"Several little bumps have come up under my eyes — is this different from milia?"
"If I get this treated once, does it clear up completely?"
These are the questions people ask most when those little grainy bumps around the eyes start to increase.
This is Director Kwon Si-jin of DA Clinic Myeongdong.
We're getting ready to open our doors in Myeongdong soon, and since so many people have been asking about syringoma ahead of our opening, we wanted to put together this overview for your information first.
We're writing this because a lot of people really do mistake it for milia and end up leaving marks by squeezing it.
Syringoma differs in nature from milia and doesn't end in one go — let me tell you why, plainly.
Syringoma Is a Benign Tumor That Originates in the Sweat Glands
Syringoma is a small benign tumor originating in the sweat gland tissue that releases sweat, and it refers to a pattern of multiple skin-colored or pale-yellow grainy bumps distributed around the eyes.
Let me first go over what syringoma actually is.
If milia are shallow pouches with trapped waste, syringoma differs in nature in that it's a lesion formed by the skin tissue itself changing.
Because it's benign it doesn't threaten your health, but it often appears clustered under the eyes or on the cheekbone area.
There's a Reason Why It's Hard to Finish in One Go
There's a clear reason why clearing up syringoma doesn't wrap up in a single session.
Syringoma is a lesion rooted not at the skin surface but relatively deep, down into the dermis.
If you only clear the surface, the tissue remaining deeper can become prominent again, and if you force it and go too deep, the burden of scarring only grows instead.
So rather than trying to remove it all at once, we approach it by dividing it over multiple sessions, reducing it in stages and watching how it progresses.
The Principle Is to Reduce the Lesion Tissue Little by Little
When dealing with syringoma, we proceed on the principle of reducing the prominent lesion tissue very gradually.
The CO2 laser works by having its light energy absorbed into water, using the resulting heat to precisely reduce only a narrow range of tissue, which is a principle that lets us work while reducing damage to the surrounding skin.
That said, if you try to remove even the deep-layer tissue all at once, the risk of scarring grows, so we clear it in stages, starting from the parts near the surface.
For these reasons, syringoma is closer to a 'concept of managing it lighter in stages' than a 'treatment that removes it completely.' (Responses and progress vary by individual)
Think of it as management rather than a one-off clearance
The first thing to hold onto with syringomas is expectation.
Syringomas often have a constitutional element, so even after clearing they can become prominent again in the same area or elsewhere over time.
So medically it's seen less as "making them disappear entirely" and more as reducing how prominent they are and managing them from there.
The eye area is thin skin too, so overreaching can lead to pigment changes or marks, which makes a careful approach important.
Rather than expecting "smooth in one go," seeing it as a process of easing the burden across several sessions will sit more comfortably.
What the CO2 laser does
The CO2 laser is what's most used for lesions. Knowing the principle makes the recovery make sense.
It's described as working by being absorbed by water in the tissue and vaporising it. Closer to boiling water off than to burning.
Two things follow from that.One is that the depth can be controlled finely; the other is that the treated site is left with a wound that goes through a healing process.That's where the scab forming and coming away comes from.
At our Myeongdong clinic we have Hestia in the CO2 family.
Recovery runs in this order
- Day 1 to 3a scab forms at the treated site. Best to avoid water contact and rubbing
- 1 to 2 weeksthe scab comes away naturally. Picking it off makes a mark likely
- The months afternew skin looks red, then gradually fades
Many people think it's over once the scab falls off, but whether pigment remains is decided in the months that follow. Red skin makes pigment easily, so taking sun on it then can leave a brown mark.
So there are three things to attend to during recovery: moisturising, keeping it covered, and sun protection.For ointments and dressings, following the instructions from where you had it done is safest.
People in These Situations Should Check One More Time
Clearing syringoma isn't a treatment casually recommended in every situation.
If you have a constitution where wounds don't heal well or a tendency toward keloids, the burden of marks remaining is greater, so it's safer to check your condition first and then decide whether to proceed.
If your skin tone is on the darker side or you get pigmentation easily, pigment changes can follow during recovery, so it's better to look at it carefully.
If there's inflammation or herpes at the treatment area, or it looks mixed in with milia or other skin lesions, it's more accurate to have your condition checked directly and then decide, rather than concluding by sight alone.
- Syringoma comes from the sweat gland
- They are reduced and faded over several sessions
- It is a different thing from milia
Frequently Asked Questions
Q. If I get it treated once, does it disappear completely?
A. Syringoma isn't a lesion that gets cleared completely in one go. It's a benign tumor rooted down into the deep layers of the skin, so if you clear only the surface, the remaining tissue can become prominent again, and if you force it and go too deep, the burden of scarring grows.That's why we approach it by dividing it over multiple sessions, reducing it in stages and watching how it progresses. Since it often has a constitutional factor, it can appear again over time, so it's closer to a concept of managing it lighter than a treatment that removes it completely.The number of sessions needed and the progress vary depending on the count, depth, and skin condition, so please keep in mind that there are individual differences.
Q. How are milia and syringoma different?
A. Both look like little bumps around the eyes and are easy to confuse, but their nature differs.Milia are closed pouches where sebum or dead skin is trapped in a shallow layer, so they're cleared relatively shallowly and are usually sorted out in one go. Syringoma, on the other hand, is a benign tumor originating in the sweat glands where the skin tissue itself has changed and settled into the deeper layers, so it's often handled in stages over multiple sessions.Since the handling method and expectations differ from each other, it's more accurate to have your skin condition checked and determine which one it's closer to, rather than distinguishing it yourself.
Q. How high is the risk of scarring or recurrence?
A. Because syringoma is a lesion settled down into the deep layers, forcing it to remove it all at once can bring on scarring or pigment changes, so we approach it in stages.Clearing it finely in a controlled environment does head toward reducing the burden, but the skin around the eyes is thin, so scabs or redness can remain for a few days right after clearing it.Also, if there's a constitutional factor, it can become prominent again in the same spot or a different one over time. So it's better to know in advance that there are individual differences in the chance of recurrence and the recovery process, and it's hard for us to promise that no marks at all will remain.
Q. How do I tell them from milia?
A. They look alike and are hard to separate by eye.Milia are closer to a sac of trapped keratin, while syringomas are described as arising from sweat glands, so the approach differs.Don't judge by whether something comes out when squeezed — have it checked.
Q. Why is it done across several sessions?
A. The lesion is settled within the skin, so handling it deeply in one go raises the risk of a mark.Reducing it gradually across sessions is described as safer in the end.
Q. If they come back, has it failed?
A. No. They're known to be difficult to finish in one go, so the approach is one of management. Recurrence itself sits within expectations.
Reducing, not removing
Gather up everything to this point and it comes to this.
Rather than a treatment that removes it in one go, syringoma is closer to management that lightens how prominent it is over several sessions.
What I asked at the very top — has it come together for you now?
If those little grainy bumps around your eyes have been on your mind, it's fine to approach it in the direction of seeing it in stages, rather than trying to finish it in one go. Just please remember that there are individual differences in the number of sessions and the result.
DA Clinic Myeongdong is set to open soon.We'll share news of our opening and treatment information first on our blog and Instagram ^^
Thank you for reading.This was Director Kwon Si-jin of DA Clinic Myeongdong.
This column is an informational article meant to provide general medical information, and the effects and side effects of treatments may vary by individual. DA Clinic Myeongdong is set to open soon. (Medical Service Act Art. 56)