Yellowish color
Spots or plaques of yellow or yellow-orange color, which are clearly visible against the background of the skin of the eyelids.
CONDITION / FACE
Xanthelasma of the eyelids.
Xanthelasma of the eyelids are yellowish flat plaques on the skin of the eyelids, most often near the inner corner of the eye. In themselves, they are benign, but this is a reason to check cholesterol and the heart; plaques are removed surgically or with a laser.
CONCEPTUAL VISUALIZATION- What it is
- Yellowish plaques on the eyelids are accumulations of fat-filled cells.
- Who more often
- Women are twice as likely as men; usually appear at the age of 35–55.
- Why is it important?
- Associated with higher cholesterol and risk of heart attack, so a lipid blood test is needed.
- Who treats it
- A surgeon who operates on the eyelids; lipids are adjusted by a family doctor or a cardiologist.
01 / WHAT IS ITWhat is
What is
xanthelasma of the eyelids.
Xanthelasma are yellowish or yellow-orange spots and plaques on the skin of the eyelids. Most often, they appear on the upper eyelid near the inner corner of the eye. This is the most common type of xanthoma - formations from clusters of cells filled with fats, mainly low-density lipoprotein cholesterol.
Xanthelasma is benign: it is not cancer. But they are not only a cosmetic problem. In some people, they appear against the background of elevated cholesterol, and large studies associate them with a higher risk of heart attack and atherosclerosis. Therefore, before removing plaques, it is worth checking blood lipids.
Women have xanthelasma about twice as often as men; they usually appear between the ages of 35 and 55. In a large survey of Copenhagen residents, 4.4% of participants had xanthelasma.
This is general information. The doctor will tell you what will suit you after the examination.
02 / SIGNSHow do they look?
How do they look?
xanthelasma
The diagnosis is usually made by examination - xanthelasma have a characteristic appearance. If the formation on the eyelid looks different, it is evaluated separately.
Near the inner corner of the eye
Most often — on the upper eyelid closer to the nose; there are also on the lower one.
Flat or convex
From a flat spot to a convex plaque or nodule. The method by which it is removed depends on the size and depth of the plaque.
Another formation?
If a spot or nodule on the eyelid does not resemble a typical xanthelasma, they are examined separately - among the formations of the eyelids there are also those that require histology.
Neoplasms of the eyelids03 / REASONSWhy do they appear?
Why do they appear?
xanthelasma
Xanthelasma is associated with lipid metabolism disorders, but only about half of patients have elevated lipid levels. High cholesterol usually does not manifest itself in any way - you can find out about it only from a blood test.
Elevated cholesterol
In a review of 15 studies (854 patients), people with xanthelasma had higher total cholesterol and "bad" cholesterol -- low-density lipoprotein -- and thicker carotid artery walls.
Heredity
High cholesterol runs in families. Among patients with hereditary (familial) hypercholesterolemia in one study, 12.1% had xanthelasma.
Other exchange disorders
Xanthelasma is also associated with low thyroid function, diabetes, weight gain, and a fatty diet.
Normal tests
Xanthelasma can also occur with normal cholesterol. In a study of 12,745 people, the risk of heart attack in those with xanthelasma was higher regardless of cholesterol levels.
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
Xanthelasma itself does not require emergency care, and plaques on the eyelids do not mean that a heart attack is imminent. The signs below are not related to the eyelids, but to the heart and brain: xanthelasma is more common in people with a higher risk of heart attack, so it is useful for you and your family to know these signs.
103 immediately if:
- chest pain that squeezes or presses;
- chest pain that radiates to the arm, neck, or jaw;
- suddenly it is very difficult to breathe - the person suffocates or cannot speak;
- lips or skin suddenly turned pale, blue or gray;
- the person is unconscious and unresponsive;
- one half of the face suddenly dropped;
- sudden weakness or numbness in the arm;
- suddenly the speech is disturbed - the words are indecipherable or confused.
Take your time, but don't delay:
In the coming weeks: if you notice xanthelasma, get a lipid blood test (lipid profile) from your family doctor - even if you feel well. Planned: consultation with a surgeon to remove plaques when lipids are checked.
05 / DIAGNOSTICSWhat is being checked?
What is being checked?
before deleting.
- Examination of the eyelids
The size, depth, and location of the plaques determine the method of removal. They also assess how much skin there is on the eyelid.
- Lipid profile
Blood analysis: total cholesterol, "bad" and "good" cholesterol, triglycerides. It is also recommended for those who previously had normal cholesterol.
- Other analyzes as needed
Your doctor may recommend having your thyroid and blood sugar checked.
- Photo in standard angles
For removal planning and follow-up.
06 / TREATMENTHow we treat
How we treat
xanthelasma
Treatment has two parts: checking and, if necessary, correcting the lipids, and removing the plaques themselves. The method of removal is chosen according to the size and depth of the plaque and its location.
01
Lipids and the heart
This part is conducted by a family doctor or a cardiologist.
- Analysis and control
- If lipids are elevated, it is advised to change the diet and move more; some people need cholesterol-lowering drugs.
- Why is this?
- The goal is to reduce the risk of heart and blood vessel disease, not just to remove plaque.
02
Plaque removal
A review of 49 studies (1,329 patients) looked at excision, lasers, electrosurgery, chemical peels, cryotherapy, and injections; the method is chosen according to the size, depth and location of the plaque.
- Surgical excision
- The plaque is cut out and the skin is sutured. Surgery is considered more appropriate for larger and deeper plaques, especially if they go deep into the skin or muscle.
- Large plaques
- Excision is combined with blepharoplasty, local skin flaps, or skin grafting to close the wound after excision.
- Laser
- Most often — CO2 and erbium lasers; they are suitable for smaller and superficial plaques. On review, more than 90% and 80% of patients, respectively, had a significant improvement (more than 75%).
- Other methods
- Chemical peeling with trichloroacetic acid, cryotherapy, radio wave removal. In a randomized trial of 36 patients, 12 weeks of excision completely removed limited plaques on all eyelids, and 22% of peels.
03
Outcome and risks
- Relapse
- Xanthelasma may reappear. In a series of 95 operations, recurrence was in 3.1% of patients, after laser excision in 295 patients — in 6.8%, in another series — in 17.5%, with no difference between methods.
- scar
- After excision, in 4.2% of patients, the scar tightened the eyelid, and a repeat operation was required.
- Change in skin color
- The most common complication is lightening or darkening of the skin at the removal site. After the laser, they occurred in 8.5% and 8.1% of patients.
07 / AT THE VALIKHNOVSKYI INSTITUTE
How
How
we treat it.
Xanthelasma are removed at Dr. Valikhnovskyi's Institute of Surgery in the "New Face" direction. The clinic is responsible for removing plaques and restoring the skin of the eyelid; analysis and correction of lipids is carried out by a family doctor or a cardiologist.
CLINIC SERVICE
A new face
Form, symmetry, facial expressions and functions after injuries, wounds, burns, removal of tumors and congenital changes.
View service
What we do for this condition
- Surgical excision — the plaque is cut out and the skin of the eyelid is sewn up.
- Removal with blepharoplasty — plaques on the upper eyelid can be removed during blepharoplasty, along with excess skin.
- Local flaps and skin grafts — after removal of large plaques, the defect is closed with skin from the adjacent area or with a skin graft.
- Correction of scars after removal — if after previous removal the scar pulls the eyelid, it is excised and the lack of tissue is filled with a graft or a spacer.
Rostislav Valikhnovskyi
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.
How treatment works with us
- Photo onlineSend a photo of the eyelids directly and from the side - the doctor will first assess the size and location of the plaques.
- AnalyzesA lipid profile from your family doctor if you haven't had one recently.
- ConsultationExamination of the eyelids, choice of removal method and discussion of risks.
- RemovalExcision — separately or together with blepharoplasty, if necessary with plastic surgery of the skin.
- RecoveryThe doctor will explain how to care for the stitches and when to come for an examination; in the future - to observe whether new plaques appear.
08 / QUESTIONS AND ANSWERSCommon
Common
questions
Short answers. What is right for you, the doctor will tell you during the consultation.
Are xanthelasma dangerous?
The plaques themselves are benign - they are not cancer. But they are associated with higher cholesterol and heart attack risk, so blood lipids should be checked.
What tests should be taken if xanthelasma appeared?
Lipid profile: total cholesterol, "bad" and "good" cholesterol, triglycerides. Your doctor may also recommend having your thyroid and blood sugar checked.
Cholesterol is normal - do I need to check something else?
Xanthelasma also occurs with normal cholesterol, and studies show a higher risk of heart attack in such people regardless of cholesterol levels. So you should talk to your family doctor about the risk to your heart.
Which is better — surgery or laser?
Depends on the plaque. Surgery is considered more appropriate for large and deep plaques, laser for smaller and superficial plaques. The doctor chooses the method after an examination.
Can xanthelasma come back after removal?
They can In various studies, relapse occurred in 3.1–17.5% of patients. After laser removal, convex plaques higher than 2 mm returned more often.
Will there be a trace?
After any method, traces are possible: a change in skin color or a scar. In one series of operations, 4.2% of patients had a scar that tightened the eyelid and required reoperation.
Can xanthelasma be removed during blepharoplasty?
Yes. Excision of large plaques is often combined with blepharoplasty or skin grafting, and a review of studies shows good results.
Sources
18 sources · reviews, guidelines and researchshowCollapse
- Serum lipids and risk of atherosclerosis in xanthelasma palpebrarum: A systematic review and meta-analysisJournal of the American Academy of Dermatology, 2020doi:10.1016/j.jaad.2019.08.082 ↗
- Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort studyBMJ, 2011doi:10.1136/bmj.d5497 ↗
- Eyelid Xanthelasma and Cardiovascular Outcomes: A Propensity-Matched AnalysisOphthalmic Plastic and Reconstructive Surgery, 2026doi:10.1097/IOP.0000000000003187 ↗
- Xanthelasma and its association with developing major cardio-cerebrovascular eventsAtherosclerosis, 2026doi:10.1016/j.atherosclerosis.2026.120647 ↗
- The pathogenesis and clinical significance of xanthelasma palpebrarumJournal of the American Academy of Dermatology, 1994doi:10.1016/s0190-9622(94)70023-0 ↗
- Relationship Between Xanthelasma Palpebrarum and HyperlipidemiaAnnals of Plastic Surgery, 2018doi:10.1097/SAP.0000000000001310 ↗
- Cutaneous manifestations in familial hypercholesterolaemiaAtherosclerosis, 2021doi:10.1016/j.atherosclerosis.2021.07.007 ↗
- Xanthelasma palpebrarum - a brief reviewClinical, Cosmetic and Investigational Dermatology, 2018doi:10.2147/CCID.S130116 ↗
- Examining treatment strategies for xanthelasma palpebrarum: a comprehensive literature review of contemporary modalitiesArchives of Dermatological Research, 2024doi:10.1007/s00403-024-02863-y ↗
- Xanthelasma palpebrarum: a review and current management principlesPlastic and Reconstructive Surgery, 2002doi:10.1097/01.PRS.0000025626.70065.2B ↗
- A Practical Review of the Management of Xanthelasma palpebrarumPlastic and Reconstructive Surgery Global Open, 2023doi:10.1097/GOX.0000000000004982 ↗
- Systematic review of laser therapy in xanthelasma palpebrarumInternational Journal of Dermatology, 2017doi:10.1111/ijd.13534 ↗
- Outcomes of surgical management of xanthelasma palpebrarumArchives of Plastic Surgery, 2013doi:10.5999/aps.2013.40.4.380 ↗
- Efficacy and safety of surgical excision vs. 70% trichloroacetic acid topical application in xanthelasma palpebrarum: a split-face randomized clinical trialClinical and Experimental Dermatology, 2026doi:10.1093/ced/llag080 ↗
- Carbon dioxide laser excision as a novel treatment for large xanthelasma palpebrarum: long-term efficacy and safetyBritish Journal of Ophthalmology, 2025doi:10.1136/bjo-2024-325581 ↗
- High cholesterolNHS, 2026nhs.uk/conditions/high-cholesterol ↗
- Heart attackNHS, 2026nhs.uk/conditions/heart-attack ↗
- Symptoms of a strokeNHS, 2024nhs.uk/conditions/stroke/symptoms ↗
The figures on the page are from these sources.
Yellow plaques
on the eyelids?
Send a photo of the eyelids. The doctor will tell you how to remove xanthelasma and what to check before doing so.