Bumps Under the Eyes (Milia, Styes, Chalazion): Causes, Diagnosis, and Treatment

Should you panic if you notice bumps below your eyes? In most cases, these lumps and bumps are benign skin problems that will go away with a bit of self-care. But some below-the-eye skin changes can indicate a serious condition that requires a doctor’s help.

Here’s what you need to know about three common causes of under-eye bumps. 

What Are Milia?

Milia are tiny white cysts that typically occur under the eyes. They look like small pimples or blisters and usually appear on the cheeks or eyelids.

The cysts are painless, and they can be mistaken for acne. They form when the skin exfoliates, and the old cells shed, but sometimes these cells get trapped under the skin and harden, causing cysts called milia.

Adults develop milia due to the following factors:

• Poor hygiene
• Oil-based makeup
• Lack of sleep 
• Skin conditions like dandruff
• Long-term steroid use
• Skin damage from the sun 

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What Are Styes?

Also known as a hordeolum, a stye is a small, red, painful eyelid lump. Hair follicle infections or bacterial infections cause them. You are at an increased risk of getting a stye if you have blepharitis, which causes eyelid swelling. 

Pain helps you identify a stye. Your eyelid is red and swollen, but it also hurts a lot. The following two types of styes exist:

External Hordeolum

This kind of stye grows at the base of the eyelash. It looks like a pimple at first look but reveals itself as a stye after a while. A hair follicle infection is often the contributing factor to an external hordeolum. 

Internal Hordeolum 

An internal hordeolum develops in the eyelid. Its appearance indicates that you have an infected oil-producing gland in the eyelid.

What Is a Chalazion?

A chalazion is a swollen nodule on the eyelid. It forms because of blockage and clogging of an oil gland in the eyelid. Often, a chalazion may start as an internal hordeolum. 

It is usually not as painful as a stye and rarely results from bacteria. However, your eyelid may turn red, swollen, and tender as the chalazion grows. The whole eyelid is likely to swell, in which case you will likely experience blurry vision.

Risk Factors for Eye Bumps 

Every kind of bump that occurs under the eyes has its specific cause. Common reasons for spots under the eyes include the following:

• Poor hygiene: Skin below and around your eyes sheds naturally, and it’s nourished by oil glands. If you don’t wash properly, old skin cells can get trapped under the skin and form milia cysts. 
• Infections: If bacterial colonies grow at the base of your eyelashes or under your eyelids, you could develop a stye. Without treatment, a stye can progress into a chalazion. 
• Long-term steroid use: Corticosteroids are associated with the development of milia. 
• Underlying health issues: Skin conditions like dandruff or rosacea are associated with milia, as are genetic or autoimmune conditions. The eye health condition blepharitis increases your risk of styes and chalazion, as does diabetes. 
• Lack of sleep: Struggling with insomnia increases your risk of milia. 

Some of these risk factors you can control. But others are based on your genetics, health, and required medications. 

How Are Eye Bumps Diagnosed?

A physical exam by an ophthalmologist should be enough to diagnose the type of under-eye bumps. The exam is likely to concentrate on your external eye area.

One specific eyelid exam you can expect is where the eye care provider shines a bright light and uses a magnifier to examine the base of the eyelashes. 

Magnification also highlights oil gland openings. Your doctor will ask questions about the eye problems and order further tests.

During diagnosis, the specialist will also likely inquire about your health history. The physician can diagnose your condition depending on other underlying conditions that could cause bumps under the eyes.

How Are Eye Bumps Treated?

The treatment options for eye bumps can vary depending on the type you have and how serious it might be. Sometimes, you can tackle issues at home. But sometimes, you’ll need a doctor’s help. 

Treating Milia

At-home care options for milia could include cleaning products like exfoliators, retinol, or facial peels. Ask your doctor before you use them, as they’re not right for all skin types, and you have to be very careful about application around the eye area.

If your milia symptoms don’t go away, your doctor could use one of these treatment options:

• Cryotherapy 
• Heat
• Laser surgery 
• Chemical peels 
• Dermabrasion 

Never squeeze or pop your skin bumps, as that could make them worse. 

Treating a Stye or Chalazion 

At-home care for a stye or chalazion involves warm compresses. A warm cloth placed on your bump for 10 to 15 minutes could dissolve the clog causing your chalazion and allow the infection to clear. 

You can press on the bump after the warm compress to help dissolve the clog. But remember not to squeeze, as that pressure could push the infection into deeper tissues. 

If your stye or chalazion doesn’t clear, your doctor could use one of these treatment options:

• Antibiotics 
• Steroid shots
• Surgery 

When to See a Doctor 

If your bumps do not decrease on their own or with at-home treatment, it is time to see your eye doctor or an urgent care physician. This is especially true if the bump under your eyes changes color or shape.

For infants, it is essential to be cautious. Have a doctor examine them when any condition develops.

Can You Wear Makeup to Cover Up the Bumps?

Wearing makeup over bumps will only make them worse. Let your skin heal before putting anything on your eyes that could irritate them. 

If you want to continue wearing makeup, consider making the following changes to stem the odds of developing bumps:

• Toss out makeup after three months. 
• Never share your makeup with anyone, including your family members. 
• Wash your face before applying makeup. 
• Only put makeup products outside the lash line. 

Preventing Future Skin Bumps

The best way to avoid spots is by having a hygienic skincare routine, which includes the following:

• Exfoliate your skin regularly. Ask your doctor which is the best exfoliator for your skin type.
• Wash your face twice daily.
• Remove makeup before going to bed.
• Wash your hands before touching your eyes.

Following good eye health practices, like not touching your eyes with unwashed hands, can also help keep you prevent bumps under the eyes.

References

1. What Are Milia? (May 2021). American Academy of Ophthalmology.

2. What Is the Difference Between a Stye and a Chalazion? Causes, Symptoms, Treatment. (June 2023). American Academy of Ophthalmology.

3. What Is Blepharitis? (August 2022). American Academy of Ophthalmology.

4. How to Use Cosmetics Safely Around Your Eyes. (August 29, 2022). American Academy of Ophthalmology.

5. Styes and Chalazia (Inflammation of the Eyelid): Overview. (December 2019). InformedHealth.org.

6. Milia. (January 2023). StatPearls.

7. Non-Surgical Removal of Milia: Treatment and Aftercare. (March 2021). Journal of Aesthetic Nursing.