Not All Eyelid Bumps are Styes

Not All Eyelid Bumps Are Styes: A Commonly Misdiagnosed Water Cyst

A patient was referred to me for what was initially thought to be a stye. She had a lesion on her right lower eyelid that had slowly grown over the past six months. It started small but gradually became darker in color and elevated. There was no pain, swelling, redness, or bleeding. She had tried warm compresses and topical antibiotics without any improvement.

When I examined her, I knew right away this was not a stye.

The lesion was softer than most styes, more mobile, and positioned about 5–6 mm away from the eyelid margin—whereas most styes appear right along the lash line. Its darker pigmentation also stood out.

What she actually had was a hidrocystoma — a benign, fluid-filled cyst that forms from a blocked sweat gland. These water cysts are fairly common around the eyes, especially at the inner and outer corners. While often mistaken for styes, they don’t respond to medications or compresses.

How We Treated It

The only effective treatment for a hidrocystoma of this size is surgical removal. In the video below, I show the step-by-step process:

• Local anesthesia is applied using a fine needle.
• A small incision is made to remove the top layer of skin.
• The cyst — which looks like a tiny water balloon — is carefully dissected and drained.
• I use electrocautery to seal any bleeding and eliminate any remaining cyst wall.
• The area is closed with a few dissolvable sutures.

After surgery, I recommend patients apply our patented BrazzoMD Silver Gel to reduce inflammation and scarring. In most cases, the skin heals beautifully with minimal to no visible mark. Recurrence is rare — less than 1%.

Hidrocystomas are harmless, but when they grow large enough to cause cosmetic concerns or confusion, removal is quick, safe, and effective.

After the cyst was removed, I placed two dissolving sutures to close the wound and place the skin edges together.  The sutures were gone in a week, and she had no visible scar.