How to diagnose an eyelid papilloma

Your eye doctor, dermatologist or primary care physician might be able to diagnose an eyelid papilloma by looking at it. If there’s any doubt, your health care provider might recommend a biopsy to evaluate the cells in a lab.

What are treatment options for eyelid papilloma?

Often, you can leave an eyelid papilloma alone. You can observe it for any changes, and your eye doctor or primary care physician can monitor it once a year. Eyelid papillomas are usually not cancerous, and some clear on their own.

If the eyelid papilloma is irritating you, you don’t like how it looks, or there’s a chance it could be cancerous, a dermatologist or ophthalmologist can remove it. It’s a simple procedure where, under local anesthesia, your doctor carefully cuts out the lesion. In some cases, your doctor will heat, or cauterize, the area to stop the bleeding. You most likely won’t need stitches. You’ll want to see a doctor who is experienced with this type of surgery, though, since your eye can water persistently if an eyelid papilloma is removed on the lower lid and the edge of the eyelid isn’t smooth after surgery.

The bottom line

As you get older, you might develop a bump on your eye called an eyelid papilloma. While you might be concerned, this type of eyelid bump usually isn't cancerous and often doesn’t need treatment. If you would like to connect with an eye care professional, reach out to Banner Health.

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