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What’s Xanthelasma?

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Xanthelasma is a condition where cholesterol builds up under the skin, causing white to yellow nodules or disc-shaped marks. It can indicate high blood lipid levels and is more common among Asians and people of Mediterranean extraction. Removal methods include electrocautery, liquid nitrogen, lasers, chemical peels, and surgical excision. Recurrence is common, and patients should address the underlying high lipid level through diet, exercise, and medication.

Xanthelasma is a condition in which lipids, especially cholesterol, build up under the skin. The result is a characteristic rash of white to yellow nodules or disc-shaped marks. These marks, called xanthelasma, are removable using a variety of dermatological treatments, but are a cause for concern, as they can indicate high blood lipid levels. This may suggest that the patient is at risk for heart disease and other conditions related to high blood lipid levels.

A very common form is xanthelasma palpebrarum, which appears around or on the eyelids. Many people find this form of the condition particularly embarrassing and disfiguring, as it is so easily visible to observers. People can also develop it on other parts of the body as well, however, and it should be checked occasionally, along with other skin changes that can indicate health problems.

There appears to be a genetic component to xanthelasma, which is more common among Asians and people of Mediterranean extraction. This condition is probably linked genetically because high blood lipid levels may have a genetic component; those who are predisposed to higher levels of cholesterol and other blood lipids may be at a higher risk of developing it. The nodules themselves are usually harmless, although sometimes irritating.

Common methods of removal include the use of electrocautery devices or chemocautery tools, along with things like liquid nitrogen, which freezes the nodules. Lasers, chemical peels, and surgical excision techniques can also be used to remove them. Patients should be aware that recurrence is common, however, especially if the underlying high lipid level is not addressed.

An individual who notices xanthelasma may speak to a dermatologist about having it removed, although this doctor may refer the patient to a specialist if it appears near the eyes. Patients may also wish to discuss the issue with their primary care physician to review tests for elevated blood lipids, along with ways to check for such elevations, if any. Diet and exercise have been shown to be very helpful, and some individuals with genetic predispositions may also consider medication.

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