A growth, or lesion, on your eyelid, may cause you to be concerned about its nature. Most patients know that skin moles can become cancerous, which is true for all skin growths and eyelid lesions, even if they are not moles in the conventional sense. An ophthalmologist should examine any lesion on the skin around the eyes because they have the training to distinguish between a benign and a malignant lesion. If the ophthalmologist suspects malignancy but is unsure because the lesion does not present all the characteristics of a malignant tumor, he may want to refer the patient to an oculoplastic surgeon (eyelid specialist) for further evaluation and biopsy.
So how can a person without medical background know when to consult with an eyelid specialist about a growth? Although you cannot and should not make a diagnosis on your own, you can undoubtedly know when to see your doctor. Benign eyelid lesions share certain aspects that characterize them as harmless. Conversely, a malignant growth will also display signs of a bad or cancerous tumor. The first helpful point for distinguishing between benign and malignant eyelid lesions is classifying them as those that are pigmented and those that are not.
When should a mole be removed?
First, let us talk about eyelid growths with brown or black pigment. When should a specialist examine them? Dermatologists have devised a rule for helping patients look out for malignancy. It is called the ABCDE rule:
- A: Asymmetry. Imagine cutting the growth in two halves. If the halves don’t match, they are asymmetrical.
- B: Borders. This means the lesion is not round but has irregular borders, like the tentacles of an octopus.
- C: Color. The growth is not evenly pigmented but has different tonalities.
- D: Diameter. Watch out for lesions larger than 6mm!
- E: Evolution. If the mole grows, it is not good to leave it alone.
This rule is quite helpful for both physician and patient. In reality, an ophthalmologist should immediately examine any pigmented lesion around the eye that grows in size or changes color.
What are the signs of cancer in a non-pigmented eyelid lesion?
If the lesion is not a mole, meaning it has no pigment, it should still be examined in some instances, as eyelid cancer is much more frequent in non-pigmented lesions than in moles (non-melanoma skin cancer).
These lesions’ most common signs of malignancy are irregular borders, raised margins, central ulceration, and small vessels (telangiectasias). Non-melanoma skin cancer is extremely common but less aggressive. As with melanoma, though, if the lesion grows, it should be examined!
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