Xanthelasma is a relatively common skin condition that manifests itself in the appearance of yellowish spots or layers on the thin skin of the eyelids – usually on the inside of the upper eyelid, but sometimes also on the lower eyelid. It is one of the most common aesthetic complaints that come to eyelid specialist clinics. Many describe the appearance as “yellow in the eyes,” and it is important to understand that this is not a problem with the whites of the eyes, but rather a subcutaneous accumulation of fats located specifically in the eyelids.
Although it is a benign lesion – that is, one that is not life-threatening – xanthelasmas on the eyelids may indicate internal health problems such as high cholesterol levels, diabetes or other metabolic syndromes. Furthermore, in many cases they cause damage to self-confidence, a sense of embarrassment, and even avoidance of social exposure. Therefore, it is important not only to understand what xanthelasma is, but also when it is worth getting tested and what options are available to you for removing xanthelasma safely and aesthetically.
Although it is a benign lesion – that is, one that is not life-threatening – xanthelasmas on the eyelids may indicate internal health problems such as high cholesterol levels, diabetes or other metabolic syndromes. Furthermore, in many cases they cause damage to self-confidence, a sense of embarrassment, and even avoidance of social exposure. Therefore, it is important not only to understand what xanthelasma is, but also when it is worth getting tested and what options are available to you for removing xanthelasma safely and aesthetically.
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Xanthelasma is a flat or slightly raised lesion, yellowish to creamy in color, that appears mainly on the inner area of the eyelids. It may look like a greasy spot, and is sometimes confused with skin tumors or an allergic reaction. However, xanthelasma has a very characteristic appearance, and an eyelid specialist will be able to identify it relatively easily with a simple clinical examination.
Biologically, xanthelasma results from the accumulation of fat cells and inflammatory cells within the dermis layer. It does not involve the eye itself – meaning there is no change in the lens or retina – but its effect is noticeable in the eyelid area and is therefore sometimes interpreted by patients as a yellow sensation in the eyes. It is important to clarify: xanthelasma is not visible within the eye itself, but on the skin around it.
The main reason for the formation of xanthelasmas is a disturbance in the balance of fats in the body. When levels of bad cholesterol (LDL) are high, especially in people with a genetic predisposition or liver problems, fat cells can accumulate in the skin – especially in thin areas such as the eyelids. The result is the appearance of yellow spots in the eyes, which grow larger over time.
However, not all cases of xanthelasma are associated with abnormal blood values. There are cases where the patient is completely healthy, with a normal lipid profile, and yet xanthelasma appears. This can be caused by:
In these cases, the recommended treatment will usually be combined – both treatment of the xanthelasma itself and an in-depth systemic examination.
In general, xanthelasmas are benign lesions and do not develop into cancerous tumors. However, they should not be ignored – both for aesthetic reasons and as a predictor of cardiovascular disease. Studies have found a statistical relationship between the appearance of xanthelasmas and an increased risk of cardiovascular events, especially if they appear at a young age or in patients without a problematic medical background.
In other words, even if you feel healthy, the appearance of xanthelasma may be a “warning light” that something in your metabolic system is out of balance. This is also the reason why Professor Guy Ben Simon recommends that every patient with xanthelasma undergo a lipid and cholesterol check. Other studies, however, have not found a connection between the appearance of xanthelasma and high blood cholesterol, so the real connection is unclear.
Sometimes other lesions can resemble xanthelasma and require different consideration or treatment. Xanthelasma-like deposits have also been described after hyaluronic acid injections.
Xanthelasma treatment is performed for aesthetic, medical, or both reasons. In some cases, small spots that do not grow can be left untreated, but when it comes to prominent, extensive lesions, or those that cause psychological distress, xanthelasma removal can be performed in various ways. The choice of treatment method is made depending on the characteristics of the lesion, location, depth, the patient’s skin, and the doctor’s experience.
In any case, do not try to remove xanthelasma at home – this is a very sensitive area, and any mistake could lead to infection, burns, or permanent damage to the eyelid skin.
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The answer is yes – in some cases, xanthelasma may return after months or years, especially when the underlying cause (such as high cholesterol) is not treated. Therefore, an integral part of the xanthelasma treatment process also includes dietary changes, medication balancing, and sometimes also the guidance of a family doctor or endocrinologist.
The eyelids are a very delicate area anatomically – they contain muscles, extremely thin skin, fat glands and tiny blood vessels. Any treatment, certainly xanthelasma surgery, must be performed by a doctor with specialized knowledge and experience in this area. Prof. Guy Ben Simon, a world expert in eyelid surgery and eye area aesthetics, performs advanced treatments to remove xanthelasmas while ensuring a natural appearance, minimal signs and maximum results.
In cases where the lesion interferes with function – for example, causing heaviness in the eyelids – there may be entitlement to reimbursement. In purely aesthetic cases – usually not.
It depends on the depth and size of the lesion. Sometimes laser is more effective, but for deep lesions, surgery gives a complete and stable result. In most cases, surgery achieves the best result.
Xanthelasma is flat, yellowish in color, and is usually located in symmetrical pairs. Milia are small white lumps unrelated to blood lipids.
After 2-4 weeks, when the swelling goes away and the scar becomes less visible.
Maintaining a proper diet, exercising, and periodic lipid tests may reduce the risk, but not always completely prevent it.
Xanthelasma may start out as a minor cosmetic concern – a yellow spot under your eye that isn’t painful or bothersome – but there may be deeper causes behind it. If you notice yellow spots under your eye or xanthelasma on your eyelids, don’t ignore it. Beyond aesthetics, it could be an early sign of a medical problem.
If you are considering xanthelasma removal, we invite you to contact Professor Guy Ben Simon ’s clinic to receive a combination of medical precision, broad aesthetic vision, and extensive experience in treating the sensitive area of the eyelids. This way, you can improve your appearance – without compromising your health or the final result.
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