Xanthelasma palpebrarum refers to soft, yellowish plaques that develop on or around the eyelids—most commonly near the inner corners. These flat or slightly raised lesions are made up of cholesterol deposits and can be associated with elevated blood lipids, though they may also occur in people with normal cholesterol levels.
While xanthelasma is harmless from a medical standpoint, many patients seek treatment for cosmetic reasons.
What Causes Xanthelasma?
Xanthelasma is caused by the buildup of lipid-laden foam cells in the superficial dermis. Risk factors include:
• Elevated LDL or total cholesterol
• Familial hyperlipidemia
• Chronic liver disease
• Genetic predisposition
• Age (more common in adults over 40)
Treatment Options for Xanthelasma
At Dermatology Solutions, we offer a variety of treatment options, depending on lesion size, location, and your skin type:
1. TCA Chemical Peels
One of the most effective non-surgical options for xanthelasma is the application of trichloroacetic acid (TCA).
In the case shown in the photo, TCA was carefully applied only to the affected area. Over the next 10–14 days, the treated plaque gradually peeled off—removing the yellow deposits with it.
Multiple sessions may be needed for larger or more stubborn plaques, but treatment is well-tolerated and offers minimal downtime.
2. Surgical Excision
For well-defined or thicker lesions, minor in-office surgical excision can offer immediate and complete removal. This procedure is done with local anesthesia and typically leaves a minimal scar, which fades over time.
3. Laser Treatment
Certain types of ablative lasers, such as CO₂ or Erbium:YAG lasers, can vaporize the cholesterol deposits with precision. These are especially useful for shallow or flat plaques, though downtime and cost may be higher than with chemical peels.
4. Electrosurgery or Radiofrequency Ablation
Some plaques may respond well to low-energy electrical cautery or radiofrequency, which can shrink or vaporize deposits with careful targeting. Healing takes 1–2 weeks, and post-treatment care is important to minimize pigment changes.
Will It Come Back?
Xanthelasma has a tendency to recur, especially in patients with uncontrolled cholesterol levels. For this reason, we recommend:
• Lipid panel screening
• Diet and lifestyle changes
• Coordination with your primary care doctor or cardiologist for long-term lipid control.
Interested in Treatment? Whether you prefer a gradual, gentle approach like TCA peels or a one-time surgical excision, we tailor treatment to your goals and skin type.
Schedule a consultation with one of our board-certified dermatologists to learn which option is best for you.
Disclaimer: The photos shown are actual images of our patient, shared with explicit written consent. These images are for educational use only and may not be copied, distributed, or reproduced without permission from our office.