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Xanthelasma

Dr Ben Wild

Overview

The eyelids are made up of various types of skin, muscle, glands, hair follicles and much more. The outer skin is the normal, tough, keratinizing skin found all over the body. The inner eyelid skin, known as the palpebral conjunctiva, is more delicate non-keratinizing skin.

Healthy eye

Frontal image of a healthy eye.


Xanthelasma is a condition characterized by yellow patches of skin on or around the eyelids. Although their appearance may be startling, these plaques are not harmful. They tend to progress slowly over time and are usually noticed on both sides of the head beneath the skin near the nose, on the eyelids, or around the eyelids.


The cholesterol plaques, although not harmful themselves, could be a sign of high low-density lipoprotein (bad cholesterol) and/or low high-density lipoprotein (good cholesterol). Both of these conditions could lead to early heart disease.

Xanthalasma

Frontal image of yellow xanthelasma spots.

Signs and Symptoms

Signs

Usually bilateral, yellowish subcutaneous cholesterol/lipid plaques typically seen nasally around the eyelids.


Symptoms

There are no symptoms.

Causes and Risk Factors

Causes

High blood cholesterol levels found in 1/3 to 1/2 of patients with xanthelasma.


Risk Factors

Middle age to elderly, female.

Prevention and Treatment

Prevention

Ensure a healthy lifestyle through diet and exercise.


Treatments

Treatments aim at improving the appearance of the yellow plaques.

· Lower cholesterol levels through diet and/or medication

· Excision

· Microdissection

· Laser ablation

· Dissolve with acetic acid solution (do not perform at home as some acetic acid solution can be corrosive)

· Chemical peels

Prognosis

Xanthelasma itself is not harmful to the eyes or vision, although, it may be the first sign of high blood cholesterol which can lead to heart disease. It is important to get tested early to know if you’re at risk. Otherwise, the yellow plaques are easily treated. Unfortunately, in 50% of people with high cholesterol, these plaques tend to reoccur.

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