What is Xanthelasma?
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What is xanthelasma?
Xanthelasma (xanthelasma palpebrarum) is a type of xanthoma, or cholesterol deposit, that appears as soft, yellow bumps or flat plaques on the eyelids, usually near the inner corners. It forms when cholesterol builds up under the skin. It is not dangerous on its own, but it is often associated with high blood fats and an increased risk of cardiovascular disease. [1]
What the research says
Xanthelasma can signal heart risk even when cholesterol is normal. In the Copenhagen City Heart Study of 12,745 adults, 563 (4.4%) had xanthelasmata. Over up to 33 years of follow-up, those with xanthelasma had higher adjusted risks of myocardial infarction (hazard ratio 1.48, 95% CI 1.23–1.79) and ischaemic heart disease (HR 1.39, 95% CI 1.20–1.60), independent of plasma cholesterol and triglycerides (Christoffersen et al., BMJ, 2011). [2]
People with xanthelasma tend to have a less favourable lipid profile. A meta-analysis of 15 case-control studies including 854 patients found significantly higher total cholesterol, LDL cholesterol and apolipoprotein B, lower apolipoprotein A1, and greater carotid intima-media thickness than in controls (Chang et al., Journal of the American Academy of Dermatology, 2019). [3]
Lasers and surgery both work, but the evidence is mostly small, uncontrolled studies. A systematic review of 49 articles covering 1,329 patients found that CO2 and Er:YAG lasers produced more than 75% improvement in over 90% and 80% of patients respectively. Surgery suited larger lesions, dyspigmentation was the most common complication, and 69% of studies were retrospective and 84% single-arm (Malekzadeh et al., Plastic and Reconstructive Surgery Global Open, 2023). [4]
Key Takeaways
Feature | Details |
Medical Category | Dermatological / metabolic |
Primary Sign | Yellow, flat or slightly raised plaques on the eyelids |
Common Location | Inner corners of the upper or lower eyelids, often on both sides |
How Common | About 1% of people (Cleveland Clinic) |
Main Cause | Localized cholesterol accumulation under the skin |
Health Indicator | High cholesterol, diabetes, thyroid problems, higher heart disease risk |
Removal Options | Cryotherapy, laser, chemical peel, radiofrequency ablation, surgical excision |
Recurrence Risk | Common after removal, especially if cholesterol stays high |
What is xanthelasma, and what does it look like?
Xanthelasma palpebrarum is the most common type of xanthoma, the medical term for a cholesterol deposit under the skin. It appears as a yellow growth on or beside the corners of the eyelids closest to the nose. The deposits are made of fats that collect in skin cells, and they are non-cancerous and do not spread to other parts of the body.
Many people with xanthelasma seek treatment because of how it looks. The more important question is what it may say about your overall health. Because the plaques are often linked with high blood fats, diabetes or thyroid disease, doctors usually recommend a basic health check when one appears. [1]
What are the symptoms and features of xanthelasma?
Xanthelasma is recognized mainly by its appearance: soft yellow or orange-yellow plaques on the eyelids that are usually painless and not itchy. They typically show these features:
Colour: distinctly yellow or orange-yellow.
Texture: soft, chalky, semi-solid or firm.
Shape: flat or slightly raised plaques, often symmetrical on both eyes, which can grow and join together over time.
Sensation: generally painless and not itchy, although a large deposit can feel uncomfortable.
Who Is Most at Risk
Risk Factor | Impact on Xanthelasma |
High Cholesterol | About half of people with xanthelasma have elevated blood cholesterol, often inherited or linked to some liver diseases. |
Sex | More commonly seen in females. |
Age | Can appear between ages 20 and 70, most often between 35 and 55. |
Lifestyle | Tobacco use, excess alcohol and weight gain increase risk. |
Medical History | Diabetes, high blood pressure, thyroid problems and a family history of high cholesterol or xanthelasma. |
What causes xanthelasma, and which conditions are linked to it?
Xanthelasma is caused by a build-up of fats in the eyelid skin and is often linked to inherited high cholesterol, diabetes, thyroid problems or liver disease. It can happen in people with normal cholesterol, but it is frequently linked to:
Inherited high cholesterol: genetic conditions such as familial hypercholesterolemia. [1]
Metabolic disorders: diabetes mellitus and thyroid problems such as hypothyroidism. [1]
Liver disease: some conditions change how the body processes fats. [1]
Inflammation: chronic inflammatory states may contribute to deposit formation. [1]
Lifestyle factors: weight gain and drinking too much alcohol can raise blood fats. [1]
How is xanthelasma diagnosed and tested?
Xanthelasma can usually be diagnosed by sight, but because the plaques can be a warning sign, providers often suggest blood tests such as a lipid panel. A diagnosis does not require tests, but because the plaques can be a warning sign, further testing is often suggested:
What It Means for Heart Health
Large population studies show that xanthelasma is associated with a higher risk of heart attack and ischaemic heart disease, even in people whose cholesterol looks normal. This does not mean that heart disease is certain. It means the finding is a good reason to review cholesterol, blood pressure, blood sugar and smoking status with your doctor. [2]
What are the management and removal options for xanthelasma?
Xanthelasmas do not go away on their own. They stay the same size or slowly grow, and they cannot be popped or squeezed. Over-the-counter products can burn the delicate eyelid skin, so removal is best done by a healthcare provider. Treatment is usually sought for cosmetic reasons. [1]
Professional Removal Methods
Method | How It Works | Good to Know |
Cryotherapy | Liquid nitrogen freezes and destroys the deposit. | Often the first-choice method. Several sessions may be needed. |
Laser Surgery | Focused light vaporises the deposit; CO2 and Er:YAG lasers are most studied. | Moderate to excellent clearance with a reasonable side-effect profile. |
Chemical Peel | Trichloroacetic acid (TCA) dissolves the plaque. | Comparative studies found CO2 laser more effective than 30–50% TCA. |
Radiofrequency Ablation | Heat energy removes the deposit, sometimes followed by stitches. | Used for small to moderate lesions. |
Surgical Excision | The affected skin is cut out. | Best for large or deep lesions, sometimes with a graft or blepharoplasty. |
Side Effects and Recovery
Recovery depends on the method. Cleveland Clinic notes that it can take about three or four days to recover, while some effects, such as skin discoloration, can take a couple of months to fade. Possible side effects include: [1]
A systematic review of 21 studies on laser therapy found moderate to excellent clearance rates with minimal side effects, although larger comparison studies are still needed (Nguyen et al., International Journal of Dermatology, 2017). [5]
How can xanthelasma be prevented, and what is the long-term outlook?
Xanthelasma often comes back after removal, so long-term management focuses on underlying causes through diet, medication, lifestyle changes and regular monitoring. Long-term management focuses on the underlying causes, which can lower the chance of recurrence:
Dietary changes: eat more vegetables and fruit and fewer fatty foods. [1]
Medication: take statins or other cholesterol-lowering drugs if your doctor prescribes them. They will not remove existing deposits but can help prevent new ones.
Lifestyle: avoid tobacco, exercise regularly and work toward a healthy weight. [1]
Regular monitoring: treat diabetes and high blood pressure and follow up with your doctor about heart health. [1]
The outlook is excellent for the deposits themselves, because they are harmless. The outlook for your heart depends on how well the underlying risk factors are controlled.
Conclusion
Xanthelasma is more than a cosmetic concern. It is a visible clue about your metabolic and cardiovascular health. The yellow plaques are harmless, but their presence is a good reason for a lipid panel and a check of blood sugar and thyroid function. By combining professional removal with proactive management of cholesterol and lifestyle factors, you can improve both your appearance and your long-term heart health.
Frequently Asked Questions
What is xanthelasma?
A yellow cholesterol deposit that forms on or near the eyelids, usually close to the nose.
Is xanthelasma cancerous?
No. It is a benign (harmless) growth.
Does xanthelasma hurt?
It is usually painless, although a large one may feel uncomfortable.
Can I pop a xanthelasma?
No. It is not a pimple and cannot be squeezed out.
What causes xanthelasma?
Cholesterol and other fats building up under the skin of the eyelid.
Is it always caused by high cholesterol?
No. About half of people with xanthelasma have high blood cholesterol, and the other half have normal levels.
Can children get xanthelasma?
It is rare in children, and most cases occur in adults. When it appears at a young age, doctors usually check for inherited high cholesterol.
Is xanthelasma hereditary?
It can run in families, especially when it is linked to inherited high cholesterol such as familial hypercholesterolemia.
How is xanthelasma diagnosed?
Usually by a simple physical exam, because the yellow plaques have a distinctive look.
Do I need blood tests?
A diagnosis does not require them, but a lipid panel, blood sugar and thyroid tests are commonly recommended to look for an underlying cause.
Will xanthelasma go away on its own?
No. Without treatment it stays the same size or slowly grows.
What is the most common removal method?
Liquid nitrogen cryotherapy is often the first-choice removal method, according to Cleveland Clinic.
Does laser treatment work?
Yes. Reviews of the evidence report moderate to excellent clearance rates with laser treatment, with carbon dioxide (CO2) lasers studied most often.
Are chemical peels safe for eyelids?
They can be, when performed by a trained medical professional. Never apply strong acids to the eyelid yourself.
Is surgery necessary?
Usually only for large or deep lesions, where excision (sometimes with a skin graft) gives the best result.
Does removal leave scars?
There is a risk of scarring and skin colour changes with any removal method.
How long does recovery take?
It often takes three or four days, depending on the treatment. Some side effects, such as skin discoloration, can take a couple of months to fade.
Can xanthelasma come back?
Yes. Recurrence is common after removal, whichever method is used.
How can I prevent recurrence?
Work with your doctor to lower cholesterol if it is high, avoid tobacco, keep a healthy weight and treat diabetes and high blood pressure.
Are there home remedies?
No proven ones. Over-the-counter products and DIY treatments can burn the delicate eyelid skin.
Does diet affect xanthelasma?
A diet with more vegetables and fruit and less fatty food helps manage cholesterol, but it will not remove deposits you already have.
Should I stop smoking?
Yes. Tobacco use is a risk factor, and quitting also protects your heart.
Is alcohol a factor?
Drinking too much alcohol can raise blood fats and is listed as a possible contributor.
Can stress cause xanthelasma?
There is no established direct link, but stress can affect lifestyle habits that influence cholesterol.
Is it related to diabetes?
Yes. Diabetes is one of the conditions that can be associated with xanthelasma.
What is the difference between xanthelasma and xanthoma?
A xanthoma is any cholesterol deposit in the skin. Xanthelasma is the type that appears on the eyelids.
Are xanthelasmas contagious?
No. They cannot spread from person to person.
Do they affect vision?
Rarely. They may interfere with vision only if they become very large.
Can exercise help?
Regular exercise helps lower cholesterol and supports heart health, although it will not remove existing deposits.
What kind of doctor treats xanthelasma?
Dermatologists and ophthalmologists commonly remove it, and your primary care doctor can check your cholesterol.
Is the procedure covered by insurance?
Often not, because removal is usually considered cosmetic. Check with your insurer.
Can thyroid problems cause it?
Yes. Hypothyroidism (an underactive thyroid) is listed as a possible cause.
What colour are the bumps?
Yellow, orange-yellow or yellowish-white.
Are they soft or hard?
They can be soft, chalky, semi-solid or firm.
Do they appear on both eyes?
Often, and they usually look similar on each side.
Can I use makeup to cover them?
Yes. A concealer can hide the yellow colour while you decide on treatment.
Is xanthelasma a sign of heart disease?
It is a marker of higher cardiovascular risk. A large Danish cohort study found higher rates of heart attack and ischaemic heart disease in people with xanthelasma, even after accounting for cholesterol levels.
What are the side effects of cryotherapy?
Possible side effects include skin colour changes, scarring, pain and, rarely, eyelid changes such as the lid turning outward.
How many sessions are needed?
Some people need several sessions for full removal.
Is the removal painful?
Your provider will usually numb or cool the area, but some discomfort afterward is possible.
Can statins remove existing bumps?
No. Statins and a low-fat diet will not remove deposits you already have, but they can lower the risk of new ones forming.
Is it more common in men or women?
It is more common in women.
What age group is most affected?
It can occur between ages 20 and 70, and most people notice it between ages 35 and 55.
Can weight loss help?
Reaching a healthy weight can improve your lipid profile and lower the chance of new deposits.
What happens if I leave it untreated?
It will usually stay the same size or grow slowly. It is not harmful on its own.
Are there different types?
Xanthelasma is a specific kind of xanthoma. It can be flat or raised, and single or multiple.
Does it itch?
Itching is not a typical symptom.
Is it related to liver disease?
Yes. Some liver diseases affect how the body handles fats and can be linked to xanthelasma.
Can I use garlic to treat it?
There is no clinical evidence that garlic or similar home remedies remove xanthelasma.
What is the first step if I notice a bump?
See a doctor to confirm the diagnosis and have your cholesterol and blood sugar checked.
References
Cleveland Clinic. Xanthelasma: What It Is, Causes and Treatment. Cleveland Clinic Health Library. Last updated June 25, 2022. https://my.clevelandclinic.org/health/diseases/23385-xanthelasma
Christoffersen M, Frikke-Schmidt R, Schnohr P, et al. Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort study. BMJ. 2011;343:d5497. PMID: 21920887. https://doi.org/10.1136/bmj.d5497
Chang HC, Sung CW, Lin MH. Serum lipids and risk of atherosclerosis in xanthelasma palpebrarum: a systematic review and meta-analysis. Journal of the American Academy of Dermatology. 2019;82(3):596–605. PMID: 31499151. https://doi.org/10.1016/j.jaad.2019.08.082
Malekzadeh H, Ormseth B, Janis JE. A practical review of the management of xanthelasma palpebrarum. Plastic and Reconstructive Surgery Global Open. 2023;11(5):e4982. PMID: 37235133. https://doi.org/10.1097/GOX.0000000000004982
Nguyen AH, Vaudreuil AM, Huerter CJ. Systematic review of laser therapy in xanthelasma palpebrarum. International Journal of Dermatology. 2017;56(3):e47–e55. PMID: 28181222. https://doi.org/10.1111/ijd.13534
Disclaimer
The information provided in this article is for educational purposes only and is not intended as medical advice. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.
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