Xanthelasma (or xanthelasma palpebrarum) is a sharply demarcated yellowish collection of cholesterol underneath {the} skin, usually on or around {the} eyelids.

What is it?

  • Xanthelasma (or xanthelasma palpebrarum) is a sharply demarcated yellowish collection of cholesterol underneath {the} skin, usually on or around {the} eyelids. Although not harmful or painful, these minor growths may possibly be disfiguring and can be removed. They are common in people of Asian origin and those from {the} Mediterranean region.

    Because of {the} hereditary component, they may possibly or may possibly not indicate high blood levels of cholesterol. Where there is no family history of xanthelasmata, they usually indicate high cholesterol and may possibly correlate with a risk of atheromatous disease.




 ur in middle-aged and elderly patients. They appear more often in females.

Our eyelids can be affected by a variety of different clinical conditions. One such condition is called xanthalasma. Here we shall take a look at this condition in a bit more detail.

What is Xanthalasma?

Xanthalasma (Greek – ‘xanthos’ = yellow, ‘elasma’ = metal plate) is characterised by {the} presence of small yellow plaques that are more often visible on {the} upper eyelid when compared to {the} lower eyelid. The most common site of these yellow plaques is {the} inner aspect of {the} eyelid, sometimes referred to as {the} inner or medial canthus.


Who gets them?

  • Although most patients have a normal lipid level, more than 30% do show an lipid abnormality. Serum cholesterol may possibly b elevated.
  • Xanthelasmas usually occ

General appearance

Other than {the} characteristic yellow colour, {the} lesions can be hard i.e. calcareous or soft. In {the} initial stages, they tend to be symmetrical with all four eyelids being involved. However, over time they may possibly join together and become larger lesions, making it look asymmetrical.


Xanthalasma seems to bear a close relationship to high levels of lipids in {the} blood. In particular, they are related to {the} change in {the} structure of proteins that carry fats in {the} blood i.e. lipoproteins. In addition, they are seen in certain genetic conditions such as type II and type IV hyperlipidaemia.

Clinical features

As has been described above, {the} lesions in xanthalasma are typically yellowish plaques that are seen on {the} inner aspect of {the} upper eyelids. They rarely cause any significant symptoms but in some cases they may possibly cause drooping of {the} eyelids, also called ptosis.

Where do they Occur?

  • The lesions occur near {the} inner upper eyelids. They are slightly elevated, yellowish, and have sharp borders.


Are they dangerous?

  • They usually do not cause patients
  • discomfort, but can cause a significant cosmetic blemish.
  • They are not malignant


The characteristic appearance makes diagnosis is fairly simple to just clinical examination. Patients may possibly undergo additional tests to check their blood cholesterol and lipid levels. If required, a biopsy may possibly be performed for further analysis and all this will show is {the} presence of certain cells called histiocytes that have within them deposition of fat.


By themselves, xanthalasma often do not cause any problems. If blood lipid levels are high, it may possibly require treatment. If {the} lesions are large and are causing problems with droopy eyelids, then in some cases, surgical treatment may possibly be offered. Additional specialist treatments such as laser ablative treatment are also available along with cryotherapy and cauterisation using chemicals.


  • Treatment consists of skin excision of {the} lesion. An alternative treatment could be {the} application of 75% trichloroacetic acid topically. Recurrence can occur with either method of treatment


Despite {the} availability of surgical treatments, xanthalasma can recur in 4 out of 10 patients.

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