Apocrine Hydrocystoma Removal in London – Consultant Dermatology Care

What Is an Apocrine Hydrocystoma?

An apocrine hydrocystoma is a benign, fluid-filled cyst that arises from apocrine sweat glands located in the eyelids and certain facial areas. These glands normally produce a small amount of scent-related sweat and open into hair follicles. When their duct becomes blocked, a cyst can form, creating a smooth, translucent bump. Because the cyst contains clear fluid, light passing through it can produce a blue-grey or smoky appearance — hence why many hydrocystomas look bluish despite being filled with colourless fluid.

Hydrocystomas are not dangerous and do not turn into cancer. People seek advice because the lesion is visible, occasionally enlarges, or looks similar to other eyelid growths that need different management. On the eyelid margin, a bump can catch on make-up applicators or contact lenses, and larger cysts can press on lashes or create minor visual distraction.

Apocrine vs Eccrine Hydrocystoma

Two main hydrocystoma types are described: apocrine and eccrine. They look similar but behave a little differently. Eccrine hydrocystomas are sweat retention cysts linked to eccrine glands and may enlarge in warm weather or with heat and humidity, sometimes appearing in multiples on the cheeks. Apocrine hydrocystomas more often occur as single lesions on or near the eyelids and are generally stable in size. Both are benign and treated with similar techniques; careful examination helps us decide the most suitable approach.

How They Present: Signs Patients Notice

• Appearance: a round or oval dome, 2–10 mm across, smooth and shiny. Colour ranges from clear to blue-grey or brownish depending on depth and light scatter.
• Surface: intact skin with no scale or ulcer. A very fine blood vessel may be visible over the surface.
• Feel: soft-firm and slightly compressible; often refills after gentle pressure.
• Symptoms: typically painless, though rubbing can make it tender. Vision is unaffected unless the lesion is large and on the margin.
• Course: slow growth over months; size may fluctuate slightly. Spontaneous disappearance is uncommon; simple puncture tends to recur.

Why Get Apocrine Hydrocystoma Checked?

While hydrocystomas are benign, certain eyelid and facial lesions can look similar at first glance. Accurate diagnosis protects you from both under- and over-treatment and offers peace of mind. We pay attention to colour, translucency, the presence of surface vessels, lash loss, ulceration and how the lesion behaves under magnification and gentle pressure. If the features are entirely typical, treatment can proceed in clinic. If anything is atypical, we explain whether imaging or pathology confirmation is sensible before or after removal.

Conditions That Can Look Similar (Differential Diagnosis)

• Basal cell carcinoma (BCC): classically a pearly, firm papule with fine surface vessels and sometimes central ulceration, often with lash loss at the lid margin. Unlike hydrocystoma, BCC is not translucent and tends to feel firmer and more tethered.
• Epidermoid cyst/“milia”: white or yellow, with a central punctum; not translucent.
• Blue naevus/other pigmented naevus: deeper blue colour without translucency; pigment rather than clear fluid causes the hue.
• Haemangioma/venous lake: compressible, dark red-blue vascular lesions; they blanch with pressure differently from cysts.
• Chalazion: a meibomian gland swelling in the eyelid; usually deeper, tender early on and not translucent.

Apocrine Hydrocystoma Diagnosis at Skinhorizon

Diagnosis is usually clinical. We take a short history (onset, change, symptoms, previous procedures) and examine the lesion under good lighting and magnification. Dermoscopy (a magnified, polarised light tool) helps confirm translucency and the absence of suspicious surface features. If removal is planned, we document size and site; for eyelid-margin lesions we consider lash direction and lid contour to maintain a neat result. Rarely, if the appearance is atypical or the lesion recurs unusually quickly, we recommend sending the tissue for histology to confirm the diagnosis.

Apocrine Hydrocystoma Treatment Options

The right approach depends on size, site, cosmetic goals and whether a specimen is desired for confirmation. Your clinician will guide you through the options and set expectations for healing.

Observation (Watchful Waiting)

If the lesion is small, typical and not bothersome, doing nothing is perfectly reasonable. We provide guidance on when to return (for example, if it grows, changes colour, becomes sore or bleeds).

Needle Drainage (Temporary)

Using a sterile needle to release the fluid can flatten the cyst quickly, offering short-term improvement before an event or photo. However, because the cyst lining remains, recurrence is common. We present this as a temporary option or as a first step before a definitive method.

Electrocautery with/without Curettage

A fine-tip device delicately opens the cyst and seals the lining to reduce recurrence. This can work very well for small, superficial lesions and those near the eyelid margin when performed with protective shielding. A tiny flat mark or colour change may occur initially and typically settles with time and good aftercare.

Laser (e.g., CO₂ or Erbium)

Laser can precisely vaporise the cyst roof and lining with excellent control in skilled hands, especially for very small or cosmetically prominent lesions. Cooling and careful energy settings protect surrounding skin, which is especially important on the lids.

Surgical Excision

For larger or recurrent hydrocystomas, or when laboratory confirmation is preferred, local anaesthetic excision removes the entire cyst and lining through a small incision aligned with natural lines. This offers the lowest recurrence risk and provides a specimen for histology. Stitches (if used) are fine and typically removed within a week at the eyelid; dissolving options may be chosen elsewhere on the face.

Comfort, Safety and Aftercare

Minor eyelid procedures are brief and well tolerated. A tiny amount of local anaesthetic quickly numbs the area; you may feel pressure but not pain. After treatment, mild swelling or bruising can occur for a few days, more so with lower-lid lesions due to gravity. We will give you clear aftercare, which usually includes:

• Keeping the area clean and dry for the first day; then gentle cleansing without rubbing.
• Applying a thin film of protective ointment as advised.
• Avoiding mascara, eyeliner and contact lenses on the treated side until the surface has sealed.
• Using cool compresses for comfort in the first 24–48 hours.
• Sleeping slightly elevated the first night or two to limit swelling.

Make-up is usually fine after 48–72 hours if the surface is intact. A tiny flat, pink or slightly darker spot may persist for several weeks as the skin remodels; it blends in over time. Sun protection helps maintain an even tone.

Skin of Colour Considerations

Hydrocystomas occur across all skin tones. In medium to deep skin, there is a higher tendency to temporary post-inflammatory hyperpigmentation after procedures. We minimise this risk by using conservative energy settings, shielding and meticulous technique, and by spacing any staged treatments. Once the surface has healed, simple pigment-balancing skincare can help any temporary colour change fade, alongside daily SPF for exposed areas.

Recurrence and Future Care

Recurrence depends on technique and whether the cyst lining is fully treated. Needle puncture alone offers the highest recurrence; cautery/laser and excision have lower rates. New hydrocystomas can develop at other sites because the underlying glands remain — this reflects individual tendency rather than anything you did. If you are prone to multiple lesions, we can plan occasional tidy-up sessions at a pace that suits your diary.

Prevention and Practical Tips

• Gentle eyelid care: avoid vigorous rubbing; use fragrance-minimal removers and soft pads for make-up.
• Heat management: while apocrine lesions are less heat-sensitive than eccrine types, avoiding hot, humid environments directly after procedures reduces swelling and speeds recovery.
• Contact lens hygiene: insert after healing has sealed; consider spectacles for a few days if the cyst is on the margin.
• Sun protection: hats and daily SPF protect healing skin and support even tone.

When to Seek Prompt Review

• A lesion that ulcerates, bleeds repeatedly or causes lash loss.
• A rapidly enlarging, firm or irregular lesion.
• Persistent redness, pain or swelling after a procedure beyond the expected course.

These features are not typical of a simple hydrocystoma and should be checked promptly. We will escalate assessment and, if needed, arrange a sample for analysis to keep you safe.

Why Choose Skinhorizon?

We provide high-quality advanced dermatology and aesthetic care with consultant oversight. Eyelid and peri-ocular skin demands finesse: accurate classification at the outset, the right technique for your lesion and skin tone, and clear aftercare to protect comfort and appearance. Our approach is conservative where appropriate, decisive when needed, and always focused on natural-looking results with minimal downtime.

Your First Visit — What to Expect

1. Assessment: concise history; magnified examination and dermoscopy; photographs for your record.
2. Discussion: confirm diagnosis; agree whether observation, in-clinic treatment or excision is best for you.
3. Procedure (if chosen): brief, eyelid-safe technique under local anaesthetic; protective measures for the eye as needed.
4. Aftercare: written, step-by-step guidance; how to clean, when to resume make-up and contact lenses; sun-smart advice.
5. Follow-up: a simple review to ensure smooth healing and to discuss any histology results if applicable.