Milia, Syringomas, Skin Tags, Warts and Other Skin Lesions

Milia, syringomas, skin tags and warts are some of the most common types of benign skin lesions. Although the treatment for these lesions is very similar, these lesions are very different. Here’s how we differentiate them.

Syringoma

Syringomas are harmless, non-cancerous sweat duct tumors arising from the dermis of the skin. They are usually seen on the eyelids and under the eyes. More commonly seen in Asians and middle aged women, syringomas present as skin coloured or yellow coloured bumps 1-3mm in diameter. They are usually asymptomatic.

Milia

Milia seeds are cysts containing keratin that have been trapped under the skin. They are white or yellow in colour and feel hard. They can be found in children and adults.

Sebaceous hyperplasia

Sebaceous hyperplasia refers to the enlarged sebaceous glands (oil glands) on the forehead and cheeks in adults from the fourth decade onwards. They appear as painless yellow bumps and look like doughnuts- raised bumps with a dimple in the center.

Skin tags (Acrochordon)

Skin tags are harmless skin-coloured growths that look like they hang off the skin. They are usually found on the eyelids, neck, folds of the armpit and under the breasts.

Warts

Warts look like grey; pebbled lumps stuck to the skin and cannot be peeled off. They can be found anywhere on the skin and are due to an infection by the virus- Human Papilloma Virus. The virus is present within the warts and the virus can be transmitted among family members by skin contact if the wart is scratched or picked.

Xanthelasma

Xanthelasma are well demarcated yellow fat deposits under the skin and are commonly found near the eyes, especially around the inner canthus of the eye. These yellow plaques are soft to touch are more commonly found on the upper eyelid than the lower eyelid. They do not affect the function of the eyes and eyelids. Xanthelasma has been associated with hyperlipidemia.

Removal

None of these skin lesions are cancerous and they do not cause any symptoms or problems. However, these skin lesions can be cosmetically unsightly and patient usually opt to remove these skin lesions to achieve a smoother and cleaner appearance.

The 2 main ways to remove these lesions are: –
· CO2 laser
· Electrocautery

After anaesthesia is applied (either topical or local), the lesion(s) can be removed quite painlessly with CO2 laser or electrocautery with very minimal downtime and very small wounds. One main point to note is the chance of recurrence as syringomas, milia seeds, warts, skin tags and xanthelasma have been known to recur even after complete removal.