What are xanthelasma and how can they be treated?

beckylouford
5 hours ago
3 min read

Xanthelasma are yellowish, flat or slightly raised patches that appear on or around the eyelids. While they are harmless and painless, these deposits can cause cosmetic concerns for many people. Understanding what xanthelasma are and the options for their removal, especially surgical treatment, can help those affected make informed decisions about managing this condition.

What causes xanthelasma?

Xanthelasma develop due to the accumulation of cholesterol-rich fatty deposits beneath the skin. These deposits often form near the inner corners of the upper and lower eyelids. Although they can appear for no specific reason, xanthelasma may be linked to certain health conditions:

Elevated cholesterol or lipid levels in the blood
Certain medical conditions such as diabetes or liver disease
Genetic factors that affect lipid metabolism

People with high cholesterol or other lipid disorders are more likely to develop xanthelasma, but they can also appear in individuals with normal cholesterol levels.

How do xanthelasma affect appearance and health?

Xanthelasma typically appear as soft, yellow plaques that can vary in size. They are usually symmetrical and painless. While they do not usually cause physical discomfort or vision problems, their location on the eyelids makes them highly visible, which can affect self-confidence and facial aesthetics.

From a health perspective, xanthelasma themselves are not dangerous. However, their presence may indicate underlying lipid imbalances that require medical attention. If you have xanthelasma it is therefore advisable to consult a healthcare provider to check cholesterol levels and overall cardiovascular risk.

Non-surgical treatment options

Before considering surgery, some people explore non-surgical methods to reduce or remove xanthelasma. These include:

Lifestyle changes: Improving diet, increasing physical activity, and managing cholesterol through medication can help prevent new deposits.
Topical treatments: Certain creams or chemical peels may lighten the plaques but often have limited effectiveness.
Laser therapy: Some lasers can target the fatty deposits, but multiple sessions may be needed, and results vary.

Non-surgical options may work for small or early-stage xanthelasma but often do not fully remove larger or more established plaques.

Surgical treatment for xanthelasma

Surgery offers a more definitive way to remove xanthelasma, especially when the deposits are large, persistent, or cause significant cosmetic concern. The main surgical approaches include:

Excision

This involves cutting out the xanthelasma under local anesthesia. Oculoplastic surgeons like Miss Ford can carefully remove the fatty deposits while preserving as much healthy skin as possible. Excision provides immediate results and is effective for larger plaques.

Skin grafting or flap reconstruction

In cases where excision leaves a significant skin defect, surgeons may use skin grafts or local flaps to restore the eyelid’s appearance and function. This approach is more complex but helps maintain eyelid movement and contour.

What to expect during and after surgery

Surgical removal of xanthelasma is usually done on an outpatient basis. The procedure takes about 30 minutes to an hour depending on the size and number of lesions. Local anesthesia numbs the area, so you will remain awake but comfortable.

After surgery, patients may experience:

Mild swelling and bruising around the eyelids
Temporary redness or tenderness
Sutures that dissolve or are removed within a week

Healing typically takes 1 to 2 weeks. Most people see a significant improvement in appearance with minimal scarring. Follow-up visits ensure proper healing and address any complications.

Risks and considerations

While surgery is generally safe, it carries some risks such as:

Scarring or changes in eyelid shape
Infection or bleeding
Recurrence of xanthelasma over time

Choosing an experienced surgeon who specializes in eyelid procedures reduces these risks. Patients should also manage underlying cholesterol issues to prevent new deposits.