Eyelid Lesions/Skin Cancer

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Benign lesions:

Multiple benign lesions occur on and around the eyelids.  They can cause irritation or simply be cosmetically unacceptable. One of the most common benign lesions on the eyelids is a chalazion or stye, which emanates from clogged oil glands in the eyelids.  If these lesions do not spontaneously resolve, they can often be injected with steroid or excised.  Evaluation is important to determine the best course of action for any lesion around the eyes.

Eyelid skin cancer

There are several types of skin cancers that can appear on and around the eyelids: basal cell carcinoma, squamous cell carcinoma, melanoma, and sebaceous gland carcinoma. A biopsy is usually required to confirm the diagnosis of skin cancer.

Basal cell and squamous cell carcinomas are the most common types that appear around the eyes. Either may appear as a painless nodule, or a crusting sore that won’t heal. They tend to enlarge locally and rarely spread to other parts of the body. Left untreated, however, they will continue to grow and invade surrounding structures. Early surgical treatment to remove them completely while maintaining a minimally invasive technique is optimal.

Melanoma is a less common but more serious form of cancer. It may present itself as a mole that bleeds, suddenly becomes tender or changes in size and shape. Sebaceous gland carcinoma is also a more serious form of skin cancer that forms in the oil glands beneath the skin’s surface. It may appear as a thickening of the eyelid or persistent eyelid inflammation. Both Melanomas and sebaceous gland carcinomas can spread to other parts of the body, and a more aggressive treatment plan may be necessary to reduce the risk of early spread.

Causes

According to the American Cancer Association, skin cancer in America is considered a growing epidemic. Excessive sun exposure is the single most important factor associated with skin cancers of the face, eyelids and arms. Other risk factors include having fair or light skin, a family history of skin cancer, a personal history of skin cancer, smoking, exposure to certain chemicals and older age. Men are two-times more likely to have basal cell carcinomas than women, and three-times more likely to have squamous cell carcinomas.

Prevention

Consistent application of a broad-spectrum sunscreen that protects against UVA and UVB rays, Vitamin D supplementation and a high intake of foods loaded with antioxidants have all been shown to prevent and protect against skin cancer.

Treatment

Surgical treatment is the most effective treatment for skin cancers around the eyes. The surgical plan follows two principles: complete removal and reconstruction if necessary. Most often, this surgery is performed on an outpatient basis, requiring a local anesthesia with or without sedation.

Risks and Complications

Recurrence is rare but may occur even after complete excision of a skin cancer. In these cases, additional surgery is usually the best option. Bleeding and infection are always a potential risk of surgery, but are very uncommon.

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