What are xanthelasmas?

Xanthelasmas are yellowish plaques that occur most commonly near the inner canthus of the eyelid, more often on the upper lid than the lower lid. Xanthelasma is the most common cutaneous xanthoma and it may be soft, semisolid, or calcareous. Frequently, they are symmetrical, and usually all four eyelids are involved. Xanthelasma tends to progress, coalesce, and become permanent. The term xanthelasma is derived from the Greek words“xanthos”(yellow) and “elasma” (beaten metal plate).

One half of these lesions are associated with elevated plasma lipid levels. Some occur with altered lipoprotein composition or structure, such as low high-density lipoprotein (HDL, “good” cholesterol) levels. They frequently occur in patients with type II and type IV hyperlipidaemia.

  • Xanthelasma is the most common type of xanthoma.
  • After the lesions arise, they remain stable or grow in size.
  • Patients usually complain for cosmetic reasons.
  • Xanthelasmas often develop in the inner side of upper eyelids.
  • The lesions are yellowish, soft, and they form plaques.
  • In general, these lesions do not affect the function of the eyelids, and blepharoptosis has been only rarely reported.

Causes

  • About half the people with xanthelasma have a lipid disorder.
  • Xanthelasmas may be among the primary and secondary causes of hyperlipidaemia.
  • Examples of primary genetic causes include familial dyslipoproteinaemia, familial hypertriglyceridemia, and familial lipoprotein lipase deficiency.
  • Uncontrolled diabetes is a common cause of secondary hyperlipidaemia.

However, most people with xanthelasma have low HDL cholesterol levels and do not have any other lipoprotein abnormalities.

Xanthelasma Treatments

Xanthelasmas probably will not go away on their own. The lesions will either stay the same size or grow over time.
If you have cosmetic concerns, the lesions can be removed. The dermatologist, Dr. Stamou, can remove xanthelasmas using one of the following methods:

  • Sublimation with Fractional CO2 Laser
  • Dissolve the lesion with trichloroaceticacid, TCA
  • Cryosurgery
  • Surgical excision
  • Electrosurgery

Despite the fact that these treatments work well, the lesions may come back, especially if you have inherited high cholesterol.