• About Face Cosmetics
• LATISSE®
• Obagi Skin Care
• BOTOX®
• JUVEDERM®
• Skin Lesions and Reconstruction
• Eyelid Surgery

Skin Lesions and Reconstruction

There are many types of skin lesions found on the eyelid and face. They can be flat or raised, pigmented or skin toned, congenital or acquired. One of the most important concerns Dr. Fischer has is to determine whether the lesion is benign or malignant (cancerous). Although most skin lesions found on the eyelid and face are benign, there are certain features Dr. Fischer may observe that can be a cause for concern. Change in color, increased size or previous skin cancer are some of those features.

Benign skin lesions include chalazions, hordeolum, skin tags, nevus or freckles, xanthalasma, hydrocycstoma (sweat gland cyst), and epithelial inclusion cysts.

A chalazion is a lump in the lid that is caused by obstruction of an oil gland within the upper or lower eyelid. This lump may increase in size over days to weeks and may occasionally become red, warm, or painful.

The gland involved in the formation of a chalazion is a modified oil gland that lies within the eyelid. There are about 40 of these glands within each of the upper and lower lids. These glands secrete oil into the tears. When one of these glands becomes blocked, it can increase in size and cause a visible lump.
Although a sty is also a lump in the eyelid caused by obstruction of an oil gland, a chalazion is not a sty. A sty, or hordeolum, represents an acute infection of the gland. A chalazion is not an infection but is an inflammation of the area. Inflammation is a process in which the body reacts to a condition and produces swelling, redness, pain, or warmth. A sty is usually more painful than a chalazion and may look infected.

A skin tag is a common, acquired benign skin growth that looks like a small piece of hanging skin. Skin tags are often described as bits of skin- or flesh-colored tissue that project from the surrounding skin from a small, narrow stalk. They typically occur in characteristic locations including the neck, underarms, eyelids, and under the breasts (especially where underwire bras rub directly beneath the breasts). Although skin tags may vary somewhat in appearance, they are usually smooth or slightly wrinkled and irregular, flesh-colored or slightly more brown, and hang from the skin by a small stalk. Early or beginning skin tags may be as small as a flattened pinpoint-sized bump around the neck. Some skin tags may be as large as a big grape.

A nevus or mole is a benign raised skin lesion commonly found on the eyelids and face. It can be pigmented or non-pigmented. A dysplastic or atypical nevus is generally larger and more irregular than ordinary moles. Their color is frequently non-uniform with pink, light and dark brown. They can be partly flat with areas of raised bumps. Dr Fischer may recommend a biopsy because of the risk of nevi to evolve into dysplastic nevi or melanomas (skin cancer).

Xanthalasma are yellow plaques that most commonly occur near the upper and lower inner canthus (the corner of the eye where the eyelids meet). They are soft, semisolid, or firm and are made up of fats in the outermost layer of the skin. Approximately 50% of all people who present with a xanthalasma have high cholesterol. These plaques can be removed using radiofrequency surgery if desired, but approximately 30% of them will recur.

Hydrocystomas, sweat gland cysts, are benign growths. They are soft, translucent, can be solitary or in a group, and they are most frequently found along the inner and outer eyelids. They grow slowly but do not resolve without removal. It is very important to remove the whole cyst to prevent recurrence.

Epithelial inclusion cysts are small white-yellow cystic lesions occurring on the face, neck, eyelid skin, or white of the eye. They may develop spontaneously or arise following trauma or surgery along an incision line. If the cyst wall is not removed, they may recur.

Malignant skin lesions are not uncommon around the eyelids and face because many skin cancers are caused by sun-exposure. The earlier a skin cancer is discovered, the less tissue has to be removed. This is particularly important around the eyelid because of the importance of the eyelids’ function to protect the eyeball.

One of the most common skin cancers found on the eyelid is basal cell carcinoma. Basal cell carcinoma is a slow-growing cancer that may look only slightly different than normal skin. The cancer may appear
as a bump that is white or light pink, flesh-colored or brown, or pearly or waxy. In some cases the skin may be just slightly raised or even flat. Other symptoms of basal cell carcinoma include:

• a skin sore that bleeds easily
• a sore that does not heal
• oozing or crusting spots in a sore
• appearance of a scar-like sore without having injured the area
• irregular blood vessels in or around the spot
• a sore with a sunken area in the middle

If caught and treated early, basal cell carcinoma is completely curable. If left untreated, though, it may grow into the surrounding tissue. This is a particularly dangerous situation around the eyelid because of the delicate relationship between the eyelid and the eyeball. Exposure to UVA and UVB rays increases a person’s risk of developing this skin cancer.

Squamous cell carcinoma is the second most common skin cancer. It occurs in the upper layer of the skin, the epidermis. Sun exposed areas like the eyelids and face are particularly susceptible. Other telltale signs of sun damage such as wrinkling, changes in pigmentation, and loss of elasticity may make Dr Fischer more concerned about skin lesions that are suspicious.

People who have fair skin, light hair, and blue, green, or gray eyes are at highest risk of developing
squamous cell carcinoma. Other risk factors include occupations requiring long hours in the outdoors,
extensive leisure time in the sun, previous basal cell skin cancer, previous skin injuries, long standing sores, and frequent use of tanning beds. In fact, individuals who utilize tanning beds are 2.5 times more likely to develop squamous cell carcinoma than those who don’t.

Malignant sebaceous gland carcinoma most commonly arise in and around the eyes. Fewer than 120 cases of sebaceous cell carcinoma have been reported elsewhere. The most common site of this cancer is the eyelid; however, this abnormal growth can occur in other areas of the eye and eyebrow. Sebaceous cell carcinoma is a lethal eyelid malignancy that may appear benign. Error or delay in diagnosis is common, and it carries a significant mortality rate if it spreads.

Click Here for a Chance to Win $1000 OFF LASIK