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 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.
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How to treat?
Syringomas are best treated with lasers including the erbium & CO2 ablative laser. I also treat isolated lesions with fine wire diathermy, TCA & surgical excision. Laser resurfacing probably gives the best outcome, whilst surgical excision gives the highest cure rate.
Will laser get rid of all syringomas?
No. When I apply ablative lasers it is to remove as much as we possibly can whilst minimising the risks of scarring & pigmentation. During the laser procedure I will have an understanding of the depth of these lesions. In some cases, I remove 95% of syringomas in one sitting, in others it may only be 40%. The deeper I chase these lesions, the higher the chances of scarring.
How long will it take to heal after laser?
6-9 days. This is when skin heals so that make up can be worn. This is very different from skin colour changes after the procedure. In Asian patients you will get skin colour changes lasting 2-12 weeks, depending on the depth of treatment. Redness is not uncommon. I will give you an indication of healing times during the consultation.
Is treatment painful?
No. I prefer to laser these lesions under mild sedation. Additionally blocks & numbing cream makes this a tolerable procedure. It takes approximately 30 minutes to complete laser surgery.
Can syringomas recur?
Yes, recurrence is the rule as the cause is genetically coded in the DNA of your skin. All treatments can reduce the look of syringomas, however the majority recur within a decade of treatment.
The use of intradermal BOTOX can reduce eccrine gland activity *sweat gland & in some cases provide longer remission.
How much is treatment?
Medicare partially covers this treatment. I can give you a better idea during the time of the consultation.
All syringoma treatments are done by Davin Lim. Milia on the other hand are managed by my nurses & therapists as the latter do not require laser surgery.
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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