Introduction

Various types of benign lesions can appear on our body and face, but that should also attract our attention. A good example is the presence of xanthelasmas in the eyelid area, since not only does it lead to an aesthetic problem, but it can also be an alert that the patient suffers from diseases such as diabetes, biliary cirrhosis, or hypercholesterolemia (high cholesterol).

What are Xanthelasmas?

It is a type of benign tumor that appears in the eyelid area and is like a flat white or yellow lump that is formed by the accumulation of fatty matter. This type of skin condition is very common in older adults or people with high levels of lipids in the blood, according to Medline Plus specialists

They can occur in one or both eyes and do not usually present any type of symptoms. The most common thing is that the patient feels discomfort on the aesthetic side since they tend to give him an appearance of fatigue and tiredness, they explain from the

Likewise, there are two types or varieties of xanthelasmas. On the one hand, there is the bilateral xanthelasma, which is when they appear in both eyes, or the unilateral xanthelasma when a visible yellowish bump appears in only one eye.

Causes

Although the presence of this type of benign eye tumor is very common, its cause is not yet known with certainty. Many studies indicate that people who develop this type of pathology could be a clear indication of:

diabetes
biliary cirrhosis
hypercholesteremia
emotional stressors
bad nutrition
sedentary lifestyle
genetic predisposition
pancreatitis

Who are the ideal candidates for treatment?

The ideal patients for treatment against xanthelasmas are men or women of any age who present some type of lump or deposit under the skin of the eyelids or skin eruptions with different shapes and that gives the eyelids a yellowish appearance, they explain by Oftalvist.

Along these lines, the patient should go to the ophthalmologist so that he can perform a complete ophthalmological examination. These treatments are contraindicated for pregnant or lactating women. Likewise, they are not recommended in patients with autoimmune, circulatory, cardiovascular, or systematic diseases.

How do I choose my ophthalmologist?

To choose the specialist who will perform the treatment to eliminate xanthelasmas, the patient must make sure that the doctor has the necessary experience to carry out the procedure. On the other hand, the patient should take prudent time to find out which are the appropriate clinics or health centers for this treatment.

Likewise, it must be ensured that the specialist has the professional title of an ophthalmologist. It is also advisable that the expert be a member of the Spanish Society of Ophthalmology (SEO).

Another important point is to ask the doctor for before and after photographs of their patients who have undergone treatments to eliminate xanthelasmas, to know the success rate of their interventions.

What is the first appointment with the ophthalmologist like?

During the first visit, the ophthalmologist will ask you how long you have noticed the presence of the lump in the eye or in both and what are the main symptoms that you have presented since the benign tumor appeared.

Subsequently, he will carry out a complete review of the patient’s clinical history, asking him about a family history of diabetes, and high cholesterol, among other pathologies that may be indicative of the presence of xanthelasma.

Finally, the specialist will perform a complete ophthalmological examination analyzing the lump and a biopsy is not usually necessary. In very particular cases, the ophthalmologist will ask for a pathological examination to determine if it is an accumulation of fat, they explain by Oftalvist.

The ophthalmologist will detail, according to the previous diagnosis and depending on the needs of each patient, what type of treatment the patient should follow to successfully eliminate the xanthelasma.

How is the treatment carried out?

There are several treatments to eliminate the skin lesions in question. Depending on the exhaustive evaluation of the ophthalmologist, the most appropriate one for each patient will be recommended.

In general, if xanthelasma occurs in the upper eyelid, it is recommended to perform surgery, since by presenting more skin, it will be easier to hide the scar. It is an outpatient surgery and very fast. To perform it, the ophthalmologist uses drops of anesthetic eye drops for the eye, then makes a small incision to remove the fat deposit, and then it is closed with sutures. During the procedure, the patient may feel a bit of a tug, but it does not cause any discomfort. This type of surgery lasts between 30 minutes to 1 hour, does not require hospitalization and the patient can go home the same day.

If the patient has a lot of excess skin on the eyelid, the patient can take the opportunity, if the ophthalmologist approves, to have a blepharoplasty.

There are other non-surgical alternatives if the xanthelasma is superficial:

Peeling and CO2 laser: Both treatments do not leave scars on the skin, but if they are poorly applied they can leave some type of lighter or darker stain. In the first (peeling) trichloroacetic acid is used, which when in contact with the skin, destroys the superficial layers of it until it reaches the area of the dermis where the lesion is located. Several weekly sessions must be repeated to eliminate it. It is important to note that after each session the area is reddish and a scab will appear that will fall off with the days. On the other hand, in the case of the CO2 laser, it is very precise and can be specifically adjusted to the amount of skin to be removed. When applied, a small scab will also appear that is naturally removed over the days. Being a more precise treatment,
Electrofulguration: The tumor is removed through the application of heat in the affected area by electric current.
Cryotherapy: Thanks to this famous treatment, xanthelasma can be effectively eliminated by applying cold to the affected area with liquid nitrogen, which causes the problem to disappear, eliminating the fat deposit.
Radiofrequency: It is one of the least used techniques but it is effective in eliminating the benign tumor from the eye areas. High-frequency electromagnetic waves are used.

If the xanthelasma reappears after treatment, the only solution is to repeat the sessions chosen according to each patient.

What are the main advantages of these treatments?

The main advantage of these treatments is that most of them are painless and quick to recover, so we can highlight:

They are very safe, effective, and fast treatments.
They give the patient a brighter look.
Most of the lesions are eliminated.
In the case of surgery, the postoperative period is very quick and painless.
The patient regains his confidence and self-esteem.

How is the recovery after an intervention?

If the ophthalmologist selected treatment without surgery, in most instances recovery is between 5 and 10 days (after the fall of the scabs) and the main care is basically:

Avoid sun exposure
use special creams or ointments to keep the area hydrated

In the case of having undergone surgery to remove the xanthelasma, the patient may experience a slight sensation of swelling in the incision area. In some cases, to avoid post-operative pain, the ophthalmologist will prescribe ibuprofen. The sutures will remain for a week and after this, the patient must return to the specialist’s office to remove them.

During the process, between the time you leave the office until you return to remove the sutures, the patient must wear sunglasses to avoid sun exposure. You will also be advised not to do physical activity and to avoid putting makeup on the incision area. After 7 days, you can put on makeup again.

After removing the sutures, the area will look a little red, but over the months, it will be a small, almost imperceptible white line.

Complications

Although they are very safe, effective treatments with long-term results, they may present some complications if the necessary care is not taken, among which the following can be highlighted, according to the specialists of Dermatology Barcelona :

In the case of a TCA peel, the main risks are: if a thicker drop than normal is applied, it can damage healthy tissues of the eye or eyelid. It can also cause changes in the pigmentation of the skin or ulceration of the treated area.
In the case of applying C02 laser: changes in pigmentation may also appear in the treated area, added to possible prolonged erythema, which is excess redness on the skin worked for a longer period than normal. Despite that, they are temporary effects.
If you have opted for surgery: the side effects may be a possible infection in the incision area. The possibility of a retraction (insufficient closure of the eyelids) or ectropion, when a part of the eyelid is twisted in the opposite direction.

In any of the above cases, the patient should go immediately to the consultation of his specialist to receive the indicated treatment to solve possible complications.

Finally, it is important to note that in any of the aforementioned cases, there is the possibility that the xanthelasma will reappear, so the patient will have to undergo the treatment again, according to what the ophthalmologist suggests.

What are the results?

Among the main results we can highlight the following:

long-lasting and fast results
the patient regains his confidence and self-esteem
vision recovers (if xanthelasma is affecting it)
the patient will have a more rested and natural look

Frequent questions

Can someone without high cholesterol get xanthelasmas? Yes, it is possible that someone can present this lesion despite not having high cholesterol, although this type of benign tumor is associated with patients with high lipid levels in the blood. They are usually treated effectively with a laser or with a small incision if they are very large, explains

Do they usually have symptoms? They have no symptoms. In general, the discomfort is caused by aesthetic issues, since in some cases they are yellowish, giving the patients an appearance of fatigue, emphasizes

Can xanthelasmas be prevented? They cannot be prevented in many cases, as there is an important genetic factor. Lipid-lowering medications help reduce the risk of onset. Other factors that would contribute to prevention are low-fat diets, drinking plenty of water and eating fruits, not smoking, doing regular physical activity, and sleeping well, say Sanita’s specialists.

Can xanthelasma affect vision? It is only a skin lesion that affects the patient aesthetically, but never affects his visual field, explains to the Integral Ophthalmological Institute.

Are marks left if a patient has to remove more than one xanthelasma? In general, the scars are practically imperceptible. In some cases when there is more than one xanthelasma to remove, it is also advisable to perform an aesthetic blepharoplasty to correct other possible problems such as eye bags, lateral canthopexy, etc., mentioned by AC Plastic Surgery.
I have had xanthelasmas for years. I have decided to take them off. I have looked at various methods. Which would be more convenient? In addition to the methods that you indicate, CO2 lasers can also be used with very good results and safely in expert hands. In this case that you are telling me, possible adverse cases, scars, eyelid recession, and infection decrease in a very significant way.

How to remove xanthelasmas on both eyelidsToday Xanthelasmas can be removed with an Erbium Laser without going into the operating room and without infiltrative anesthesia. It is a minimally invasive process that leaves practically no scars. You can make a consultation with our ophthalmologist.

Treatment for syringoma and xanthelasma currently Xanthelasmas can be completely removed and very effectively with laser, either with CO2 or ErbioYAG lasers, both in their ablative form, what they do is vaporize the lesions, leaving a small scab in the area that I eat. any wound heals in a few days, without leaving a mark or scar, and without requiring a scalpel or stitches.