Noticing small, persistent bumps on your skin, especially around the delicate under-eye area, can be a source of cosmetic frustration. While many assume these bumps are stubborn milia or a type of acne, they are often a distinct condition known as syringoma. These small growths are entirely benign (non-cancerous) and pose no threat to your physical health. However, their appearance in prominent areas can significantly impact self-esteem. Understanding that syringomas are not a reflection of poor hygiene or a serious illness, but rather a common and harmless skin condition, is the first step toward managing them effectively and making informed decisions about potential treatment.

A syringoma is a benign (non-cancerous) growth of sweat glands, most commonly appearing as small, flesh-colored or yellowish bumps around the eyes, particularly the lower eyelids. These growths arise from the eccrine sweat ducts, which are responsible for regulating body temperature through perspiration.

Syringomas are harmless and not contagious, but they may be a cosmetic concern, especially when they appear in clusters on the face. They typically develop during adolescence or early adulthood and are more common in women and individuals with darker skin tones or Asiatic descent.

Syringomas can be classified into a few different clinical types:

• Localized: The most common form, where the bumps appear in one or two specific areas, typically around the eyes.
• Familial: Some cases of syringoma run in families, suggesting a genetic predisposition. In these cases, multiple family members may develop the condition.
• Associated with Down Syndrome: Individuals with Down syndrome have a significantly higher incidence of syringomas.
• Eruptive: This is a less common variant where numerous syringomas appear suddenly, often on the chest, neck, and abdomen, and can sometimes be itchy.

The exact cause of syringoma isn’t fully understood. However, research and clinical observation point to several factors that are believed to play a role in their development.

1. Overstimulation or Obstruction of Sweat Glands: One of the most widely accepted theories is that syringomas form as a response to the inflammation, obstruction, or overactivity of the eccrine sweat ducts. The body’s attempt to respond to this stimulus causes the benign overgrowth of the ductal cells. This may explain why the eruptive form of syringoma can sometimes be itchy, especially in response to heat and sweating. In a hot and humid climate increased sweat gland activity could potentially be a contributing factor to their prominence or irritation.

2. Hormonal Influence: There is a strong clinical association that suggests hormones play a significant role. Syringomas are far more common in women than in men and often first appear during periods of major hormonal fluctuation, such as puberty or pregnancy (Gupta et al., 2023). This has led researchers to believe that hormones like progesterone and estrogen may influence the growth and activity of the eccrine sweat duct cells, making them more prone to developing into syringomas in susceptible individuals.

3. Genetic Predisposition: As mentioned, some cases of syringoma are inherited in an autosomal dominant pattern, meaning a single copy of an altered gene passed from one parent is enough to cause the condition. This indicates that for some people, their genetic makeup makes their sweat ducts inherently more likely to form these growths.

Clinically, syringomas often develop in patients with no identifiable trigger, but when they’re associated with systemic conditions like diabetes or genetic syndromes, they may appear more widely or earlier in life.

Syringomas aren’t “caught” or transmitted, they develop internally and cannot spread from person to person. Instead, certain risk factors make you more likely to develop these benign growths. These factors are closely linked to the proposed causes and help explain who is most commonly affected.

The primary risk factors for developing syringomas include:

• Gender: Syringomas are diagnosed significantly more often in women than in men, reinforcing the theory of hormonal influence.
• Age: While they can appear at any age, they most commonly begin to develop during adolescence and early adulthood, between the ages of 15 and 40.
• Family History: Having a close family member (like a parent or sibling) with syringomas increases your chances of developing them yourself.
• Associated Medical Conditions: Certain medical conditions are linked to a much higher incidence of syringomas. These include genetic syndromes like Down syndrome, Marfan syndrome, and Ehlers-Danlos syndrome. Additionally, individuals with diabetes mellitus are more prone to developing a specific variant called clear-cell syringoma.

Syringomas, often diagnosed clinically by dermatologists due to their characteristic appearance, usually present as asymptomatic skin growths, although the eruptive type may cause itching, particularly during sweating.

The most common signs and symptoms involve the physical appearance of the bumps:

• They appear as small, firm bumps (papules), typically measuring 1 to 3 millimeters in diameter.
• Their color is usually similar to the person’s own skin tone, but they can also be yellowish, pinkish, or slightly translucent.
• They tend to appear in clusters and are often symmetrically distributed (appearing in the same pattern on both sides of the body).
• The surface of the bumps is smooth.

The most classic location for syringomas is the periorbital region, the delicate skin on the eyelids and directly underneath the eyes. However, they can appear in other areas where sweat glands are concentrated. Other common locations include the armpits (axillae), chest, neck, abdomen, and genital area (specifically the vulva in women).

Diagnosis

Syringoma diagnosis is almost always made clinically by a dermatologist.

• Clinical Examination: A dermatologist can typically identify syringomas based on their highly characteristic appearance (small, firm, skin-colored bumps) and their classic location (especially around the eyes).
• Dermoscopy: In some cases, the doctor may use a dermatoscope, which is a special handheld magnifying lens with a light source, to get a more detailed look at the bumps’ structure.
• Skin Biopsy: While not usually necessary for diagnosis, a skin biopsy is the only way to be 100% certain. A biopsy might be performed if the bumps look unusual, if they are symptomatic, or if the doctor needs to definitively rule out other, more serious conditions. This involves numbing the area and removing a tiny piece of one of the bumps to be examined under a microscope by a pathologist.

Treatment

Treatment is usually cosmetic, as syringomas are benign and painless. However, many patients seek removal due to their appearance, especially when located around the eyes or in large numbers.There is no guaranteed permanent cure, and recurrence is common, even after removal.

Treatment options include:

• Topical Treatments: These are the least invasive but also the least effective. Creams containing topical retinoids (like tretinoin) or atropine may be tried, but they rarely lead to significant improvement as they do not penetrate deep enough to affect the tumor.
• Electrodessication and Curettage: This is a very common procedure where a dermatologist uses a sharp, spoon-shaped instrument (a curette) to scrape the lesion and then uses a fine electric needle to burn the base. It is effective but requires a skilled hand to minimize scarring.
• Cryotherapy: This involves lightly freezing the bumps with liquid nitrogen. It carries a risk of causing light or dark spots (hypopigmentation or hyperpigmentation), especially in individuals with darker skin tones.
• Laser Ablation: This is often considered the most effective and precise treatment. A CO₂ laser or Erbium laser is used to vaporize the syringoma tissue layer by layer. This allows the operator to have precise control over the depth of treatment, which can lead to better cosmetic outcomes with a lower risk of scarring compared to other destructive methods.
• Microneedling with Radiofrequency (RF): This newer technique uses fine needles to deliver radiofrequency energy deep into the dermis, heating and destroying the syringoma tissue from within while protecting the skin’s surface.

Syringoma is a benign but sometimes bothersome skin condition that results from the overgrowth of sweat gland ducts, commonly on the face. While not medically dangerous, they can affect confidence and appearance, especially when located in visible areas.There is no guaranteed way to prevent syringomas, and treatment is typically cosmetic. Options like laser therapy, electrosurgery, or topical retinoids may improve appearance, but recurrence is common.

If you notice small, persistent bumps around the eyes or upper body that don’t go away with typical skin care, it’s worth seeing a dermatologist. Early evaluation can confirm the diagnosis and explore treatment options tailored to your skin type and preferences.

• Gupta, S., Hocar, O., & Bogle, M. A. (2023). Syringomas. eMedicine. Medscape. Retrieved from https://emedicine.medscape.com/article/1059871-overview
• Geist, R., & Crane, J. S. (2025, January). Syringoma. In StatPearls. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK603740/
• Singh, A., & Oakley, A. (2024, December). Syringoma. DermNet NZ. Retrieved from https://dermnetnz.org/topics/syringoma