What are these yellow spots on my eyelids? 

There are many skin disorders that give a window into one’s health.  Probably none more so than Xanthelasma.  It’s something I always point out to patients, even if it is not the patient’s primary concern or the reason for their visit.  Read on to learn more about this condition, and why we take it so seriously.

Xanthelasma is the name for small yellow plaques on the inner corners of the eye.  Most often the upper eyelid, but it can be seen on both.  Xanthelasma occurs when cholesterol and other fats are deposited in this area.  It is interesting that this always occurs in this location and only very rarely on other areas of the face or body. 

Xanthelasma is so serious because it is a sign of significantly elevated cholesterol and/or triglycerides or a familial predisposition for elevated cholesterol and triglycerides. I often tell patients that in these cases the eyes are a window to see what is happening in their arteries as cholesterol and triglycerides are being deposited greatly increasing risk of cardiovascular disease. One study showed that Xanthelasma is a predictor of increased risk of myocardial infection and death. 

Patients with Xanthelasma need to have their cholesterol and triglycerides checked on a regular basis.  Over 50% of patients with Xanthelasma will have elevated lipids.   In these patients, diet and exercise is often not enough to bring the levels down.  Often medications are required.  For those with normal lipids and Xanthelasma, we recommend re-checking labs every 6-12 months.

Xanthelasma can be treated for cosmetic reasons, but often recurs especially if the cholesterol and/or triglycerides are not lowered.  In the office we usually treat by electrodessicating the spots to melt them down and purposely scar them closed to not reaccumulate lipids.  Often insurance will not cover this procedure as removal is for cosmetic purposes only.  There are tons of other reported methods for destroying and removing these areas in the medical literature.  There is no one single treatment option, but Dr Rosenberger finds electrodessication to be the simplest, easiest and least expensive method. 

The one condition that resembles Xanthelasma is Orange Palpebral Spots.  Unlike Xanthelasma, orange palpebral spots are not associated with any underlying conditions and are not raised.  Orange palpebral spots are not associated with any one thing; however, excessive carotenoids are frequently implicated. These spots are not related to cholesterol at all and do not carry increase risks like Xanthelasma.

If you or a loved one has Xanthelasma, don’t ignore it. Get your lipids checked today!

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