Xanthelasma are soft, flat, yellow patches (plaques) that usually appear around the inner corners of the upper or lower eyelids. They are filled with a fatty substance called cholesterol.
Xanthelasma tend to affect people in their 40s and older, and occur more often in women than men.
The exact cause of xanthelasma is not fully understood. However, in around half of cases they are due to high blood cholesterol levels, which can increase the risk of cardiovascular disease.
Xanthelasma are generally harmless and do not need to be treated. However, if they concern you, it may be possible to remove it with options such as minor surgery, laser, chemicals, or freeze therapy.
The main symptom of xanthelasma is the appearance of soft yellow plaques on or around the eyelids. These are harmless, and do not generally affect your vision or how your eyelids work.
The fatty plaques can grow or stay the same over time, but they don’t usually go away on their own.
The exact cause of xanthelasma is not fully understood, but they are often associated with high blood cholesterol levels.
Xanthelasma are common in people with genetic disorders causing inherited high cholesterol levels. They are also seen in a condition affecting the liver, which is associated with very high blood cholesterol levels, called primary biliary cirrhosis.
Xanthelasma can affect people with normal cholesterol levels, although this is less likely in younger people.
Your doctor can usually diagnose xanthelasma by examining your eyelids. He or she may ask you questions about your lifestyle, medical history, and family history of diseases.
As xanthelasma are commonly seen in people with high blood cholesterol, your doctor may recommend blood tests to check your cholesterol levels.
If blood tests show that you have raised blood levels of cholesterol, your doctor may work out your risk of developing cardiovascular disease in the future and provide advice on how to reduce this risk.
In people who have normal cholesterol levels and xanthelasma, the relationship between xanthelasma and fatty build-up in arteries (atherosclerosis) is not clear. Some studies show that these people tend to have other risk factors for cardiovascular disease, but larger studies are needed to confirm the association.
Xanthelasma are usually harmless and typically do not affect eyesight or your eyelid movements. Therefore, they can be left alone and do need treatment.
However, if you are unhappy with their appearance, speak to your doctor as you may be able to have them removed.
There are several options for removal, including:
- a small surgical procedure
- laser treatment
- freeze therapy
- chemical treatment such as trichloroacetic acid (TCA)
However, xanthelasma can come back even after removal.
If you have raised levels of blood cholesterol and other fats, your doctor may prescribe cholesterol-lowering medication and recommend some changes to your diet. However, these treatments do not tend to affect the size or appearance of the plaques.
In general, xanthelasma do not generally go away on their own. They can grow or stay the same over time. However, as they are harmless and do not cause any problems with your vision, the plaques do not need to be removed.
If you are bothered by their appearance, you can speak to your doctor about what options are available to you for removal. It is important to bear in mind that xanthelasma may come back even after removal.
Despite being harmless, xanthelasma can indicate you have high blood cholesterol levels. If you think you have xanthelasma, see your doctor for a blood test and an assessment of your risk factors for developing cardiovascular disease, such as a heart attack or stroke. Your doctor will be able to advise on cholesterol-lowering measures and how best to reduce your overall risk.
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