What is it
Xanthelasma is a type of xanthoma, that is, local deposition of lipids in the skin. Externally, it is a flat or slightly raised soft plaque of a creamy-yellow color with clear boundaries, ranging in size from a few millimeters to one and a half to two centimeters. More often it is located on the upper eyelid closer to the nose and occurs on both sides. The growths are painless, do not change vision or affect eyelid movement, but may gradually enlarge over months and years.
- Flat, soft, yellow plaques
- Favorite place - inner corner of the upper eyelid
- Often symmetrical
- Doesn't hurt or itch
- Slowly grow and merge with each other
Why do they appear?
In approximately half of the cases, xanthelasmas are associated with lipid metabolism disorders: increased total cholesterol and LDL, hereditary forms of hyperlipidemia. The second half of cases occur in people with normal indicators - then local characteristics of the skin and vascular wall play a role. Additional contributions are made by diabetes mellitus, obesity, hypothyroidism, liver disease and bile stagnation, and taking certain medications. That is why, even with a purely aesthetic complaint, the doctor recommends getting tested.
- Elevated cholesterol and LDL
- Hereditary disorders of fat metabolism
- Diabetes and obesity
- Hypothyroidism
- Diseases of the liver and biliary tract
- Normal lipids in approximately half of patients
What examinations are needed
The diagnosis is made during a routine examination: the appearance and location of the plaques are very characteristic, additional visualization is not required. The main attention is paid to finding the cause. They take a lipid spectrum with the determination of total cholesterol, LDL, HDL and triglycerides, blood glucose, and, if indicated, liver tests and thyroid hormones. It is also important to assess cardiovascular risk: measure blood pressure, find out about smoking and family history of early heart attacks. If the type of formation is atypical, the doctor excludes other tumors of the skin of the eyelid.
- Examination by a dermatologist or ophthalmologist
- Lipid spectrum
- Total cholesterol and LDL
- Blood glucose
- Liver tests and TSH as indicated
- Cardiovascular risk assessment
How to remove
The method is selected according to the size, thickness and location of the plaque. Small surface formations are removed by laser, radio wave or spot treatment with a chemical agent. Large and deep ones are better to be excised surgically with a thin suture: this way there is less risk of reappearance and the scar is neater. The intervention is performed under local anesthesia on an outpatient basis. The skin of the eyelids is thin, so the procedure should be performed by a doctor familiar with the anatomy of this area: inaccurate removal can lead to eversion of the eyelid and persistent stains.
- Surgical excision for large plaques
- Laser removal
- Radio wave method
- Chemical destruction of small lesions
- Local anesthesia, outpatient
- Sun protection and post-procedure scar care
Relapses and prevention
Removal solves the cosmetic problem, but does not eliminate the cause: plaques return in a significant proportion of patients, especially with persistent high cholesterol and multiple lesions. Therefore, in parallel with removal, it is worth working on metabolism: eating a diet with limited saturated fats, vegetables and fiber, regular physical activity, weight loss, quitting smoking. In case of severe hyperlipidemia, the doctor may prescribe lipid-lowering therapy - these drugs are selected only by a specialist, taking into account cardiovascular risk.
- Cholesterol and LDL control
- Diet limited in saturated fat
- Regular physical activity
- Losing weight and quitting smoking
- Compensation for diabetes and hypothyroidism
- Lipid-lowering therapy as prescribed by a doctor
