Pigmentation on the Eyelids

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There are many different types of pigmented lesions which can be found on the eyelid, most of which are harmless, but there are some which can be dangerous.

What is the problem with pigmentation on the eyelids?

If you find a pigmented lesion on your eyelid it is very important to go to the doctors. It should be removed and examined to determine whether or not it is cancerous.

If pigmentation is found on the eyelids in babies and infants then it could cause eyesight problems. Often, when these lesions are found on children then it can be sign of other disease, so further investigation should be done by a doctor.

Who is likely to get eyelid pigmentation?

The likelihood of getting eyelid pigmentation is dependent upon both you and the type of pigmentation. Some pigmented lesions are seen in babies, while others are seen in the elderly. There are also a number of environment factors which will influence whether or not you will get eyelid pigmentation, for example increased sun exposure will increase the likelihood that you will develop eyelid pigmentation.

Appearance of benign eyelid pigmentation

There a number of benign pigmented lesions which can be present on the eyelid:

• Freckles are small tan coloured spots. They are most often found in light skinned people and usually get darker after exposure to the sun. Freckles are cause by melanocytes producing too much melanin.
• Lentigo simplex is usually found as brown spots and is most often found in childhood. They are not affected by exposure to the sun.
• Sun spots are usually found in older people who have had regular sun exposure. They are usually tan brown in colour, have irregular borders and increase in size over time.
• Melasma pigmentation is brown in colour and irregular in shape. This occurs on the face and is most common during pregnancy or in those who are taking oral contraceptives.
• Melanocytic nevus is a common skin pigmentation found on the eyelid. It usually appears in childhood when it is small and tan brown in colour.
• Congenital melanocytic nevus is found in around 1% of babies and is usually very highly pigmented.
• Spindle-epithelioid cell nevus is pink or orange in colour and is found in children and young adults.
• Balloon cell nevus is slightly pigmented and small.
• Nevus of Ota is blue or purple in colour.
• Blue nevus pigmented lesions are blue and less than 1 cm wide.

Malignant lesions

Melanomas usually have irregular borders and are tan, brown or black in colour. All pigmented lesions on the eyelid should be looked at by a doctor to ensure that it is not a melanoma.

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