Yellow deposits can form around your eyelids as a side effect of having high levels of lipids in your blood. The medical term for these deposits is xanthelasma. These yellow spots may not be harmful initially, but they can gradually worsen and cause pain. They may also be a sign of a more serious underlying health problem.
Keep reading to learn about what causes this condition and available treatment options.
Xanthelasma are yellowish-white lumps of fatty material accumulated under the skin on the inner parts of your upper and lower eyelids. The plaques contain lipids, or fats, including cholesterol, and usually appear symmetrically between your eyes and nose.
These lesions and plaques don’t impair the function of your eyelids. That means they shouldn’t affect your ability to blink, or open or close your eyes. They can gradually become larger over time and cause discomfort. Usually they don’t need to be removed unless they become uncomfortable or for cosmetic reasons.
Anyone may get cholesterol deposits around their eyes. But this condition is most common in people with a lipid disorder called dyslipidemia. People with this disorder have too many lipids in their bloodstream, such as triglycerides and certain forms of cholesterol.
You may have dyslipidemia if you have any of the following conditions:
- hypercholesterolemia, identified by total cholesterol greater than 200 milligrams per deciliter (mg/dL)
- hypertriglyceridemia, identified by triglycerides above 150 mg/dL
- high levels of low-density lipoprotein (LDL), also known as bad cholesterol, identified by LDL above 100 mg/dL
- high levels of high-density lipoprotein (HDL), also known as good cholesterol, identified by HDL above 40 mg/dL
There are various factors that can cause you to have too many lipids in your bloodstream, and in turn develop xanthelasma around your eye. Some causes are genetic, meaning you can’t do much to prevent them. Other causes are the result of lifestyle choices or side effects of some medications.
Genetic causes may include:
- deficiency of familial lipoprotein lipase, the enzyme that breaks down lipids
- familial hypertriglyceridemia, a genetic condition that causes people to have higher amounts of triglycerides in their blood
- familial dyslipoproteinemia, a genetic condition that causes people to have higher amounts of lipids in their blood
Lifestyle factors may include:
- diets high in saturated fats and low in unsaturated fats
- excess alcohol consumption
- lack of cardiovascular exercise
- weight gain
- a diet low in fiber
Medications that may increase your risk for developing cholesterol deposits around your eye include:
- oral contraceptives
- estrogen-containing medications
- thiazide diuretics
- protease inhibitors
- anabolic steroids
- antiepileptic drugs
Some conditions such as kidney disease, hypothyroidism, and diabetes mellitus can also contribute to the development of cholesterol deposits. That’s because these conditions can increase lipid concentration in your blood. Sometimes the cause of dyslipidemia is unknown.
Your doctor will want to know when you first noticed the yellow spots and whether they’ve changed since you noticed them. They may be able to make a diagnosis from a visual exam because xanthelasma have a distinctive appearance.
Your doctor may also want to know if you have a medical history for dyslipidemia. They may look for risk factors of the condition such as diet and genetics. They may also do a blood panel test to determine your lipid levels. A blood panel test measures your HDL and LDL cholesterol, triglyceride, and apolipoprotein B100 levels. The results from this test can help your doctor to determine if your xanthelasma are caused by elevated lipoprotein levels.
Your doctor may be able to remove the cholesterol deposits. There are a few different methods they may use:
- Surgical excision using a very small blade is typically the first option to remove one of these growths. Recovery is at least four weeks.
- Chemical cauterization uses chlorinated acetic acids and can remove the deposits without leaving much scarring.
- Cryotherapy used repeatedly can destroy xanthelasma. This carries the risk of scarring and changes to the pigment of your skin.
- Carbon dioxide and argon laser ablation is less invasive than surgery and has a reasonable success rate. It carries the risk of pigmentation changes.
- Electrodessication can be used with cryotherapy.
For any procedure, it’s important to monitor your recovery. Note any side effects you experience, and let your doctor know about them at your next appointment. Xanthelasma have a high recurrence rate, especially in cases of surgical excision or severe hyperlipidemia.
The underlying cause of xanthelasma may be dyslipidemia, so your doctor may also recommend lifestyle changes to help manage lipids in your bloodstream. That’s because the underlying cause of xanthelasma may be dyslipidemia. Controlling the amount of lipids in your blood may help reduce your risk for developing future deposits.
- Work with a dietitian to evaluate your diet and come up with a plan for any changes you may need to make.
- Limit the amount of saturated fats you eat to fewer than 9 percent of your daily calorie intake.
- Increase your intake of fiber.
- Eat more protein, especially plant protein that contains fewer calories, lower fat, and more fiber. Some types of plant-based protein include tofu or beans.
- Reduce alcohol intake. Women should have no more than one drink per day, and men should have no more than two. A drink is defined as 5 ounces of wine or 12 ounces of beer.
- If you smoke or chew tobacco, quit. Talk to your doctor about programs for quitting smoking if you need help breaking the habit.
- Eat a moderate number of calories from monounsaturated and polyunsaturated fats.
- Participate in 30 minutes of moderate-intensity cardiovascular exercises three times per week.
- Do resistance exercises twice per week.
Your doctor may also prescribe medication that manages triglycerides or cholesterol.
Xanthelasma result from fatty deposits that build up around your eye. It can occur in people of all ages, but most often occurs in middle-aged and older adults. Xanthelasma are generally not painful, but they can gradually build up and cause more discomfort if left untreated.
Xanthelasma can be treated through a variety of techniques including surgery and cryotherapy. Your doctor may also recommend creating a plan that addresses the underlying cause of it, which is often dyslipidemia.