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
– 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.
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!