Xanthelasma

What is xanthelasma?

Xanthelasma, or xanthelasma palpebrarum (XP), is a harmless, yellow growth that appears on or by the corners of your eyelids next to your nose. Cholesterol deposits build up under your skin to form a xanthelasma.

Having xanthelasmas could be a sign of another condition, such as:

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

Researchers have found that having xanthelasmas means it’s very likely that you’ll have these conditions in the future:

• Heart disease.
• Heart attack.
• Atherosclerosis (even if your cholesterol levels are normal).
• High cholesterol.

Who does xanthelasma affect?

Half of the people with xanthelasmas have high cholesterol levels. Healthcare providers usually see these levels in people with the kind of high cholesterol you get from your parents or some liver diseases.

However, the other 50% of people with xanthelasmas don’t have high cholesterol.

Risk factors for xanthelasma include being assigned female at birth or having:

• Overweight.
• A tobacco product habit.
• High cholesterol.
• Diabetes.
• High blood pressure.
• Family history of high cholesterol or xanthelasma.

You can get xanthelasmas between ages 20 and 70. Most people get them between ages 35 and 55.

How common is xanthelasma?

Xanthelasmas are the most common type of xanthoma (cholesterol deposits) that affect your skin. However, only about 1% of people have xanthelasmas.

What are the symptoms?

Xanthelasmas are areas of yellow skin around your eyelids. They may be:

• Flat or bumpy.
• Soft or firm.
• Uncomfortable.

What causes xanthelasma?

Possible xanthelasma causes include:

• High cholesterol you inherit from your parents.
• Diabetes mellitus.
• Weight gain.
• Thyroid issues like hypothyroidism.
• Inflammation.
• Drinking too much alcohol.

Does xanthelasma mean you have high cholesterol?

Yes, it’s very likely that you have high cholesterol if you have xanthelasmas. High cholesterol doesn’t cause any symptoms at first. A blood test can tell you if you have it.

You can bring cholesterol down to a normal level in these ways:

• Eating more vegetables and fruits and fewer fatty foods.
• Exercising more.
• Taking cholesterol-lowering drugs.

How is xanthelasma diagnosed?

Your healthcare provider will be able to see xanthelasma on the skin around your eyelids. You can have one or more xanthelasmas. If you have more than one, they may look the same on each eyelid.

What tests will be done to diagnose xanthelasma?

A xanthelasma diagnosis doesn’t require tests, but your healthcare provider may want to check your:

• Cholesterol levels to check for high cholesterol.
• Thyroid function to see if you have a thyroid problem.
• Blood sugar to find out if you have diabetes.
• Liver function to find out if you have liver disease.

Can xanthelasma go away on its own?

No. A xanthelasma doesn’t go away without treatment. Instead, it stays the same size or gets bigger. You can’t pop or squeeze a xanthelasma like a pimple. Products you can buy without a prescription and use on your own could burn your skin, so it’s best to see your healthcare provider instead.

What is the best treatment for xanthelasmas?

Xanthelasma removal by a healthcare provider is the best option. Your provider will most likely want to use liquid nitrogen cryotherapy as a first-choice removal method.

Although your provider may ask you to change to a low-fat diet and take a statin, those steps won’t get rid of the xanthelasmas you already have.

How are xanthelasmas removed?

Although xanthelasmas don’t hurt you, you may want to remove them anyway. Xanthelasma removal methods include:

• Surgery.
• Liquid nitrogen cryotherapy (using extreme cold).
• Laser surgery.
• Radiofrequency ablation (sometimes with stitches afterward).
• Chemical peel.
• Surgery using extreme heat.

These xanthelasma treatments usually work. However, you may need several sessions to remove your xanthelasmas.

Xanthelasmas often come back after removal, no matter which treatment you get. The chance of recurrence can be lowered if you work with your doctor on lowering your cholesterol.

Side effects of the treatment

Side effects from removing xanthelasmas include:

• Skin color changes.
• Scars.
• Pain.
• Eyelid turning inside out or looking like it’s getting pulled in further toward your eye.

How long does it take to recover from this treatment?

It can take three or four days to recover from xanthelasma treatment, depending on which treatment you get. Some side effects go away in days, while others (like skin discoloration) take a couple of months to go away.

How can I reduce my risk?

You can reduce your risk of xanthelasmas in these ways:

• Reduce high cholesterol if you have it.
• Don’t use tobacco products.
• Achieve a weight that's healthy for you.
• Treat diabetes and high blood pressure.

What can I expect if I have xanthelasma?

While xanthelasmas can be signs of other health conditions, they aren’t harmful themselves. People usually seek treatment because they don’t like the way xanthelasmas look. To have the most accurate prognosis, your healthcare provider will check your cholesterol level and perform other blood tests.

How do I take care of myself?

You don’t need to do anything to care for xanthelasmas because they’re harmless. However, the skin around your eyelids may need special care after xanthelasma removal. For example, you may need to apply an antibiotic to your eyelid skin.

Also, because xanthelasmas are an indicator or warning sign of high cholesterol and heart issues, you should follow your healthcare provider’s instructions for keeping your heart healthy.

When should I see my healthcare provider?

If you have your xanthelasmas removed, go to follow-up appointments with your healthcare provider. The checkup schedule may vary depending on which type of xanthelasma treatment you had. You may have appointments one month and three months after your procedure, for example.

Contact your provider if you’re having bothersome side effects from xanthelasma treatment. You should also let them know if your xanthelasmas return.

What questions should I ask my doctor?

• Which treatment is the best option for my situation?
• How long will my recovery be for the specific treatment I’m getting?
• How many cases have you treated that are like mine?
• Do I need to be checked for high cholesterol and heart disease?

A note from Cleveland Clinic

Although your biggest concern right now may be the way your xanthelasmas look, you can rest assured that treatments are available. You may need to be patient, as it can take several appointments to remove your xanthelasmas completely. Your healthcare provider will likely be concerned about your cholesterol. Getting treatment for high cholesterol may not be what you had in mind, but it can help prevent heart problems in the future.