Xanthelasma

Xanthelasma are soft, yellowish cholesterol deposits that commonly appear around the upper and lower eyelids. They often present as flat or slightly raised plaques and are typically painless and harmless. While xanthelasma do not cause health problems on their own, many people seek treatment for cosmetic reasons, as the lesions can be visible and difficult to conceal.

Although xanthelasma can occur in people with normal cholesterol levels, they may also be associated with high cholesterol, raised triglycerides, or lipid metabolism disorders. For this reason, your dermatologist may recommend a blood test to check cholesterol and lipid levels.

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Why Not Surgical Excision?

In the past, surgical removal was sometimes performed for xanthelasma. However, surgical excision is associated with a high recurrence rate and the risk of scarring, especially on the delicate eyelid skin. For this reason, our dermatologists generally do not recommend surgery as the first-line treatment.

Our Preferred Treatments for Xanthelasma

At Northside Dermatology, we use evidence-based, minimally invasive techniques tailored to the size, thickness, and location of your xanthelasma.

1. CO₂ Ablative Laser Resurfacing

• Our preferred treatment method for most cases.
• The CO₂ laser precisely removes the cholesterol deposits while minimising damage to surrounding skin.
• Depending on the response, 1 to 3 treatment sessions may be required.
• Treatment performed under local anaesthetic

2. Electrocautery

• Effective for smaller or thinner xanthelasma lesions.
• Uses controlled heat energy to target and remove deposits.
• Depending on the response, 3 to 5 treatment sessions may be required.

3. Chemical Cautery (Trichloroacetic Acid, TCA)

• An option for selected cases.
• Involves applying a chemical solution that gradually breaks down the cholesterol deposits.
• Usually requires multiple treatments to achieve the best cosmetic result.

What to Expect After Treatment

• Recurrence is possible: Even with successful removal, xanthelasma may return over time, especially if there are underlying cholesterol or lipid abnormalities.
• Downtime: Most treatments involve some redness, swelling, or crusting that typically resolves within days to a week.
• Results vary: Outcomes depend on the size, thickness, and location of the xanthelasma, as well as the chosen treatment method.

Why Choose a Dermatologist for Xanthelasma Removal?

Eyelid skin is delicate, and treating xanthelasma requires precision to minimise the risk of scarring, pigment change, or recurrence. A specialist dermatologist has the expertise to select the safest and most effective treatment for your individual case.

At Northside Dermatology, we provide evidence-based treatments for xanthelasma, tailored to your needs.