Xanthelasma removal at a glance
| What is removed | Yellowish deposits in the eyelid skin (xanthelasmas) |
|---|---|
| Methods | CO2 laser or radiofrequency; for more extensive lesions, a surgical approach is considered |
| Anaesthesia | Local |
| Before the procedure | Consultation and, if the doctor considers it necessary, a lipid profile test |
| Season | From autumn to early spring, to allow adequate sun protection |
| Number of interventions | Deeper and more extensive lesions sometimes require an additional procedure |
| Recurrence | Possible, regardless of the method used |
| Price | In the current dermatology price list |
What are xanthelasmas and how can you recognise them?
Xanthelasmas (Latin: xanthelasma palpebrarum) areflat or slightly raised yellowish lesions caused by the accumulation of lipids in skin cells. They appear on the upper and lower eyelids, on one or both eyes, and are most commonly soft, smooth and clearly demarcated.
The lesions usually grow gradually, over months. They are more frequent in older people, but can also appear earlier, regardless of gender.
Not every pale bump around the eye is a xanthelasma. An examination distinguishes them from other lesions in this area, such as milia and syringomas, so that the appropriate procedure can be chosen.
Do xanthelasmas mean high cholesterol?
The development of xanthelasmas may be linked to hereditary and metabolic factors, as well as to conditions such as lipid disorders, diabetes, obesity or liver disease. They can, however, also occur in people with completely normal cholesterol and triglyceride levels.
Because of this, a doctor may suggest checking total cholesterol, LDL, HDL and triglycerides, along with additional tests depending on your general health. Not every patient needs an extensive panel of tests.
Removing the deposits and treating any lipid disorder are two separate things. Regulating laboratory values is important for health, but it does not make existing eyelid lesions disappear.
How is the removal method chosen?
The choice depends on the size, depth and distribution of the lesions, their proximity to the eyelid margin, skin quality and previous treatments. The doctor assesses the expected benefit, the course of healing and the possibility of a visible mark.
For larger or deeper deposits, a surgical approach is also evaluated, while laser and radiofrequency methods are most commonly chosen for smaller and more superficial lesions. No single method is best for all patients — the plan is based on the examination findings.
Smaller lesions are generally easier to remove, so an examination makes sense even when deposits are just starting to become noticeable.
Xanthelasma removal methods
CO2 laser xanthelasma removal The
CO2 laser is an ablative laser that allows tissue to be removed in layers while preserving the surrounding skin. In the case of xanthelasmas, the lesion is removed layer by layer, and the energy simultaneously coagulates tiny blood vessels, so bleeding during the procedure is minimal.
The treatment is performed under local anaesthesia and is scheduled during the months of lower UV exposure, from autumn to early spring, in order to reduce the possibility of subsequent pigmentation. After the procedure, swelling, redness and a scab may occur, and the depth of the treatment affects the duration of healing.
Radiofrequency xanthelasma removal
The radiofrequency method uses high-frequency energy for the controlled removal of lesions, without mechanical pressure and without conventional scalpel incisions. The procedure is performed under local anaesthesia and is brief, depending on the size and number of lesions.
Whether the method is suitable is assessed during the examination — it is most often suited to clearly demarcated and more superficially positioned lesions. After the procedure, a thin scab forms, and the doctor explains the expected course of recovery and whether a single intervention or gradual removal is planned.
Eye protection during the procedure
The eyelid area requires a carefully tailored treatment plan. The procedure is performed with eye protection and a controlled treatment depth, and before it begins, the doctor checks whether you have had any previous interventions on your eyelids or eyes and whether you have any problems with your vision.
Contact lenses are removed before the procedure, and no make-up should be worn that day.
When an additional procedure is needed
With deeper and more extensive lesions, a single intervention is sometimes not sufficient to remove the lesion completely. When this is anticipated, the doctor explains it in advance, along with a follow-up plan, so that the remainder of the lesion is treated once the skin has recovered.
Further treatment of the remainder of an existing lesion is not the same as the recurrence of xanthelasma after successful removal.
What happens at the examination and how should you prepare?
During the examination, the doctor assesses the lesions and discusses with you your previous treatments, chronic conditions, the medication you are taking, allergies, and any previous procedures on your eyelids or eyes.
It is useful to bring available lipid test results and a list of your medication. A photo of the lesion may help with preliminary communication, but the final treatment plan is determined during an in-person examination.
If you are not sure what kind of lesion you have, the first step is a dermatological examination.
Recovery and care after removal
In the first few days, redness, swelling and a scab are possible at the treated site. The skin surface heals when the scab falls off spontaneously, usually within seven to ten days, while the swelling subsides sooner. It takes longer for the skin colour to even out, and may continue for weeks after healing.
Do not pick off the scabs, and use only the skincare your doctor recommends. Instructions regarding washing, make-up, physical activities and sun protection are provided after the procedure, depending on the extent of the treatment.
The date of the follow-up appointment and the return to normal activities are determined by the extent of the treatment and the course of healing.
Do scars remain and can xanthelasmas return?
The aim of the treatment is the removal of lesions with the best possible aesthetic result, but a visible mark or change in skin colour at the treated site is possible. The outcome depends on the depth of the treatment, the size of the lesion and individual healing, with skin discolouration being the most common adverse effect of these procedures.
Xanthelasmata may recur, regardless of the method chosen — this is known for all procedures currently in use. A follow-up allows for the evaluation of the results and agreement on further steps, if required.
Xanthelasma removal price
The price depends on the number, size and depth of the lesions, the chosen method and the scope of the procedure. The eyelid region requires precise work, so the treatment plan is determined individually, following an examination.
Current prices can be found in our dermatology price list. After the examination, you will receive a treatment proposal and cost information, including a follow-up plan and any potential additional interventions.
Frequently asked questions about xanthelasma removal
Can xanthelasmas be removed with creams, ointments or natural remedies?
Creams and ointments should not be considered a reliable substitute for an examination and appropriate treatment. It is particularly important not to use corrosive preparations on your own in the immediate vicinity of the eye, as the eyelid skin is thin and sensitive, and the result can be a permanent mark.
Is the procedure painful?
The procedure is performed under local anaesthesia. The injection of the anaesthetic may sting briefly, after which the treated area will feel numb. Mild tenderness and tightness are possible once the effects of the anaesthetic wear off.
Is one procedure enough?
It depends on the extent and depth of the lesions. For small deposits it usually is, whereas for deeper ones an additional procedure is planned. The doctor explains this before starting, so you know in advance what to expect.
Is the treatment only done in winter?
The timing is chosen according to the method and whether adequate sun protection is possible. These procedures are planned during the period of reduced UV radiation, from autumn to early spring, as this reduces the possibility of subsequent pigmentation at the treated site.
Book xanthelasma removal in Belgrade
Imedic poliklinika is located at Kneza Miloša 23, 2nd floor, Belgrade. Opening hours: Monday–Sunday, 9:00–21:00.
Appointments can be booked by phone: 064 237 0707. If you contact us from abroad, we are also available via Viber and WhatsApp on the same number.
Author: Dr Ivica Jeremić
PhD in Medical Sciences (Molecular Medicine and Immunology), rheumatology subspecialist, dermatology resident.
Updated:
Expert sources
PubMed: A Practical Review of the Management of Xanthelasma palpebrarum
NCBI: Xanthelasma – An Update on Treatment Modalities
American Academy of Ophthalmology EyeWiki: Ocular Injuries Due to Cosmetic Laser
