Xanthelasma

Xanthelasma is a common, noncancerous skin condition marked by yellowish, soft plaques that develop on or around the eyelids. These deposits are made up of cholesterol and other fats that accumulate under the skin. While xanthelasma itself is harmless and usually painless, it can be a visible sign of underlying lipid abnormalities or cardiovascular risk.

The condition can affect people of any age but is more common in middle-aged and older adults. Xanthelasma does not usually affect vision, but its appearance may cause cosmetic concern.

Symptoms

The main symptom of xanthelasma is the presence of characteristic skin lesions. Typical features include:

• Yellow, cream-colored, or pale plaques on the upper or lower eyelids

• Soft or slightly firm, flat or raised patches

• Symmetrical lesions on both eyes in many cases

• Gradual increase in size over time

Xanthelasma is usually painless and does not cause itching or inflammation.

Causes

Xanthelasma occurs when cholesterol-rich material builds up in the skin. This buildup may be associated with abnormal levels of blood lipids, although some people with normal cholesterol levels can also develop the condition.

Common underlying causes include:

• Elevated low-density lipoprotein cholesterol

• Elevated triglyceride levels

• Disorders of lipid metabolism

• Reduced ability of the body to process or remove cholesterol

In some cases, no clear cause is identified.

Risk Factors

Several factors increase the likelihood of developing xanthelasma. These include:

• High cholesterol or triglyceride levels

• Family history of lipid disorders

• Diabetes mellitus

• Obesity

• High blood pressure

• Smoking

• Advancing age

Xanthelasma may also be more common in women than in men.

Complications

Xanthelasma itself does not usually cause medical complications, but it may be associated with other health risks. Possible concerns include:

• Increased risk of cardiovascular disease

• Underlying atherosclerosis

• Cosmetic distress or reduced self-confidence

The lesions may recur even after treatment, especially if lipid levels remain uncontrolled.

Prevention

Xanthelasma cannot always be prevented, but the risk may be reduced by managing underlying health conditions. Preventive measures include:

• Maintaining healthy cholesterol and triglyceride levels

• Eating a balanced diet low in saturated and trans fats

• Exercising regularly

• Achieving and maintaining a healthy weight

• Controlling blood sugar levels in people with diabetes

• Avoiding tobacco use

Regular health checkups and lipid screening can help identify risk factors early and reduce the likelihood of developing xanthelasma or related cardiovascular conditions.