Got a smattering of hard white, yellowish or skin-colored bumps on the skin under your eyes? You may think that they’re particularly persistent pimples—but they’re probably syringomas, or benign tumors that form in the ducts of the sweat glands.
“The bump you see is just the ‘tip of the iceberg,’ because at least half of the syringoma lies beneath the skin’s surface,” said Neal B. Schultz, MD, an assistant clinical professor of dermatology at Mount Sinai School of Medicine and author of It’s Not Just About Wrinkles. A syringoma forms when (for unknown reasons) there is an overgrowth of cells within a sweat gland duct. The duct becomes enlarged by and clogged with the extra cells, forming a hard round bump about one to three millimeters in diameter.
Syringomas can occur singly or in clusters. Though they most often appear below the eyes, they also can form elsewhere on the face, in the armpits, on the chest or lower abdomen, or on the male or female genitalia. Syringomas can affect just about anyone at any age, but they are more common in women than in men, and arise most frequently during adolescence and at midlife. People with diabetes or a family history of syringomas are at increased risk.
Though technically they are tumors, syringomas are harmless and painless…do not signal cancer or any underlying medical problem…and will not spread (like warts do). Thus they do not require treatment. However, many people consider the bumps unsightly—and want to get rid of them.
Unfortunately, there is no way to prevent syringomas from forming in the first place—and there’s nothing you can do at home to banish the bumps once they appear. “No squeezing, steaming, over-the-counter cream or other do-it-yourself treatment can make syringomas go away. All you’ll accomplish is to irritate and perhaps scar the skin,” Dr. Schultz said. Don’t bother trying a wart remover on syringomas, either—this would just irritate the skin between the bumps without getting rid of the syringomas themselves. Makeup can mask their color, but the bumps will still be visible and may cast shadows under overhead light, Dr. Schultz added.
So what can you do? See your dermatologist. Once successfully treated, an individual syringoma will not regrow—however, with or without treatment, you may develop additional syringomas in nearby sweat ducts.
Do not expect (or allow) the dermatologist to cut off the top of a syringoma with a scalpel or other tool, Dr. Schultz advised—the growth would still be visible because its whitish-yellowish color is noticeably different from the surrounding skin. He also cautioned against having the entire syringoma scooped out under local anesthesia, because this could leave a pit that would be more unsightly than the bump. Instead, Dr. Schultz advised talking to your dermatologist about…
Bichloroacetic acid (BCA). A dermatologist can apply this topical medication very precisely to the tip of each syringoma, causing a brief burning sensation. The bump crusts over. When the crust falls off, typically in a week to 10 days, it usually leaves excellent results, Dr. Schultz said—no bump, no hole, no permanent discoloration—after just a single treatment. For those reasons, BCA is his treatment of choice for his own patients.
Electrocautery. With this treatment, after numbing the skin with a local anesthetic (such as Lidocaine), a small probe with an electric current running through it is used to burn away each syringoma. A single session can destroy the part of the syringoma that’s above skin level. Usually, this does not leave you with mismatched skin color the way cutting off the top of the bump does. Or you can have multiple sessions spaced three to four weeks apart to remove the entire growth gradually enough that the area heals without leaving a hole. Be aware, though, that electrocautery may leave dark spots and even little holes if the syringomas are overtreated. That’s why Dr. Schultz recommended that it be used only when BCA doesn’t work.
The cost of syringoma treatment varies depending on the doctor, your location, the technique used and the number of bumps being treated, but expect to pay several hundred dollars per session. Unfortunately, insurance does not cover the cost since syringoma treatment is considered strictly cosmetic—but people who want their bump-free complexions restored may consider the money well-spent.
