Syringomas

At A Glance; Syringomas

  • Best Results1-2 sessions
  • Treatment Recovery7+ days
  • Procedure Time30 minutes
  • Skin SpecialistDermatologist
  • Duration of ResultsVariable
  • AnaestheticNumbing + local blocks + sedation
  • Back to Work5-7 days
  • Cost$$ (Medicare Subsidy Applies)

Syringomas

Syringomas are tiny bumps & lumps under the skin. They frequently involve the upper & lower eyelids. This is classed as a benign, non-cancerous tumour of the eccrine or sweat glands. These lesions are best treated with erbium or CO2 lasers. As this is a genetic condition, recurrence is often seen.

FactsFacts On Syringomas

  • These are common benign tumours of skin
  • Syringomas are more frequent in Asian – Ethnic patients
  • Syringomas are skin-coloured bumps around the eyelids
  • Extensive eruptive syringomas can affect the chest, face & limbs
  • Laser ablation gives the best results
  • Small isolated syringomas can be treated with fine wire hyfrecation
  • A partial Medicare rebate applies to removal of benign facial tumours

Who gets syringomas?

These tumours are most commonly found in young adults. They are more frequently seen in ethnicities including Chinese, however they also occur in the other populations. Syringomas are usually present in mid-teens to early adulthood. They are asymptomatic however may enlarge in summer or the hotter months due to increased production of sweat.

Where do they occur?

Most commonly syringomas occur on the lower eyelids followed by upper eyelids. Eruptive lesions can be seen around the mouth, chest & limbs. Syrinogmas can resemble viral warts & are frequently mistaken for cholesterol deposits known as xanthelasmas. They may look like milia, cysts or whiteheads.

What do they look like?

Syringomas are tiny 1-3 mm spots & dots that lie underneath the skin. They are most frequently found around the lower & upper eyelid. Rare cases are ‘eruptive and occur on the chest, abdomen & even on the legs. In some cases, they seem to get larger during the hotter days of summer (due to increased sweat activity). Unlike xanthelasma, syringomas are more numerous & often skin coloured. 

How are they different from milia?

These lesions frequently occur around the eyes & clinical differentiation can be tricky. Milia are generally rounder (like a 1-2 mm ball), whilst syringomas are flatter (plaque-like), and often skin coloured compared to milia, which are whiter. If in doubt a tiny 1-2 mm skin biopsy can differentiate between these conditions.

Other conditions such as trichodiscomas, fibrofolliculomas, angiofibromas, xanthelasmas & plane warts should be considered in the diagnosis, these will have specific histological features on biopsy. 

Davin’s viewpoint on treating syringomas

These are the most common benign (non-cancerous) tumours of skin I treat. Syringomas are very common in Asian patients. The biggest mistake I see is over correction of these skin lesions. Ethnic patients are prone to developing skin colour changes, but most importantly they have a brisk melanocytic & fibroblastic response. The latter can lay down abnormal collagen leading to scars. My biggest hint is to be conservative in treatments. I see way too many iatrogenic scarring due to lasers (and plasma). Better off to have 2-3 sessions compared to one with higher risks of scars.

In ethnic skin patients, post inflammatory pigmentation is generally the rule. It can take 3 to 4 months to resolve. Pico lasers can quicken resolution.

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