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

Bumps under the eyes can develop with little or no warning and bring with them little to no pain, but their presence can indicate a more serious issue.

Bumps generally fall into one of three categories—milia, stye or chalazion. They are white, red or yellow. Causes include:

• Bacterial infection
• Poor hand hygiene
• Viral infection
• Overuse of steroids

What Are Milia?

Milia are tiny white cysts that typically occur under the eyes. They look like small pimples or blisters and usually appear along the outer ring of your eyelid. 

The cysts are painless, and it is possible to mistake them for acne. They form when 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 because of poor hygiene or oil-based makeup, which often closes facial pores. Lack of sleep can also lead to the development of milia.

Babies also encounter milia, but the condition often clears on its own after a few weeks.

Long-term use of corticosteroids, autoimmune conditions or damage to the skin caused by the sun, rash or injury are other causes of milia. 

What Are Styes?

Also known as a hordeolum, styes are small, red and painful lumps on the eyelids. Hair follicle infection or bacterial infection of the oil-producing gland in the eyelids causes styes.

You are at an increased risk of getting a stye if you have blepharitis, a condition that causes red, swollen and sore eyelids. 

The most accurate way of identifying a stye is that it appears red and leaves the eyelid tender. A scratchy sore eye also indicates that a stye might be developing. You can get one of two kinds of styes—external hordeolum or internal hordeolum.

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 is an indication that you have an infected oil-producing gland in the eyelid.

The most common causes of eye bumps are poor hygiene, infection, or underlying health conditions

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 some blurry vision.

Causes of Eye Bumps

A physical eye exam by an opthalmologist should be enough to diagnose the type of under-eye-bumps.

Every kind of bump that occurs under the eyes has its specific cause. The top three common reasons for spots under the eyes are 

• Poor hygiene: Failing to wash your eye area properly or touching your eyes with dirty hands can lead to bumps under the eyes. Also, sleeping with makeup is a known cause of bumps under the eyes.
• Infection: A bacterial attack may cause styes to develop, which will proceed to turn into a chalazion. Additionally, viral infections also cause chalazion.
• Underlying health conditions: Milia could develop due to genetic or autoimmune disorders. Blepharitis could contribute to stye development. Medics also attribute stye and chalazion to diabetes.

Excess exposure to the sun and overuse of steroids also plays a role in the development of bumps under the eyes.

Diagnosis 

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 you questions about the eye problems and order further tests.

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

Treatment

For starters, don’t pop any bumps since it could cause your eyes harm. Treatment for bumps under your eyes may often be an antibiotics prescription.

Before giving you any medication, the doctor may drain fluid from the nodes through a small incision.

However, you have the prerogative to take over-the-counter medications before it gets to that point. Steroid injections also go a long way in reducing the swelling and inflammation caused by spots under the eyes.

If your nodes continue recurring, consult your ophthalmologist. In addition, you should also consider evaluating your personal hygiene habits, a possible cause of the recurrence.

Use exfoliators and facial peels to clear bumps. Warm compresses with clean washcloths are also effective against spots under the eyes.

If the chalazion does not go away after several weeks, it may require medical treatment, which may include an incision to drain or an injection of steroids to reduce the inflammation and swelling.

When to See a Doctor

If your bumps do not abate 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, whether expected or unexpected.

Home Remedies

Milia, styes and chalazion usually clear up within a few weeks, but you can speed up the healing process by applying the following home remedies:

• Put warm compresses on your eye using a warm damp cloth several times a day.
• Do not poke or squeeze the bumps as it could worsen the condition.
• Always practice good hand hygiene.
• Do not wear contact lenses or makeup until your eyelid heals.

Can You Use Makeup Over Milia? Styes? Chalazion?

Wearing makeup over bumps will only make the conditions worse.

Wearing makeup over bumps will only make the conditions worse. If you want to continue wearing makeup, consider making some changes to stem the odds of developing bumps.

• Toss out any old or expired makeup. Exports recommend replacing mascara and eye shadow every three months to prevent transferring bacteria to your eye area.
• If you share eye makeup, consider not sharing because it can be a reason why bumps under the eyes develop.
• Confirm that you are wearing makeup correctly. It is easy to form bad habits over time. In this case, a few easy adjustments may keep you safe from an infection like chalazia.

Prevention 

Managing conditions like diabetes and blepharitis can help prevent the development of bumps under the eyes. The best way to avoid spots is by having a hygienic skincare routine, which includes:

• Exfoliating your skin regularly. Ask your doctor which is the best exfoliator for your skin type.
• Washing your face twice daily.
• Disinfecting your contact lenses.
• Removing makeup before going to bed.
• Washing your hands before touching your eyes.

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

References

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

2. Corticosteroids. (January 2020). Cleveland Clinic.

3. What is Blepharitis? (September 2021). American Academy of Ophthalmology.

4. What are Styes and Chalazia? (November 2021). American Academy of Ophthalmology.

5. How to Use Cosmetics Safely Around Your Eyes. (March 2021). American Academy of Ophthalmology.

6. Diabetic Eye Disease. (October 2021). American Academy of Ophthalmology.

7. 5 Ways to Maintain Good Vision and Healthy Eyes. (December 2020). Cleveland Clinic.