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Fatty deposits that form in the eyelids can become a cosmetic problem for some people. These yellowish plaques beneath the skin usually appear symmetrically in the inner corners of the eyelids, usually affecting both the upper and lower lids. This condition is medically known as xanthelasma palpebrarum (or xanthelasma) and it usually affects women in their 40s or 50s. Men and younger people may also be affected. Although it is not harmful to one's health, it can be cosmetically disfiguring and it can sometimes cause drooping of the upper lids. However, eyesight or function of the eyelids is not affected.

Xanthelasma may not directly harm one's health but they are usually associated with high blood cholesterol levels, which increase the risk for heart disease, metabolic disease, diabetes, cancer, and other medical conditions.

Although not all individuals with xanthelasma have these health problems, it is advisable for one to be examined and tested for the presence of these underlying conditions, which are more dangerous to one's health.

Treatment for Xanthelasma

Once cholesterol deposits on the eyelids form they may remain static or may increase slowly with time. They do not disappear naturally. Affected individuals may choose not to treat them, but must see a doctor for treatment of underlying problems if any, to prevent heart disease or other serious consequences of high cholesterol. However, although improvement in the diet and use of anti-cholesterol drugs may improve blood cholesterol levels, the fatty deposits in the eyelids may not disappear.

There are several surgical options for removing xanthelasma to restore one's appearance. Simple surgical excision of the fatty deposits with or without the use of a surgical microscope may be done to remove them, followed by covering the area with a flap of skin. However, this can result in scarring or eyelid retraction, which may need further cosmetic surgical management.

The use of carbon dioxide and argon lasers to remove the xanthelasma is another technique which is simpler and easier to do but it can also lead to scarring and changes in the color of the skin.

Other techniques include chemical cauterization, which involves coagulating and dissolving the fatty deposits using chlorinated acetic acids, leading to minimal scarring, and cryotherapy and electrodessication to destroy superficial xanthelasma.

It is important for patients to remember that recurrence may occur in about 40 percent of patients. Recurrence is more common after secondary excisions, in patients with high blood cholesterol, and in those whose upper and lower lids are affected.

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