Eyelid Cancer: Symptoms and Signs
Eyelid cancer is skin cancer that starts on or in the eyelid. The most common type, basal cell carcinoma, grows slowly and rarely spreads. Signs include a lump or sore that does not heal, bleeds or crusts, and eyelashes falling out. Found early, it can usually be removed completely and the eyelid rebuilt.
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Eyelid cancer at a glance
- What it is
- Skin cancer on the eyelid, most often basal cell carcinoma, a slow-growing type.
- How common
- The eyelids are a common site for skin cancer, mostly in people over 50 and most often on the lower lid.
- Is it serious?
- It needs treating, but most types grow slowly, and early treatment usually removes it completely.
- Does it go away?
- No. A cancer will not heal on its own, which is why a sore that does not heal is checked.
- When to get it checked
- Any eyelid lump or sore that grows, bleeds, crusts or scabs for more than four weeks.
What is eyelid cancer?
Eyelid cancer, or skin cancer on the eyelid, is a cancer that starts in the skin or glands of the eyelid. The eyelids get a lot of sun and have very thin skin, so they are a common place for skin cancer to develop. Most cancers on the eyelid are found on the lower lid and at the inner corner of the eye.
The most common type by far is basal cell carcinoma (BCC), sometimes called a rodent ulcer. It grows slowly and very rarely spreads, but if it is left it can damage the eyelid and the tissue around the eye. Squamous cell carcinoma, sebaceous gland carcinoma and melanoma are less common and more likely to spread, which is why any suspicious lump is checked early.
Eyelid cancer symptoms
Eyelid cancer is usually painless, so the signs are mostly what you can see:
A lump that grows
A firm, pearly or skin-coloured lump, often with tiny blood vessels on its surface.
A sore that does not heal
A spot or ulcer that bleeds, crusts or scabs, and has not healed after four weeks.
Lost eyelashes
Lashes falling out over a lump or along part of the lid edge.
A change in the lid edge
Thickening, notching or a change in the shape of the edge of the eyelid.
A red, scaly patch
A rough or scaly area of skin that does not settle with moisturiser.
Redness or a chalazion that keeps returning
Long-lasting inflammation of one lid, or a chalazion that keeps coming back in the same place, can rarely be sebaceous gland carcinoma.
Eyelid cancer causes and risk factors
Sun exposure
Years of UV exposure, from sunlight or sunbeds, is the main cause of skin cancer on the eyelid.
Fair skin
Fair skin that burns easily, light-coloured eyes and red or fair hair raise the risk.
Age
Most eyelid cancers occur after the age of 50.
Previous skin cancer
Having had a skin cancer before makes another more likely.
A weakened immune system
Medicines taken after an organ transplant, or conditions that lower immunity, raise the risk, especially of squamous cell carcinoma.
Radiotherapy
Previous radiotherapy to the face increases the risk.
Rare genetic conditions
Conditions such as Gorlin syndrome (basal cell naevus syndrome) and xeroderma pigmentosum.
Smoking
Smoking is linked with a higher risk of squamous cell carcinoma.
Chalazion or eyelid cancer?
Most lumps on the eyelid are harmless. These differences help, but only a specialist, and sometimes a biopsy, can be sure. Read more about a chalazion.
| Chalazion | Eyelid cancer | |
|---|---|---|
| How it starts | Over days, often tender at first | Slowly over months, usually painless |
| Surface | Smooth skin over the lump | May be pearly, ulcerated or crusted, and may bleed |
| Eyelashes | Lashes stay in place | Lashes may fall out over the lump |
| Over time | Usually settles within weeks to months | Keeps growing and does not heal |
| Coming back | Can recur, usually in a different place | A chalazion that returns in the same place needs a biopsy |
When to see a doctor about a lump on your eyelid
Most eyelid lumps are not cancer, but these signs should always be checked.
See a doctor promptly if
- A lump or sore on the eyelid hurts, itches, bleeds, crusts or scabs for more than four weeks
- A lump is getting bigger or has changed colour or texture
- Eyelashes are falling out over a lump
- The edge of the eyelid has changed shape or thickened
- A mole on or near the eyelid changes in size, shape or colour
Book a check if
- You have a chalazion that keeps coming back in the same place
- One eyelid stays red or inflamed despite treatment
- You have had skin cancer before and notice anything new
- You are unsure about any lump on your eyelid
Your GP can refer you urgently if cancer is suspected. Finding it early means a smaller operation and a simpler repair.
How eyelid cancer is diagnosed at Perfect Eyes
Eyelid cancer is diagnosed by examination and confirmed by a biopsy.
- Step 1
Examination
Dr Sabrina examines the lump under a slit-lamp microscope, with the lid edge and lashes, and checks the lymph nodes in front of the ear and in the neck.
- Step 2
Biopsy
A small sample is taken under local anaesthetic and examined in a laboratory, which confirms whether it is cancer and which type.
- Step 3
Planning removal and repair
The cancer is removed with a margin of healthy tissue, sometimes with Mohs surgery, and the eyelid is rebuilt. Rarer types may need scans first.
Treatment for eyelid cancer
Reconstructive Surgery
Eyelid cancer is treated by removing it completely, with a margin of healthy tissue, then rebuilding the eyelid so it protects the eye, closes properly and looks natural. Dr Sabrina, an oculoplastic surgeon, uses nearby skin, flaps or grafts depending on the size of the gap.
Protecting your eyelids from skin cancer
Most eyelid cancers are caused by the sun, so protection and regular checks make the biggest difference.
What helps
- Wraparound sunglasses that block UV
- A wide-brimmed hat in strong sun
- Sunscreen of at least SPF 30 with 4-star UVA protection, in a formula made for the eye area
- Shade between 11am and 3pm from March to October in the UK
- Checking your eyelids in the mirror once a month for anything new or changing
What to avoid
- Sunbeds
- Burning in the sun
- Ignoring a sore that has not healed after four weeks
- Picking at or treating a suspicious lump yourself
Meet the Expert: Dr Sabrina Shah-Desai
MS, FRCS (Ed) Ophth
Dr Sabrina Shah-Desai, MS, FRCS (Ed) Ophth is a multi-award-winning Oculoplastic Reconstructive Surgeon and Aesthetic Practitioner specialising in reconstructive, revisional, and cosmetic surgery of the eyelids, as well as non-surgical treatments for the eyes and face. With 25 years of surgical and 17 years of non-surgical experience, she is globally recognised for her pioneering, minimally invasive techniques.
Listed in Tatler’s Beauty & Cosmetic Surgery Guide every year from 2019 to 2026, she is known as the “go-to” surgeon for discerning patients seeking subtle, natural results, and is highly sought after for revisional procedures by those who have undergone previous fillers or eyelid surgeries.
- Listed on the Royal College of Surgeons of England register of Board-Certified Cosmetic Surgeons
- Listed in Tatler’s Beauty & Cosmetic Surgery Guide every year from 2019 to 2026
- 25 years of surgical and 17 years of non-surgical experience
Frequently asked questions
Call or email us today, we would be delighted to answer your questions.
The initial signs to watch out for include a growth on the eyelid that can be red, brown, or black, broken skin on the eyelid that does not heal, and a change in the appearance of the eyelid skin. Other signs and symptoms can include:
- A painless, reddish growth that feels smooth, shiny, and firm.
- A sore that bleeds or develops a scab.
- A rough, brown, or red patch.
- It's rare to experience pain unless the cancer has extended to the nerves or inside the eye and has elevated the pressure inside the eye (intraocular pressure). Eyelid cancer might not always display obvious symptoms and may only be detected during a regular eye examination.
Signs of eyelid cancer may include:
- A swelling on your eyelid that's getting larger.
- Persistent skin irritation with loss of fine lanugo hair on the skin.
- Skin irritation.
- Bleeding from the lump.
- Change in colour of an eyelid lump.
These signs can also be caused by less serious eyelid conditions, so they do not always indicate cancer. Nonetheless, having these symptoms assessed by a doctor as soon as possible is crucial.
Sources
- Basal cell carcinoma of the eyelid / around the eyeThe Dudley Group NHS Foundation Trust
- Non-melanoma skin cancerNHS
- Sunscreen and sun safetyNHS
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