Xanthelasma
Also known as: Xanthelasma Palpebrarum
Yellowish cholesterol plaques on the eyelids. Benign but may signal high blood lipids - worth checking.
What to look for
Side-by-side comparison
Normal eyelid
Even skin color
Xanthelasma
Yellowish plaque on eyelid
Xanthelasma are soft, yellowish, flat or slightly raised plaques that develop on or around the eyelids, most commonly on the inner upper eyelids. They are deposits of cholesterol-laden macrophages (foam cells) in the skin.
While xanthelasma themselves are harmless and purely cosmetic, approximately 50% of patients with xanthelasma have elevated blood lipid levels (hyperlipidemia). Therefore, all patients presenting with xanthelasma should have a fasting lipid panel performed.
Xanthelasma can also occur with normal cholesterol levels, in which case they may reflect abnormal cholesterol metabolism rather than elevated total levels.
Treatment is cosmetic and includes surgical excision, laser ablation, chemical peels (trichloroacetic acid), and cryotherapy. Recurrence after treatment is common (approximately 40%), especially in patients with persistent hyperlipidemia.
Quick self-check
Does this look like xanthelasma? Answer 2 questions.
Are there soft, yellowish patches on your eyelids?
Have you had your cholesterol levels checked?
Risk factors
- Hyperlipidemia (high cholesterol or triglycerides)
- Family history of cardiovascular disease
- Age over 40
- Female sex (slightly more common)
- Diabetes, hypothyroidism, or liver disease
When to see a dermatologist
- ⚠Yellowish patches developing on the eyelids (get lipid panel checked)
- ⚠If you also have chest pain, family history of heart disease
- ⚠For cosmetic removal
Want a more detailed check?
Our full ABCDE checker evaluates 5 clinical criteria in 30 seconds.
Full ABCDE check →Frequently asked questions
Does xanthelasma mean I have high cholesterol?
About 50% of people with xanthelasma have elevated lipids. The other 50% have normal levels. Either way, a lipid panel should be checked, and cardiovascular risk assessment is worthwhile.
Will xanthelasma go away if I lower my cholesterol?
Unfortunately, existing xanthelasma rarely resolve even with successful lipid lowering. However, treating hyperlipidemia may slow progression and reduce cardiovascular risk. Removal requires procedural treatment.