What is Xanthelasma?
Xanthoma is a skin condition where certain fats build up and become visible under the surface of the skin. Xanthelasmas are flat, soft, yellow bumps that typically develop on the upper and lower eyelids. They are usually well defined lesions with sharp edges and can vary in size from small bumps to very large plaques. These growths are non-cancerous (benign) and painless, but may be a sign of other underlying health concerns. The development of xanthelasma has some heredity components and may indicate elevated blood cholesterol levels in approximately 50% of cases. It is important to have cholesterol and triglycerides tested, as effective treatment of elevated levels may result in some improvement to the lesions.
However, 50% of patients with this condition have normal blood cholesterol levels and the lesions have developed spontaneously. Xanthelasma are not painful or dangerous, but can be cosmetically disfiguring to some patients. If the cosmetic appearance is not bothersome, no treatment is required and the lesions may simply be left in place.
Removal of these lesions can be quite difficult as they are often deep and patients will likely continue to develop more over time. The goal of treatment is to obtain a 60 – 75% improvement to the appearance of skin plaques. The Co2 laser is the most effective method of removing these lesions. A needle is used to inject a small amount of local anesthetic to the area being treated. The laser is used to remove the cholesterol deposits precisely, a layer at a time. Several passes with the laser is necessary to reach the base of the deposit. With very large and deep plaques, it may be impossible to remove them completely without scarring. Our goal is to remove the bulk of the lesion, to soften, flatten and minimize the appearance. After removal of the excess cholesterol, the areas will be open and will need to heal.
Over time, additional lesions will likely develop. It may be necessary to repeat treatments every few years for maintenance.