Xanthelasma treatment

Xanthelasma or palpebral xanthoma is manifested by spots or papules of yellowish or orange color, which often start at the level of the angle of the eyelids near the nose but which can merge into sheets and spread over all of the eyelids.

If the lesions of xanthelasma are completely painless, they can still be considered unsightly and alter the beauty of the look.

Xanthomatosis not associated with a lipid disorder is quite rare and can lead to a hematological disease.

Most often, xanthomatosis is associated with a lipid disorder in the blood (hyperlipidemia), either by an increase in the level of blood cholesterol (hypercholesterolemia), or by hypertriglyceridemia. This metabolic pathology can be of genetic origin ( hereditary hyperlipidemia ) or follow chronic diseases such as diabetes , hepatic cirrhosis, chronic renal failure or even certain medications ( oral contraception , corticosteroids).

The appearance of xanthoma of the eyelids requires the prescription of a fasting lipid assessment with a dosage of cholesterol (HDL and LDL) and triglycerides.

The diagnosis of xanthelasma is easily made by your dermatologist. Clinical examination is sufficient to recognize xanthoma lesions of the eyelids .

In case of doubt, a skin biopsy of the lesion can be performed and its anatomopathological study confirms the diagnosis. This will find macrophages (immune cells) rich in lipids. Separately, the diagnosis of xanthelasma indicates the search for other localizations of xanthomatosis in the same patient:

• Tendon xanthomas: found mainly at the level of the Achilles tendon
• Tuberous xanthoma at pressure zones: recognizable by their large volume and reddish color.
• Eruptive xanthoma : found on the buttocks, elbows or knees, these lesions appear suddenly and can be painful. Hypertriglyceridemia is found in the vast majority of cases.
• Diffuse plane xanthoma: yellowish lesions in sheets located at the level of the trunk and the root of the limbs. This form of xanthoma is quite often associated with hematological pathologies with hyperimmunoglobulinemia.
• Palmar striated xanthomas at the level of the flexion creases of the palms and fingers. This clinical sign suggests mixed hyperlipidemia .

When the palpebral xanthoma follows a lipid disorder in the blood, it is obviously essential to take care of this pathology. The objective is to normalize cholesterol and triglyceride levels in the blood, to adopt an appropriate lifestyle and to detect complications associated with lipid disorders (diabetes, cardiovascular diseases, etc.).

Drug treatments (fibrates, statins) may be prescribed. Faced with aesthetic discomfort, it is possible to treat xanthelasma locally with the co2 laser .

As with any medical dermatology act at Skin Marceau, our specialist assistant sees you first, before the intervention of the dermatologist.

The Co2 laser acts by vaporizing the lesions, under local anesthesia . The installation of a protective eye shell is always appropriate. Usually one session is enough. It is an effective and safe treatment with fewer scarring complications compared to other lasers (hypopigmentation in the treated areas is possible, but it is transient).

The consequences are simple, the application of hydrocolloid dressings is generally necessary during the days following the treatment.

If the results are satisfactory with a disappearance of the yellowish spots on the eyelids , it should be noted that the recurrence rate of xanthelasma after treatment is estimated at 50% of cases, and this regardless of the type of technique.

The prices for the treatment of xanthelasma lesions are available in the table below: