By Published On: 17 July 20123 min read

A Xanthelasma is a small yellowish looking growth or bump that appears on or near the eyelids, usually next to the nose.

There are some “good” and some “bad” things about them.

Firstly the good thing about them is that they aren’t painful and do not really affect the proper workings of the eye – which is a positive if you have one or more!

There are a couple of bad things however:

•    They look unsightly and invariably cause embarrassment to sufferers, especially when meeting someone who tactlessly pronounces “What’s that thing next to your eye?”

•    The presence of a xanthelasma has a good chance of indicating high cholesterol in the body along with all the problems associated with it.

The presence of high cholesterol in the body is identifiable from the fact that the xanthelasma bumps contain concentrated fatty cholesterol deposits. The cholesterol is the reason for the yellowish appearance and the use of the Greek prefix “xanthos”, meaning yellow.

A worrying concern is that published research carried out on a group of people with xanthelasmata identified as more likely those people likely to “suffer a heart attack or die within 10 years”!

You need to consult the research – some of the group studied were in their seventies – it’s not surprising they died within 10 years!

Nonetheless of course, whatever findings research makes, high cholesterol is without doubt an indicator, if not a major cause, of high blood pressure, stroke and heart disease.

Who gets them?

Incidence of xanthelasmata is quite rare, and it’s important to establish at the onset if there is a hereditary factor since if found to be the case then usually there are no associated problems with high cholesterol.

Those more likely to exhibit the condition are:

•    People from Asia and the Mediterranean

•    Women rather than men

•    Those in their forties and fifties

•    Those with “lipid” disorders, meaning those with abnormally high measured levels of cholesterol and triglycerides

Diagnosis

– easy of course since highly visible symptoms, and especially when a blood sample sent off to the pathology laboratory will give a detailed appraisal of cholesterol and its various sub categories.

Treatment

Early intervention is required to stop any xanthelasmata from getting bigger, more bulbous and tumour-like, in which case not only do they look more unsightly, but the medical profession then changes the description from “xanthelasma” to “xanthoma”, being a term used for locations anywhere on the skin.

Surgical removal or cauterisations are of course the only real avenues of treatment as it’s improbable that cholesterol lowering drugs are going to have any affect whatsoever:

•    Conventional surgery – small xanthelasmata can be cut out easily, but bigger bulging ones may need to have a “cap” taken off and put back on after the procedure to prevent undue scarring

•    Carbon dioxide and argon laser surgery – good reasons for adopting this method are the lack of stitches and reduced bleeding

•    Cauterisation using chemicals – an acetic acid, chlorinated to enhance antiseptic properties, has been found to work quite well

•    Freezing – as in the case of dermatologists removing small skin growths, this is a well tried technique, but does occasionally mean some scarring is visible.

What are the outcomes?

The xanthelasmata are going to appear again in some 40% of cases, but of course previous or alternative treatments can be repeated.

A risk assessment for heart disease should be carried out as a matter of course – this will maybe prompt the patient to maintain a nutritious and healthy diet and follow a course of exercise, which can do no harm!

Comments

48 Comments

  1. carla mendoza 21 September 2013 at 7:41 pm - Reply

    The information is very helpful. I have this in my left eyelid but my cholesterol levels are in range. What else can it be? Im 36 yrs old and do suffer from high blood pressure since i was 22.

  2. Larry 7 October 2013 at 10:35 am - Reply

    Is there any place in sydney i can get my xanthelasma radiosurgery done?

  3. Vicki 5 November 2013 at 2:47 am - Reply

    Hi Jim

    I have these unsightly patches on my eyelids, and I also have very hooded upper eyelids that cause me a lot of embarrassment and also often cause my vision to be partially affected. Would an oculoplastic surgeon do both of these surgeries, or would I have to go to two separate surgeons?
    Thanks for your advice.

  4. Vicki 7 November 2013 at 9:50 am - Reply

    How can I get the names of the surgeons who perform removal of xanthelasma? I am on the mid north coast of NSW. I have the patches on both eyelids, and they are growing quite rapidly. People keep asking me what they are. I would love to be rid of them. Can you help please?

  5. Karla 21 December 2013 at 5:56 am - Reply

    I’ve been suffering from the same problem the first time was my colesteol high levels managed and made removal surgery in Brazil. More they appeared again, but now I have my cholesterol levels checked, it really bothers me. I live in Artarmon and if possible you direct me to a good specialist near me, I would be very grateful.

  6. Rebecca 29 January 2014 at 7:48 am - Reply

    Hello, I have these on birth eyes, upper and lower lids, I live in Coffs Harbour do you know anyone who could remove these for me? And the rough cost, thanks so much, I’m 36 a and incredible paranoid.

  7. Allison 18 March 2014 at 1:34 am - Reply

    Who would you recommend to perform xanthelasma treatment in the ACT?

  8. lisa louise gardner 18 March 2014 at 4:49 pm - Reply

    I have these on both my eyelids and they ave grown I also have high iron normal cholesterol levels I have a gene defect and hemochromatosis I have several lumps on my body and under my kbees causing loads of pain. ive changed surgeries 3 tyms n still the drs wnt do a thing I was told I wud need and MRI on my knees nothing happend im thinking of bein a ginniw pig ti get it aall sorted drs wnt gelp me plz ne advice

  9. lisa louise gardner 18 March 2014 at 4:55 pm - Reply

    sorry 4got to say im in the uk. I cant quiet understand y no dr is willing to help me with it all. im 32, im of slim build also.cant belive no dr is willing to give me the time of day they diagnosed it so surely they shud sort it out I also have two of these lumps under my right breast which was shown on the scan but was told no cause of concern. wot can I do im at the point of givin up im going round in circles wiv diff drs and surgeries

  10. Susie 26 April 2014 at 2:12 pm - Reply

    Hi there, I have the yellow bumps on my eyelids and now growing into one of my eye corners. Is there someone in Melbourne I can see about removal of these? Thanks.

  11. Shermaine 12 March 2015 at 4:46 am - Reply

    Hi Jim,

    I have these yellow patches on both my upper eyelids. Do you know anyone in Brisbane that are good at the removal of these patches? Thank you.

  12. Nicky 22 September 2015 at 8:53 am - Reply

    Hi Jim
    I have noticed these marks on my upper eyelid and beneath one eye, my doctor prescribed me steroid cream to apply 3 times daily which did nothing, i got a second opinion and he tried to prescribe the same thing. Do you know anyone in Perth that can remove them? Your help is appreciated.

  13. Danie 27 October 2015 at 2:42 pm - Reply

    Who would you recommend to perform xanthelasma treatment in country WA

  14. Nic 10 November 2015 at 4:30 am - Reply

    Hi Dr Kokkinakis
    I have the same problem on my left eye, can you recommend someone in Perth that may eb able to help? I am 34 years old.

  15. sharon 4 July 2016 at 11:02 am - Reply

    Hi
    I dont suffer from high cholesterol levels but have these on my eyelids is there anyone you can recommend in the Brisbane area for removal

  16. Jim Kokkinakis 8 May 2017 at 1:27 pm - Reply
  17. Sina 14 June 2017 at 2:35 pm - Reply

    Hi I have these on both eyelids now really annoying so need to know plse if you of any Doctors in the Brisbane area who can remove/treat these things..cheers.

    • Sina 14 June 2017 at 2:36 pm - Reply

      Sorry ‘if you know’

    • Jim Kokkinakis 6 July 2017 at 2:27 pm - Reply

      You need to see a lid specialist. See David Stephensen optometrist in Brisbane he will be able to refer you.

  18. Lyn G 4 July 2017 at 9:40 pm - Reply

    Should I be worried ? I have these, female 39- eat healthy and exercise- am I going to die in the next ten yrs ?

    • Jim Kokkinakis 6 July 2017 at 2:34 pm - Reply

      Because of Xanthelasma – absolutely not!

  19. Monica 16 January 2018 at 3:14 am - Reply

    I have this above and below both eyes. It was caused by excessive swelling due to an abusive ex-husbands abuse. The layers of skin never grew back together after swelling went down and liquids hardened in pockets between the layers of skin. I had an unsuccessful sergery were skin was cut open and skin was scrapped of fatty tissue in hopes layers would reattach but it only refilled Again. It is a content reminder of what happen.

    • Jim Kokkinakis 22 February 2018 at 10:34 am - Reply

      I am so sorry that physical abuse can also be a cause of something that looks like Xanthelasma.

  20. Mark Allsworth 11 November 2019 at 8:36 pm - Reply

    I had xanthelasma patches that were getting really noticeable, following multiple suggestions on internet searches I had my cholesterol checked by my GP: This proved to be within the normal range and my GP declined treatment saying it was unnecessary at that time.
    Moving forward a year or so, despite having a perfect BMI, dietary regimen and getting plenty of exercise. I was unfortunate enough to have a heart attack, which happily was relatively mild and easily treated with two stents. Following the surgery I was prescribed four drugs which I would have to continue taking for the rest of my life.
    Two of the drugs quite common and are extensively used on cardiac patients, the first was Aspirin (a very small dose to thin the blood) and Atorvastatin (commonly referred to as a statins and used to treat high cholesterol) 80mg which is the maximum does currently given, despite still having “normal” cholesterol.
    Within a very short time, following strange digestive issues which, despite the cardiac doctors protests, were eventually tied down to being the Aspirin which was discontinued but the statins continued at the previously stated maximum dose.
    Now, two years after my heart attack and rudely healthy, I notice that the xanthelasma patches have all but disappeared completely. I am now left wondering whether, if I had been put on statins originally it would have cured the xanthelasma patches and may even have been instrumental in preventing my heart attack?

  21. Mia 16 November 2020 at 5:38 pm - Reply

    Why can’t a xanthelasma be removed by a GP now? They used to be able do this. Is this some kind of litigation prevention scheme cooked up by the TGA and Governement in Australia?

    • Jim Kokkinakis 11 February 2021 at 2:44 pm - Reply

      GPs should not touch this. You need to see a dermatologist or an oculoplastic surgeon.

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