Enlarge view Site map Search Skin cancers are often found on or around the eyelid skin, most usually on the lower eyelid. They can also be found on the margins of the eyelid, corners, eyebrows or rarely near the eye on the conjunctiva (the inner lining of the eyelid).
They appear as lumps or elevations of the skin or as small swellings or nodules. In some cases, eyelashes are distorted or missing. The cancerous area may be ulcerated, may bleed or crust and the skin shape may be distorted. These cancers are painless. Diagnosis may need to be confirmed by taking a sample of skin (a biopsy).
Skin cancers are normally caused by excessive exposure to UV light — the sun or sun beds. The face, eyelids and arms are the main areas to be affected and fair-skinned people are much more likely to develop skin cancer than those with darker skin. Rarely, skin cancer can be an inherited condition.
Basal cell carcinoma (BCC) is the most common form of UK skin cancer, also known as rodent ulcer. Early signs can include small lumps, scar-like or eczema-like changes on the skin. You may also see a small sore with raised borders.
The second most common type is squamous cell carcinoma (SCC). The first sign of this can be a patch of scaly eczema. It is generally located near an orifice, such as the eye, mouth or ear.
These two cancers spread locally, are slow-growing but can invade neighbouring parts of the body. They do not spread (metastasise) into non-adjacent areas. When detected early, there is a good chance of removing the tumour completely and minimising the amount of tissue that needs to be removed.
Sebaceous gland carcinoma is a cancer of the glands that produce our natural skin oils and in 75 per cent of cases affects the glands around the eye. Causes vary and include triggers ranging from benign lumps to exposure to radiation and, rarely, a genetic condition called Muir Torre' syndrome.
Malignant melanoma is cancer of the melanin-forming cells that give you a tan. The more moles you have on your skin, the higher the risk of developing a melanoma. This usually looks like a large mole, which becomes itchy and painful, grows or becomes irregular. It may get darker, become mottled or bleed for no apparent reason.
Again, excessive UV exposure is the major cause of melanoma. Fairer-skinned people are more likely to develop it and there may be a genetic link in some cases. These are more serious forms of skin cancer because they may metastasise to other parts of the body. They need prompt, aggressive treatment because of the threat of early spreading.
"How grateful I am for the magnificent job you have done repairing my eyelid. I realise how lucky I have been to have your attention and to have achieved such a very good result. My family are all amazed and delighted with the outcome."
To prevent a recurrence, the tumour should be removed completely, while as much healthy tissue as possible is preserved. Removal may be followed by reconstructive surgery, which could involve a skin graft.
The general approach to removing skin cancer is known as margin-controlled excision, where the edge of the cancer is identified and the growth within this area is removed. It normally takes place under a local anaesthetic.
Several methods are available:
For full information about what to do before and after surgery, see Patient information, which you can download as a pdf.
One of the most advanced treatments for skin cancer is named after the man who invented it in the 1930s, Dr Frederick Mohs. In Mohs' surgery, the tumour is removed piece by piece. Each piece is immediately frozen and examined under a microscope. If some cancer might still be present, more tissue is removed and examined. This goes on until there are no signs of any cancer cells. Reconstruction is then carried out.
Mohs Micrographic Surgery (MMS) relies on the surgeon also being a pathologist and identifying cancer cells. The surgery is very precise and means that the maximum amount of healthy tissue is retained, while removing cells that could cause a recurrence of the cancer.
The cure rate for MMS is up to 99 per cent for skin cancers that have not been treated by other methods and more than 90 per cent where other forms of treatment have failed.
Some tumours do not respond to common treatments, including those greater than 2cm in diameter, those in difficult locations, such as the eyelid, and tumours complicated by previous treatment. Removing a recurring skin cancer is more complicated because scar tissue makes it difficult to differentiate between cancerous and healthy tissue. Again, the Mohs approach makes effective treatment possible.
Mr Malhotra recommends MMS to treat difficult basal cell carcinomas (BCC), and squamous cell carcinomas (SCC). Both are most often caused by excessive exposure to UV light from the sun or sun beds.
It can also be used to treat less common tumours, including melanoma, sebaceous carcinoma (SG) or microcystic adnexal carcinoma (MAC) — a tumour of a facial sweat gland. These may require more than one visit as often the skin pieces need to be processed as paraffin sections, which takes considerably longer, in order to provide greater clarity.
MMS is particularly useful when:
All procedures begin with a consultation. For full information about what to do before and after surgery, see Patient information.
Benign eyelid lump — Chalazion
Benign eyelid lump — Chalazion — Patient information
Cataracts — Patient information
Drooping upper eyelids — Ptosis
Drooping upper eyelids — Ptosis — Patient information
Excessive, involuntary blinking — Blepharospasm
Excessive, involuntary blinking — Blepharospasm — Patient information
Eye bags/heavy eyelids — Blepharoplasty
Eyelid skin cancer — Patient information
Facial paralysis — Facial palsy
Facial paralysis — Facial palsy — Patient information
Inward-turning eyelid — Entropion
Inward-turning eyelid — Entropion — Patient information
Outward-turning lower eyelids — Ectropion
Outward-turning lower eyelids — Ectropion — Patient information
Thyroid eye disease — Patient information
Watery eye — Epiphora — Patient information
Artificial eyes and orbital implants
Artificial eyes and orbital implants — Patient information
Asian eyelid surgery — Patient information
Brow lift — Patient information
Cataract removal and lens replacement
Chemical peel — Patient information
Eyelid lift — Blepharoplasty — Patient information
Cheek and facial contouring — Patient information
Lip filling and shaping — Patient information
Tear trough fillers — Patient information
Upper eyelid contouring — Patient information
Mohs surgery — Patient information