Is this Xanthelasma or Milia or something else entirely? (photos)

Question

Hello, I am a 41 year old male and for the past few years I have had this little "lump" on the top of my left eyelid. It is kinda hard, but it does not hurt in anyway. Recently, I started to notice a similar lump on my lower eyelid on the same eye. The only things that I can find online is that they look like Xanthelasma or Milia, but I am not a doctor so I don't know which one it is or if it's something else entirely. My right eye is perfectly normal from what I can tell.

S. Larry Schlesinger, MD, FACS · Answer

More than likely, you have milia.  Milia are small collections of sebum, little pearls of sebaceous material produced when sebaceous glands lose their opening to the outside world, and just keep making the sebum which keeps getting packed harder and harder.These little lumps are not dangerous in any way.  They are not painful, and the only downside to them is that they are unattractive.  If you were my patient, I would take an 18 gauge needle and gently nick the top of the miniature cyst, apply lateral pressure, and normally the pearl of sebum pops out......end of story.  These little cysts are of minor consequence, and they don't require true surgical intervention.With reference to your question about Xanthelasmas, they tend to cluster around the inner canthus of the eye (area between the inner angle of the eye and the nose.  They tend not to be as discreet as milia.  They usually are not isolated but are in clusters, and they tend to be flatter and more yellow than what your photograph indicates.  These also are painless, fatty deposits even less attractive than milia, and these actually need to be surgically removed.

John J. Martin, Jr., MD · Answer

They don't appear to be either xanthelasma or milia.  However they both look benign.  If they bother you or they are growing see an oculoplastic surgeon to have them removed.  The one on the lower eyelid looks like a sebaceous cyst.  Upper eyelid lesion may be a papilloma.

Mehryar (Ray) Taban, MD, FACS · Answer

They look like benign sebaceous cysts but it is best to see an oculoplastic specialist and consider removal, biopsy.

Eric M. Joseph, MD · Answer

Your small, white eyelid bumps may be milia. If this is the case, these bumps may be unroofed and improved. Consider visiting a reputable dermatologist or facial plastic surgeon to see what might be best for you.Hope this helps.

Kenneth D. Steinsapir, MD · Answer

Sometimes the only way to know is by shaving the bump off and having the pathologist study it under a microscope.  I recommend seeing a fellowship trained oculoplastic surgeon to assess you and discuss if a biopsy is warranted give the risks, benefits, and alternatives.  The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a regional directory on their website that can hep you find a highly qualified surgeon in your area.

Is this Xanthelasma or Milia or something else entirely? (photos)

Answers (7)

Answer: Based on your photo, you do not appear to have eyelid xanthelasma.

Answer: Based on your photo, you do not appear to have eyelid xanthelasma.

Answer: It really does not look like either of these options.

Answer: It really does not look like either of these options.

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.

Is this Xanthelasma or Milia or something else entirely? (photos)

Answers (7)

Answer: Based on your photo, you do not appear to have eyelid xanthelasma.

Answer: Based on your photo, you do not appear to have eyelid xanthelasma.

Answer: It really does not look like either of these options.

Answer: It really does not look like either of these options.

Browse related questions

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.