Syringoma

Syringoma | Cosmetic and Reconstructive Surgery | EyePlastics

Part of our complete guide to Eyelid Skin Tumors — this page covers syringoma in depth.

What Is a Syringoma?

A syringoma is a common, benign growth that arises from the eccrine (sweat) ducts of the skin. Syringomas have a strong predilection for the lower eyelids and the surrounding cheek and periorbital skin, where they appear as multiple small bumps. They are entirely non-cancerous and never transform into skin cancer — the concern they raise is almost always cosmetic.

Because they sit on the delicate eyelid skin and are usually multiple, syringomas are best evaluated and treated by an oculoplastic surgeon, who can address them safely so close to the eye.

Syringomas are one of several benign eyelid lesions. Any single, new, growing, bleeding, or lash-destroying lesion should still be examined, because eyelid skin cancers can occasionally mimic benign bumps.

Appearance & Symptoms

Syringomas typically present as:

Multiple small papules, usually 1–3 mm in size
Skin-colored to yellowish or light-brown, soft, dome-shaped bumps
A symmetric, bilateral distribution on the lower eyelids and upper cheeks
Usually asymptomatic — they do not typically itch, hurt, or bleed

They often first appear around puberty or in early adulthood and tend to slowly increase in number over time. Some people notice they become more prominent with heat, humidity, or sweating.

Causes & Associations

Syringomas are benign overgrowths of normal sweat-duct tissue; their exact trigger is unknown. They are more common in women and can run in families. Recognized associations include:

Down syndrome — a higher incidence of eyelid syringomas is well described
Diabetes mellitus — linked to the clear-cell histologic variant
Family history — some cases are inherited (eruptive syringomas)

None of these associations make the lesions themselves dangerous — syringomas remain benign regardless of the underlying setting.

Diagnosis

The diagnosis is usually made clinically, based on the characteristic appearance and distribution. When a lesion is atypical or solitary, a small biopsy confirms the diagnosis; under the microscope, syringomas show characteristic comma-shaped or “tadpole” ducts embedded in a fibrous stroma. The main look-alikes a specialist will distinguish include xanthelasma, milia, sebaceous hyperplasia, trichoepithelioma, and — importantly — basal cell carcinoma.

Treatment Options

Treatment is elective and cosmetic. It is also genuinely challenging: syringomas extend into the deeper (dermal) layer of the skin, they are usually numerous, and they sit on thin eyelid skin next to the eye. For these reasons, recurrence is common and realistic expectations are important. Options an oculoplastic surgeon may use, alone or in combination, include:

CO₂ laser ablation — a common choice periocularly, vaporizing lesions with fine control
Electrodesiccation / electrocautery — precise thermal destruction of individual papules
Surgical excision — suited to a small number of larger lesions
Trichloroacetic acid (TCA) or other chemical methods in selected cases

Because treatment is performed millimeters from the eyelid margin and ocular surface, the goals are to improve appearance while protecting the eye and minimizing scarring, pigment change, and lid-position problems. More than one session is frequently needed, and new lesions can still appear over time.

Important: Syringomas are deep and often recurrent, so no treatment guarantees permanent clearance. Having them treated by a fellowship-trained oculoplastic surgeon — rather than a non-specialist — lowers the risk of complications on the eyelid.

When to See a Specialist

Consider an evaluation if eyelid bumps are cosmetically bothersome, if you are unsure whether a growth is a harmless syringoma or something that needs attention, or if a lesion is new, solitary, changing, bleeding, or destroying eyelashes. An oculoplastic surgeon can confirm the diagnosis and, if you wish, discuss the safest options for treating lesions around the eye.

Find an ASOPRS oculoplastic surgeon near you to evaluate eyelid syringomas and review your options.

Frequently Asked Questions

Are syringomas dangerous?: No. Syringomas are benign growths of sweat-duct tissue and do not become cancerous. They are a cosmetic concern only. That said, a new or changing single lesion should be examined, because eyelid skin cancers can occasionally resemble benign bumps.
Will syringomas go away on their own?: No. They tend to persist and often slowly increase in number over the years. They do not resolve spontaneously.
Do syringomas come back after removal?: Recurrence is common. Because the lesions extend into the deeper layer of the skin and are usually numerous, more than one treatment session may be needed and new lesions can still appear over time.
What is the best treatment for syringomas on the eyelid?: There is no single best method. CO2 laser, electrocautery, and excision are all used, often in combination. Because treatment is performed right next to the eye, it is safest in the hands of a fellowship-trained oculoplastic surgeon, with realistic expectations about recurrence.

Your Surgeon

M. Polly McKinstry, MD

Cosmetic and Reconstructive Surgery

🏅 ASOPRS Fellowship Trained

📞 949-645-2250