What is Xanthelasma?
Xanthelasma (also called xanthelasma palpebrarum) is a condition where yellowish, cholesterol-rich deposits form under the skin, typically around the upper and lower eyelids. These deposits are soft, flat, or slightly raised and are generally painless.
While xanthelasma itself does not usually cause any physical harm, many people find it cosmetically troubling. Some patients may feel self-conscious or embarrassed about their appearance, especially when the plaques are large or very noticeable. Importantly, the presence of xanthelasma can sometimes be a warning sign of underlying cholesterol problems or lipid metabolism disorders, which need medical evaluation.
Causes of Xanthelasma
Several risk factors contribute to the formation of xanthelasma:
- High cholesterol or lipid levels:
Many individuals with xanthelasma have elevated cholesterol or triglyceride levels, particularly LDL (bad cholesterol). Fatty deposits form when excess lipids accumulate in the skin. - Genetic predisposition:
Xanthelasma can run in families. If close relatives have had it, you may be at higher risk even if your cholesterol levels are normal. - Associated medical conditions:
Diseases like diabetes, hypothyroidism, liver disease, or familial hypercholesterolemia can increase the risk of xanthelasma. - Lifestyle factors:
Poor diet (high in saturated fats), smoking, alcohol consumption, and a sedentary lifestyle can worsen lipid profiles, making xanthelasma more likely. - Aging:
As skin loses elasticity with age, it becomes easier for fatty deposits to become visible on the thin eyelid skin.
It’s important to note that some individuals with normal cholesterol levels may still develop xanthelasma due to genetic or unknown factors.
Symptoms of Xanthelasma
Xanthelasma typically appears with the following characteristics:
- Yellowish plaques:
The deposits are yellow to pale in color and usually soft to touch. - Location:
Most often found near the inner corners of the upper eyelids, but they can also affect the lower eyelids. - Shape and size:
The plaques are flat or slightly raised and can range from a few millimeters to several centimeters in size. - Painless:
They do not cause discomfort or itchiness, but can gradually enlarge over time if untreated. - Cosmetic concern:
Even though harmless, many people seek treatment because of how it affects their appearance and confidence.
Treatment Options for Xanthelasma
Non-Surgical Treatments:
- Topical Medications:
Some acid-based creams (such as trichloroacetic acid preparations) may gradually reduce the appearance of small plaques. However, they require multiple applications and results can vary. - Laser Therapy and Chemical Peels have been tried but it can not remove the Xantholasma completely and the scarring can be unpredictable and the rate of recurrence could be much higher.
Surgical Treatments:
The surgical removal offers the most predictable results.
- Direct Excision:
A highly precise technique where the plaque is surgically cut out under local anaesthesia. - Excision of the Xantholasma is incorporated with upper blepharoplasty under local anaesthetic : This method gives the improved aesthetic appearance of the upper eyelid along with removal of the Xantholasma. This is only suitable if the Xantholasma is located within the zone of upper blepharoplasty skin excision.
- Reconstruction if needed:
In cases of large excisions, skin is closed carefully with either local flap or a skin graft preferably taken from eyelids or from the back of the ear to maintain the natural contour of the eyelids.
The Xanthelasma Treatment Process at MACS Clinic
- Initial Consultation:
You will meet with our senior consultant plastic surgeon, Mr. Shailesh Vadodaria to discuss your concerns, assess the plaques, and review your medical and cholesterol history. - Clinical Examination:
A detailed physical exam determines the size, location, and treatment plan required for you. - Pre-treatment Investigations:
If needed, Mr. Vadodaria may recommend blood tests like a lipid profile to identify any underlying health issues. - Treatment Planning: Mr. Vadodaria will explain you the surgical excision procedure along with the pros and cons.
- Procedure: Mr. Vadodaria performs this procedures of excision of Xantholasma / direct closure or removal of Xantholasma incorporating with upper blepharoplasty approach under local anaesthetics as a day case procedure at MACS Clinic.
- Aftercare and Recovery:
Mr. Vadodaria will provide you specific instructions for caring for the treated area and schedule follow-up appointments in one week and 6 weeks time to monitor healing.
Post-Operative Care
Proper aftercare enhances healing and optimizes cosmetic outcomes:
- Keep the area clean and avoid touching or rubbing your eyes.
- Ice pack application
- Head up position in the first 72 hours to reduce swelling, bruising and discolouration
- Apply ointments as prescribed to prevent infection and promote healing.
- Avoid sun exposure; use sunglasses if you go outside to prevent pigmentation changes.
- Mild swelling or bruising may occur but usually settles within a few days.
- Follow up at MACS clinic to ensure proper recovery.
Complete healing typically occurs within 7 to 10 days, and scars (if any) are usually very fine and fade with time.
Complications of Xanthelasma Treatment
While complications are rare, they may include:
- Minor swelling and redness at the treated site
- Small scars, which are minimized using advanced techniques
- Pigmentation changes, especially if aftercare advice is not followed
- Recurrence of plaques, particularly if underlying lipid levels remain uncontrolled
- Unsatisfactory outcome
- Unrealistic expectations
- Epicathal folds
- Ectropion
Why Do People Opt for Xanthelasma Treatment?
People choose to have xanthelasma treated for several reasons:
- Cosmetic Enhancement:
Improving the appearance of the eyelids leads to better self-esteem. - Professional Confidence:
Especially important for individuals in client-facing roles or public positions. - Prevent Psychological Impact:
Visible plaques can cause embarrassment or make people feel self-conscious. - Functional Issues:
In rare cases where plaques are very large, they can cause eyelid heaviness or interfere with vision. - Prevent Future Growth:
Removing plaques early can prevent them from becoming larger or more difficult to treat later.
Why Choose MACS Clinic for Umbilicoplasty?
✔ Expertise: Mr. Shailesh Vadodaria, senior consultant plastic surgeon has experience of nearly 20 years in minor surgery.
✔ Patient-Centric Care: We endeavour to treat every patient with empathy, discretion, and professionalism.
✔ Sterile Environment: Clean, state-of-the-art facilities ensure safety and comfort.
✔Cosmetic Consideration: We minimize scarring
✔ Quick Appointments & Efficient Recovery: Minimal downtime.
✔ CQC registered clinic with outstanding rating for patients’ care
Contact MACS Clinic
- Phone: 020 7078 4378
- WhatsApp: 07792 648 726
- Email: enquiries@macsclinic.co.uk
- Website: www.macsclinic.co.uk
- BOOK a FREE Video Consultation: https://calendly.com/macsclinic/free-video-consultation?month=2025-01
