Xanthelasma is a member of the xanthomas family and represents fatty deposits in the skin cells around the eyes. It is visible as yellow, harmless bumps.

What is xanthelasma?

  • Xanthelasma is the result of accumulation of cholesterol in the macrophages (cells in the skin around the eyes).
  • It is manifested by smaller or larger, symmetrical or asymmetrical yellow growths.
  • It can appear on the eyelids or subcutaneously, although xanthelasma under the skin is extremely rare.
  • Xanthelasma usually occurs in adults between the ages of 20 and 70. Most patients are between 35 and 55 years old.

Risk factors

The disease can particularly affect people:

  • Female
  • Overweight
  • Smoking
  • With diabetes
  • With high blood pressure
  • With hyperlipidemia (an increased cholesterol)
  • With atherosclerosis (even if cholesterol levels are normal)
  • Suffering from liver disease and heart disease
  • With a family history of xanthelasma

Xanthelasma can also be a sign of other diseases such as:

  •  Hyperlipidemia (high cholesterol)
  • Diabetes
  • Thyroid gland problems

Xanthelasma: Causes

The causes of xanthelasma can be multiple, which is why an ophthalmological examination is recommended for diagnosis. Among the most common are:

  • Genetic inheritance of high cholesterol
  • Weight gain
  • Thyroid gland disorders (hypothyroidism)
  • Inflammation
  • Diabetes mellitus
  • Excessive alcohol consumption

Symptoms of xanthelasma

Signs of xanthelasma are yellow spots on the eyelid. Initially they are flat, but over time they swell. Although harmless, they cause discomfort. They can be:

  • Soft or firm
  • On the upper or lower eyelid
  • Symmetrical or asymmetrical

Diagnosis and investigations

During the examination, the specialist will ask you questions about your medical history (genetic inheritance, risk factors, previous ophthalmological procedures, etc.) Then the doctor will perform a physical examination of your xanthelasma/xanthelasmas.

Diagnosing xanthelasma does not require further ophthalmological investigations, but if the specialist deems it necessary may request tests for:

  • Determination of lipid profile (cholesterol level)
  • Detecting a thyroid disorder
  • Screening for diabetes (sugar levels)
  • Determination of liver and kidney functions

Xanthelasma: Treatment

Several xanthelasma removal procedures are available:

  • Laser vaporization
  • Cryotherapy with liquid nitrogen
  • Radiofrequency ablation (4Mhz)
  • Electrodesiccation
  • Local applications of TCA acid
  • Surgery

Side effects of xanthelasma removal may include:

  • Skin color changes
  • Scars
  • Eyelid discomfort
  • Inward tilting of the eyelids (entropion)

Treatments for xanthelasma are usually effective. Some procedures may require several sessions to remove them completely.

There’s also a risk that it may reappear over time, so it’s important to have a diet that keeps your cholesterol levels within normal limits, quit smoking and don’t drink too much alcohol.

Frequently asked questions

Can xanthelasma disappear by itself?

No. Xanthelasma does not disappear without treatment. However, there is a possibility that they will stop growing once they reach a certain size.

How long does recovery take after xanthelasma removal?

It can take up to 3-4 days, depending on the treatment chosen. Some side effects of the procedure disappear within a few days, while others (skin depigmentation) may take several months to disappear completely.

How do I reduce the risk of illness?

Experts recommend:

  • A balanced diet, low in fat and rich in vegetables and fruit
  • Quitting smoking and alcohol
  • Regular exercise
  • Medication prescribed by the specialist doctor to lower cholesterol, treat diabetes or high blood pressure

It is essential not to squeeze xanthelasma or try to treat it yourself at home. Schedule an examination at one of Dr. Holhoș’ clinics and make sure you’re in good hands.

Text medically reviewed by Dr. Teodor Holhoș, Ophthalmic Surgeon
Written by Dr. Holhos Team

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