Xanthelasma

  • Best Results1-2 sessions
  • Treatment Recovery5-8 days
  • Procedure Time30 minutes
  • Skin SpecialistDr Davin Lim
  • Duration of ResultsVariable
  • AnaestheticLocal, sedation
  • Back to WorkVariable
  • Cost$$ Medicare

Xanthelasma

Xanthelasma are yellow patches commonly found in the inside corners of the eye. In some cases, they involve the upper & lower eyelids. Xanthelasmas are soft plaques of cholesterol deposits. They may be a marker of heart disease.

FactsFacts on Xanthelasmas

  • These are soft fatty deposits surrounding the eye
  • They can be a maker for increased cholesterol levels
  • One third of patients will have elevated blood lipids
  • Xanthelasma can be treated with surgery or laser resurfacing
  • Keeping cholesterol levels low can reduce recurrence in some
  • Xanthelasmas are asymptomatic

What are xanthelasmas?

Xanthelasma is the most common form of lipid or cholesterol skin build up. They are located on the upper and lower eyelids. Xanthelasmas start off as yellow patches & bumps that enlarge over years. They are yellow to orange in colour.

What are your chances of having high cholesterol?

Xanthelasma are associated with elevations in lipids in over one third of cases. If you have signs of xanthelasma it is prudent to see your doctor to see if your cholesterol is elevated. Elevated cholesterol levels are a marker of heart disease & stroke.

How to treat xanthelasma?

My primary treatment is with a laser, either an erbium or a CO2 laser. In most cases one laser resurfacing session addresses 60 to 95% of the lesion. For XXL xanthelasma, you may require two sessions of laser. In some cases, I combine surgery with laser (depending on the size and location).

Other methods to treat xanthelasma include TCA or phenol peels as well as RF ablation. Creams do not work.

Do xanthelasmas come back?

Yes. With laser & or surgical excision, xanthelasma can still return. This is because your skin has a genetic abnormality that predisposes to recurrence. Most patients will have remission for 4-10 years.

Davin’s viewpoint on xanthelasma treatments

Xanthelasmas are common benign eyelid or periocular tumours. The incidence is around 1%. In over a third of cases there are elevated cholesterol levels in the blood. Rarely, this condition is familial (familial dyslipidaemia). Hence, the first step is a fasting lipid level via your GP. With extensive xanthelasma or atypical lesions, other forms of xanthomas are in the differential.

There are rare cases of eyelid xanthomas involving reduction in cholesterol levels (Zocor statin). This is the exceptional, rather than the rule. Lasers provide a good reduction in most cases. In extensive eyelid involvement, I may excise & laser, or perform a two-step procedure. Healing takes place over a week or more.

If there is no access to CO2 or erbium lasers, RF or even cautious cryotherapy may be attempted. Another simple option is application of TCA 35 to 50%, two to three coats. With TCA or phenol peels, 2-4 sessions are required. Xanthelasmas can be recurrent. I cannot predict the timeframe.

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