A xanthelasma is a soft, yellowish, fatty deposit that forms under your skin. It can be harmless but may signal an underlying issue with your lipid levels or be an early sign of heart disease.

If you’ve got bumpy yellow patches on the inside corners of your eyelids or around your eyes, you might have a condition known as xanthelasma palpebrarum (XP).

It’s not harmful, but in rare cases it may be an indicator of possible heart disease. That’s why it’s a good idea to have it checked by your doctor or a dermatologist.

Photo of xanthelasma

Anybody can develop xanthelasma, but you’re more at risk if:

  • you’re a woman
  • you’re between the ages of 30 and 50
  • you’re of Asian or Mediterranean descent
  • you’re a smoker
  • you’re obese
  • you have high blood pressure
  • you have diabetes
  • your lipid levels (the fats in your blood, including cholesterol) are abnormally high

Your doctor can diagnose XP visually by examining the skin around your eyes. Your doctor may order a series of lipid profiles to see if your lipid levels are causing your symptoms.

To test your lipid levels, your doctor will do a blood draw and then send the blood to a lab for testing. In most cases, you should have your results within a week.

Most of the time, xanthelasma is completely harmless, but you may still want to have it removed. There are a number of treatment options available:

  • Cryotherapy: This involves freezing the xanthelasma with liquid nitrogen or another chemical.
  • Laser surgery: One type of laser technique, known as fractional CO2, has been shown to be especially effective
  • Traditional surgery: The surgeon will use a knife to remove the xanthelasma.
  • Radiofrequency advanced electrolysis (RAF): A 2015 study found this technique to be effective at eliminating or reducing xanthelasma with very few cases of recurrence.
  • Chemical peels: One small study showed that more than 90 percent of participants who underwent treatment with tricholoroacetic acid (TCA) experienced satisfactory to excellent results.
  • Medication: A study published in the British Journal of Ophthalmology suggests that the statin drug simvastatin (Zocor) — which treats high cholesterol — may also treat xanthelasma.

It’s possible xanthelasma may reappear after treatment.

Managing your cholesterol

Lowering your cholesterol may also help treat the xanthelasma. For some people, changes to diet and lifestyle choices may be enough to manage cholesterol. To lower your cholesterol:

  • avoid smoking and limit your alcohol consumption
  • maintain a healthy weight
  • exercise at least 30 minutes most days of the week
  • limit your consumption of saturated fats, which are found in things like butter

Your doctor may need to prescribe statins or another medication to help lower your cholesterol. There are also some natural remedies that may work, but talk to your doctor before using supplements or alternative treatments for cholesterol.

Removing xanthelasma is considered a cosmetic procedure. That means you’re unlikely to be covered for treatment through health insurance. Surgery or cryotherapy can cost thousands of dollars out of pocket.

Oral medications, like simvastatin (Zocor), may be covered by insurance, and can also treat any underlying lipid abnormality of high cholesterol. Before you make a decision on treatment, talk to your doctor and weigh your options carefully.

Xanthelasma is usually harmless, but it may be a sign of an underlying issue with your lipid levels. It may also be an early warning sign of heart disease.

Talk to your doctor if you notice any fatty deposits around your eyes so they can evaluate you for any underlying conditions. Some treatments won’t be covered by insurance, so talk to your doctor about all of your options and make sure you’re aware of all costs before beginning treatment.