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41

Xanthelasma

A Xanthelasma is a small yellowish looking growth or bump that appears on or near the eyelids, usually next to the nose.

There are some “good” and some “bad” things about them.

Firstly the good thing about them is that they aren’t painful and do not really affect the proper workings of the eye – which is a positive if you have one or more!

There are a couple of bad things however:

•    They look unsightly and invariably cause embarrassment to sufferers, especially when meeting someone who tactlessly pronounces “What’s that thing next to your eye?”

•    The presence of a xanthelasma has a good chance of indicating high cholesterol in the body along with all the problems associated with it.

The presence of high cholesterol in the body is identifiable from the fact that the xanthelasma bumps contain concentrated fatty cholesterol deposits. The cholesterol is the reason for the yellowish appearance and the use of the Greek prefix “xanthos”, meaning yellow.

A worrying concern is that published research carried out on a group of people with xanthelasmata identified as more likely those people likely to “suffer a heart attack or die within 10 years”!

You need to consult the research – some of the group studied were in their seventies – it’s not surprising they died within 10 years!

Nonetheless of course, whatever findings research makes, high cholesterol is without doubt an indicator, if not a major cause, of high blood pressure, stroke and heart disease.

Who gets them?

Incidence of xanthelasmata is quite rare, and it’s important to establish at the onset if there is a hereditary factor since if found to be the case then usually there are no associated problems with high cholesterol.

Those more likely to exhibit the condition are:

•    People from Asia and the Mediterranean

•    Women rather than men

•    Those in their forties and fifties

•    Those with “lipid” disorders, meaning those with abnormally high measured levels of cholesterol and triglycerides

Diagnosis

– easy of course since highly visible symptoms, and especially when a blood sample sent off to the pathology laboratory will give a detailed appraisal of cholesterol and its various sub categories.

Treatment

Early intervention is required to stop any xanthelasmata from getting bigger, more bulbous and tumour-like, in which case not only do they look more unsightly, but the medical profession then changes the description from “xanthelasma” to “xanthoma”, being a term used for locations anywhere on the skin.

Surgical removal or cauterisations are of course the only real avenues of treatment as it’s improbable that cholesterol lowering drugs are going to have any affect whatsoever:

•    Conventional surgery – small xanthelasmata can be cut out easily, but bigger bulging ones may need to have a “cap” taken off and put back on after the procedure to prevent undue scarring

•    Carbon dioxide and argon laser surgery – good reasons for adopting this method are the lack of stitches and reduced bleeding

•    Cauterisation using chemicals – an acetic acid, chlorinated to enhance antiseptic properties, has been found to work quite well

•    Freezing – as in the case of dermatologists removing small skin growths, this is a well tried technique, but does occasionally mean some scarring is visible.

What are the outcomes?

The xanthelasmata are going to appear again in some 40% of cases, but of course previous or alternative treatments can be repeated.

A risk assessment for heart disease should be carried out as a matter of course – this will maybe prompt the patient to maintain a nutritious and healthy diet and follow a course of exercise, which can do no harm!

About the Author

Dr Jim Kokkinakis (Optometrist) graduated in 1983 from the Optometry School University of NSW. He is currently a Senior Lecturer there and regular speaker to both Optometrists and Ophthalmologists in Australia and Internationally. He has a specialist clinical practice in the Sydney CBD with interests in Eye Strain, Computer Vision problems, Treatment of Eye Diseases and complex Contact lens Fittings.

Comments (41)

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  1. carla mendoza says:

    The information is very helpful. I have this in my left eyelid but my cholesterol levels are in range. What else can it be? Im 36 yrs old and do suffer from high blood pressure since i was 22.

    • Jim (http://www NULL.optometrist NULL.com NULL.au) says:

      Hi Carla
      If you cholesterol levels are normal, I dont think you have much to worry about. I would see an oculoplastic surgeon in view of removing them if you are worried about their look. Where do you live – we might know someone near you to recommend.

  2. Larry says:

    Is there any place in sydney i can get my xanthelasma radiosurgery done?

    • Jim (http://www NULL.optometrist NULL.com NULL.au) says:

      Hi Larry
      There are a few specialists in Sydney that can perform this procedure. You will need an assessment and a referral. There are two in the CBD, one in Miranda and another in Chatswood I think. Out of those three areas which is best for you?

      • Larry says:

        I think cbd would be ideal, can you please let me know how will i get an assessment from here on?

        • Jim (http://www NULL.optometrist NULL.com NULL.au) says:

          Sorry about the late reply. Dr Anthony Maloof or Dr Raf Gabriel are both located on Macquarie Street. You will need a referral. If you have any other eye or vision issues you would visit an optometrist or otherwise a GP.

    • sharon says:

      Hi there is a demertologist near westmead hospital who treats xanthelasma patients

      • Jim (http://www NULL.optometrist NULL.com NULL.au) says:

        I would recommend you see an oculoplastic surgeon called Dr Krishna Tumuluri. You can find him on his profile page here: http://www.sah.org.au/ktumuluri (http://www NULL.sah NULL.org NULL.au/ktumuluri)
        Regards
        Jim Kokkinakis

        • Roshni says:

          Can you please provide and approximation of related cost? Thank you

          • admin says:

            I honestly can not provide an estimate. I suspect that if you are in Australia you will be looking at at least $2000 per eyelid and it would also depend on how much of the eyelids are affected. You will need to see an oculoplastic surgeon for this.

      • Rania says:

        Hi. Can u tell me his name plz .

  3. Vicki says:

    Hi Jim

    I have these unsightly patches on my eyelids, and I also have very hooded upper eyelids that cause me a lot of embarrassment and also often cause my vision to be partially affected. Would an oculoplastic surgeon do both of these surgeries, or would I have to go to two separate surgeons?
    Thanks for your advice.

  4. Vicki says:

    How can I get the names of the surgeons who perform removal of xanthelasma? I am on the mid north coast of NSW. I have the patches on both eyelids, and they are growing quite rapidly. People keep asking me what they are. I would love to be rid of them. Can you help please?

    • Jim (http://www NULL.optometrist NULL.com NULL.au) says:

      Hi Vicki
      The best person that i know for these types of procedures is Dr Raf Gabriel – he is located in Macquarie Street in Sydney CBD.

  5. Karla says:

    I’ve been suffering from the same problem the first time was my colesteol high levels managed and made removal surgery in Brazil. More they appeared again, but now I have my cholesterol levels checked, it really bothers me. I live in Artarmon and if possible you direct me to a good specialist near me, I would be very grateful.

    • Jim (http://www NULL.optometrist NULL.com NULL.au) says:

      Hi Karla
      This is a common problem and as i mentioned in a previous post, oculoplastic surgeons are best for this. In Sydney CBD there are two great people, Dr Anthony Maloof or Dr Raf Gabriel are both located on Macquarie Street. They will require a referral to see them.

  6. Rebecca says:

    Hello, I have these on birth eyes, upper and lower lids, I live in Coffs Harbour do you know anyone who could remove these for me? And the rough cost, thanks so much, I’m 36 a and incredible paranoid.

    • admin says:

      Hi Rebecca
      I am not familiar with anyone in Coffs Harbour – if you are interested in coming to Sydney then I can recommend a few people for you
      Dr Jim Kokkinakis

  7. Allison says:

    Who would you recommend to perform xanthelasma treatment in the ACT?

    • admin says:

      Hi Allison
      Being Sydney we are not familiar with any oculoplastic ophthalmologist in the ACT. I can highly recommend Dr Raf Gabriel in Macquarie Street Sydney.
      Regards
      Dr Jim Kokkinakis

  8. lisa louise gardner says:

    I have these on both my eyelids and they ave grown I also have high iron normal cholesterol levels I have a gene defect and hemochromatosis I have several lumps on my body and under my kbees causing loads of pain. ive changed surgeries 3 tyms n still the drs wnt do a thing I was told I wud need and MRI on my knees nothing happend im thinking of bein a ginniw pig ti get it aall sorted drs wnt gelp me plz ne advice

    • admin says:

      It is imperative to treat your high iron levels. Xanthelasma is not consider dangerous and only cosmetic. You will have to organise this through some private ophthalmolgist.
      Regards
      Dr Jim kokkinakis

  9. lisa louise gardner says:

    sorry 4got to say im in the uk. I cant quiet understand y no dr is willing to help me with it all. im 32, im of slim build also.cant belive no dr is willing to give me the time of day they diagnosed it so surely they shud sort it out I also have two of these lumps under my right breast which was shown on the scan but was told no cause of concern. wot can I do im at the point of givin up im going round in circles wiv diff drs and surgeries

    • admin says:

      Again the UK system similar to the Australian medical system will only fund significant issues that will relate to your health. Removal of xanthelasma is considered cosmetic. You will be able to to remove them but it will be private pay.
      regards
      Dr Jim Kokkinakis

  10. Susie (http://xanthelasma) says:

    Hi there, I have the yellow bumps on my eyelids and now growing into one of my eye corners. Is there someone in Melbourne I can see about removal of these? Thanks.

    • admin says:

      Hi Susie
      In Melbourne the guy to see is:
      Dr Charles Su
      This is his website:
      http://www.drcharlessu.com.au/ (http://www NULL.drcharlessu NULL.com NULL.au/)
      Regards
      Jim Kokkinakis
      Optometrist

  11. Shermaine says:

    Hi Jim,

    I have these yellow patches on both my upper eyelids. Do you know anyone in Brisbane that are good at the removal of these patches? Thank you.

    • Jim (http://www NULL.optometrist NULL.com NULL.au) says:

      You could try Brendan Cronin in Brisbane. if he cannot help you call his practice and he will know of someone.

  12. Nicky says:

    Hi Jim
    I have noticed these marks on my upper eyelid and beneath one eye, my doctor prescribed me steroid cream to apply 3 times daily which did nothing, i got a second opinion and he tried to prescribe the same thing. Do you know anyone in Perth that can remove them? Your help is appreciated.

    • admin says:

      Nickie these will not go away with a steroid cream. You will need to see an oculoplastic specialist. You will need a referral. I can recommend Damon Ezekiel and be guided by what he says.

  13. Danie says:

    Who would you recommend to perform xanthelasma treatment in country WA

  14. Nic says:

    Hi Dr Kokkinakis
    I have the same problem on my left eye, can you recommend someone in Perth that may eb able to help? I am 34 years old.

    • admin says:

      Sorry for the late reply. I am not familiar with an eyelid specialist in Perth, but I can recommend seeing Damon Ezekiel Optometrist in Perth. You will need a referral so Damon could organize this.

  15. sharon says:

    Hi
    I dont suffer from high cholesterol levels but have these on my eyelids is there anyone you can recommend in the Brisbane area for removal

  16. Michelle says:

    Hi there
    Again like several others I have great cholesterol levels and have 4 small yet noticeable xanthelasma under my right eyelid and I’m only 33!!! I feel ugly and unsightly but need a minimal recovery time as work, 2 young children and no family in Oz – recommendations of good dr’s in Perth appreciated 😊

    • admin says:

      You need to see an oculoplastic surgeon. In perth I am not familiar with one, but my colleague Damon Ezekiel might. Look him up on Google.

  17. Dawn says:

    Hi I’ve one by my eyelid I hate it and very embarrassed by it I try to hide my side of the face it’s on ! Is there anyone near northolt ,London that I can see and how much roughly do they cost to remove ! Please and thankyou

    • admin says:

      Hi Dawn
      We are in Australia so i cannot comment about London. It would be an elective procedure so i doubt it would be covered under your NHS.

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