Understanding Xanthelasma: Causes and Treatment

Curious about those yellowish spots around the eyelids?

These spots are soft, flat, or slightly raised and often appear near the inner corner of the upper or lower eyelid. Although xanthelasma is usually harmless and painless, it may signal issues with cholesterol levels.

Causes and Risk Factors

Xanthelasma happens when cholesterol builds up in skin cells. This can be caused by genetics, high blood fats, or metabolic issues. People with certain cholesterol disorders, like familial hypercholesterolemia, have a higher risk of xanthelasma.

Xanthelasma is more common in middle-aged and older adults, especially women, and those of Asian and Mediterranean backgrounds. Other risk factors include diabetes, obesity, smoking, and high blood pressure, all of which can lead to abnormal blood fat levels.

Symptoms and Diagnosis

Xanthelasma is easy to spot due to its unique look. It shows up as yellowish plaques on both eyelids, often soft and ranging in size from a few millimeters to a few centimeters. It’s not painful, but some may find it affects their appearance.

Doctors usually diagnose xanthelasma simply by looking at it. Sometimes, they may do a biopsy to be sure. This test would show fat-filled cells in the skin, confirming xanthelasma.

Treatment Options

Xanthelasma doesn’t need treatment for health reasons, but many choose removal for appearance. Treatment options include:

1. Surgical Removal: This is the most reliable method. It removes the plaques under local anesthesia, but there may be scarring.
2. Laser Therapy: Carbon dioxide and argon lasers can remove xanthelasma with minimal scarring. 
3. Chemical Peels: Chemicals like trichloroacetic acid (TCA) remove plaques by causing controlled skin damage, which heals and clears the plaques. This can cause skin irritation or color changes.
4. Cryotherapy: Freezing with liquid nitrogen is simple but may not work for larger plaques. However using liquid nitrogen close to the eyes can make some patients very uncomfortable. 
5. Medications: Lipid-lowering drugs like statins can help manage blood fats, possibly shrinking the plaques or slowing their growth. However these are not direct treatments for xanthelasma.

With all methods of removal, there is always the risk that the Xanthelasma may return.

Conclusion

Though mainly a cosmetic issue, it can signal lipid problems that may need medical care. Treatments can remove the plaques, but they can come back. Prevention focuses on managing high cholesterol and making healthy lifestyle choices. Anyone with xanthelasma should see a healthcare provider to check for any related health risks.