Xanthelasma Palpebrarum
What is Xanthelasma palpebrarum?
Xanthelasma is a sharply demarcated yellowish deposit of fat underneath the skin, usually on or around the eyelids. While they are neither harmful nor painful, these minor growths may be cosmetically unacceptable and can be removed.
Quick facts:
- Frequently, they are symmetrical; often, 4 lids are involved. Xanthelasma have a tendency to increase slowly, and become permanent.
- Around half of the cases are linked with higher than average cholesterol levels.
- A study of almost 13,000 people found with the patches, concluded that these people were more likely have a heart attack or heart disease.
- Increased lipid levels are present in 50% patients with Xanthelasma.
- Family history of high lipid levels, Xanthelasma and diabetes to be enquired.
- Increased lipid levels can also be an association, usually caused by underlying uncontrolled diabetes.
- Some patients exhibiting Xanthelasma have normal lipid levels but this is less common in younger patients. Although these patients are not at increased risk of heart disease, they are more commonly found to have other risk factors for cardiovascular disease eg a higher BMI, waist circumference and deranged lipid levels.
Do I need to biopsy the area to confirm?
On examination we can make a diagnosis of Xanthelasma but to document and confirm diagnosis some doctors would prefer to take a biopsy.
Does Xanthelasma increase with time?
They are generally permanent with tendency to increase in number and coalesce with time.
What are the different Treatments available?
- Patients should have their fasting lipid levels checked and those with increased lipid levels should have a cardiac risk assessment done. If the ten-year risk of cardiovascular disease is assessed at greater than 10%, lifestyle intervention should be considered as per primary prevention of cardiovascular risk protocols. If the risk is 20% or greater, intervention might include the use of aspirin and lipid lowering drugs.
- The lesions can be left alone unless the patient wishes them removed for cosmetic reasons. The condition is itself harmless. Lesions can recur in patients after treatment.
- Various options are available including surgical excision, chemical treatment with trichloroacetic acid, laser treatment.
- Laser treatment for Xanthelasma
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