Patients often ignore a small bump or scab on the eyelid for months, assuming it is a stye or dry skin. Most eyelid bumps are harmless. But one that bleeds, crusts, will not heal or slowly changes the shape of the lid deserves a closer look, because it may be basal cell carcinoma.
The most common eyelid cancer
According to EyeWiki, the American Academy of Ophthalmology’s clinical encyclopedia, basal cell carcinoma (BCC) is the most common eyelid malignancy, accounting for over 90% of malignant eyelid tumors. It is linked to ultraviolet light damage to the skin, particularly UVB.
Who is at risk
EyeWiki notes that BCC tends to occur in lightly pigmented people at sites of sun exposure, although it can occur with any skin tone. Radiation exposure is among the other risk factors listed.
Signs to watch for
- A skin lesion that does not heal
- Ulceration, bleeding or crusting
- Loss of eyelashes in one spot
- Tiny visible blood vessels on the bump
- A change in the shape or position of the eyelid
EyeWiki also notes some lesions cause no symptoms at all, which is why a doctor should examine anything that persists.
Diagnosis and treatment
BCC can be suspected on examination, but the diagnosis is confirmed with a biopsy. EyeWiki describes BCC as nearly always locally invasive, so treatment is recommended to prevent damage to nearby tissue. The standard approach is complete surgical removal with margin control, using frozen sections or Mohs surgery to make sure no cancer cells remain at the edges. A topical cream has been used in some cases but is not as effective as surgery. EyeWiki reports five-year cure rates of up to 98%.
Prevention
EyeWiki recommends minimizing sun exposure with sunblock, hats, sunglasses and protective clothing.
Who treats it
Eyelid cancer surgery and reconstruction are performed by oculoplastic surgeons and Mohs surgeons, and we refer patients when a lesion looks suspicious. If you have not had an eye exam in a while, our first visit guide explains what a comprehensive exam includes, including a look at the eyelids.
The rule I give patients is easy to remember: an eyelid spot that has not healed in a few weeks should be examined.
Source: Basal Cell Carcinoma (EyeWiki, American Academy of Ophthalmology, reviewed 9/22/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.