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Xanthelasma is one of the more visible symptoms of hypercholesterolemia, and it’s characterized by bumps (also known as cholesterol deposits) that form around the eyes.

People who have hypercholesterolemia may rarely show visible signs, such as yellow deposits which appear around the eyelids. Medically speaking, this condition is known as xanthelasma and, while seemingly harmless at first, can actually get worse and cause a lot of pain.

Xanthelasma: What are the symptoms?

Xanthelasma is a very visible condition, which is noticeable through the lumps that form on the insides of the upper and lower eyelids. The lumps have a yellow-white color, and are full of fats and cholesterol build-up. While they do not prevent the eyelids from functioning properly, they can become larger if left untreated. They can also be a sign of some underlying medical conditions, so people who have them should seek immediate medical attention. People who choose to have them removed often do so either because they are unaesthetic, or because they become uncomfortable.

What causes xanthelasma?

Generally speaking, all people who have high cholesterol levels can end up with xanthelasma, but this is rather typical of people who have dyslipidemia (a lipid disorder). Having dyslipidemia means that there are too many lipids in the bloodstream (“lipids” meaning either certain types of cholesterol or triglycerides).

Dyslipidemia is usually caused by the following factors:

  • When the total cholesterol levels exceed the threshold of 200 mg/dL.
  • When bad cholesterol levels are above 100 mg/dL.
  • When good cholesterol levels are above 40 mg/dL.
  • When the level of triglycerides exceeds 150 mg/dL.
In most cases, xanthelasma is a consequence of hypercholesterolemia, a health problem created by an unbalanced diet and a sedentary lifestyle. However, there are cases when hypercholesterolemia can’t be prevented, as it is a result of a mutated gene that’s passed on from parent to child. The condition is called familial hypercholesterolemia, and can be spotted through a genetic test.

Other genetic causes that could potentially lead to xanthelasma are:

  • Familial hypertriglyceridemia, which is a genetic disorder that leads to a higher level of triglycerides in the blood.
  • Familial dyslipoproteinemia is characterized by an elevated amount of blood lipids caused by a genetic condition.
  • Insufficient lipoprotein lipase, the enzyme in charge with lipid breakdown.

Aside from genetic factors, xanthelasma can also be caused by a series of lifestyle factors, such as obesity, smoking, not consuming enough fiber, not getting enough exercise, consuming too much alcohol, eating too many saturated fats. Xanthelasma can additionally be a side effect of certain types of medication, such as anabolic steroids, thiazide diuretics, corticosteroids, medication that contains estrogen, beta-blockers, and retinoids.

Xanthelasma: How is the diagnosis made?

Xanthelasma has quite a distinct appearance, which makes it easier to trace during a visual exam. Doctors will ask when you first spotted the bumps, and if the bumps have undergone any changes recently. Doctors may also inquire about family history to see if there were any cases of dyslipidemia, but will also look into potential causes, such as genetic factors or diet. Blood panel tests are also relevant to check the body’s lipid levels. Through such a test, doctors can identify your good and bad cholesterol levels, but also the number of triglycerides and apolipoprotein B100 levels.

Xanthelasma: Treatment

Cholesterol deposits can be removed upon request through a series of different methods. Doctors will discuss with their patients to see which one of the following is the most suitable option:

  • Surgical excision is a process that uses a small blade to remove the bumps, and has a recovery period of at least one month.
  • Cryotherapy is a repeat procedure that can remove the cholesterol deposits around the eyes. However, there is the risk of scarring the skin and can also potentially lead to changes in skin pigmentation.
  • Cauterization is another removal process that implies using chlorinated acetic acids. The main advantage of this procedure is that it barely leaves any scars.
  • Carbon dioxide and argon laser ablation is an alternative to surgical excision, but with the risk of skin pigmentation changes.
One of the things to remember at this point is that these cholesterol deposits that form around the eyes have a high recurrence rate after being removed through surgical excision. Monitoring your recovery is a very important part following the procedure, and you should keep your doctor up to date with any changes.

Xanthelasma: What you need to know about prevention

Since xanthelasma is caused by excess cholesterol, keeping cholesterol levels under control is an important part of the prevention process. While normalizing lipid levels does not cause the bumps to disappear, they can prevent future ones.

Doctors will work together with their patients to develop a plan that makes them improve their dietary choices, by switching to foods that are low in cholesterol and fat. Dietary chances also include foods that are rich in soluble fiber, starting with fruits, vegetables, legumes, oats, barley, and whole grains. Switching to lean meat also helps, as long as it’s not deep fried meat.

Another important thing that helps prevent hypercholesterolemia is exercising on a regular basis. Unless you have to lose weight, even 30 minutes of walking every day can go a long way.

Smoking is also known to lead to heart problems and mess with cholesterol level, so those of you who are known to have this problem should also quit smoking as soon as possible. On the other hand, alcohol also has a negative impact on cholesterol and triglycerides levels. Limiting your daily alcohol intake to a single drink helps.


Xanthelasma is one of the more visible symptoms of hypercholesterolemia, and it’s characterized by bumps (also known as cholesterol deposits) that form around the eyes. While they are easy to diagnose through various tests, xanthelasma has a distinct look, so the doctor will pretty much suspect what they’re dealing with right away.

Xanthelasma can be removed through different medical procedures, but treating the underlying cause is important. This means that aside from the actual removal of the deposit, one must take hypercholesterolemia treatment, as well as endure that they’ve made the changes required to prevent cholesterol and triglycerides levels from skyrocketing once more.

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