Xanthelasma (yellow deposits in eyelids)

What is xanthelasma?

Xanthelasma are yellow deposits in the skin of the eyelids. They can be flat or slightly raised. They form when deposits of cholesterol (lipid or fat) build up under the skin. While xanthelasma themselves are not harmful, they can be a sign of high cholesterol and heart disease.

What causes xanthelasma?

Up to half the people with xanthelasma have high cholesterol levels in the blood, but the other half or more have normal cholesterol. There may be other factors such as inflammation and leaking blood vessels that lead to xanthelasma, as it is more common in people with diabetes, high blood pressure, and if you smoke or are overweight.

How is xanthelasma diagnosed?

Xanthelasma is diagnosed clinically by a doctor looking at the skin around your eyes. We may order tests to check the levels of lipids/cholesterol in your blood. This can show if there is a potential underlying health issue causing your xanthelasma.

How is xanthelasma treated?

Xanthelasma do not go away on their own. They tend to stay the same size or grow larger. While they are generally harmless, you may want to have them removed for cosmetic reasons. Xanthelasma is treated by removing the skin containing the lesion and repairing the defect with sutures. Sometimes this is done in conjunction with upper lid blepharoplasty surgery. Xanthelasma can recur after surgery.

Other treatments are used including:

• cold or freezing surgery (called cryotherapy)

• laser surgery

• heat surgery (electric needle radiofrequency)

• chemical peels
  

Most treatments are successful in removing xanthelasma at least temporarily. But there are potential side effects like scarring, changes in skin colour (hyperpigmentation or depigmentation) and recurrence of the lesion. If the lesion is large, recurrent or deep, surgery is the treatment of choice.

What can I do to prevent xanthelasma?

Taking care of your general health may not make xanthelasma go away, but it may prevent recurrence after treatment and it will improve your health and wellbeing.  Taking steps to care for yourself with a healthy diet, regular exercise and no smoking or drinking alcohol, can help prevent recurrence of xanthelasma and support you to feel great again.

Xanthelasma can be a sign of other disease

If you have xanthelasma, it is important to see your doctor for regular checkups to make sure you don’t have high cholesterol and are not at risk of a heart attack or stroke. Together we can take care of you to keep your eyes, your heart and the whole of you in good health.