Xanthelasma

Xanthelasma

Although xanthelasma is harmless, it can still be very difficult for those affected. The deposits under the skin are usually in a clearly visible place and are therefore an aesthetic problem. People who notice xanthelasma on their skin should definitely see their doctor right away.

What is a xanthelasma?

Xanthelasma are yellowish, sometimes reddish, fatty nodules in the skin of the eyelids. They appear symmetrically on the inner corner of the upper and lower eyelids. In most cases, the upper eyelids are affected. The sharply defined fat deposits are usually soft (foam cells), consist mostly of cholesterol and can be moved with a little pressure. The skin above allows the lipid deposits to show through. For meaning of hypochondrogenesis in English, please visit sportingology.com.

Although they are not contagious and cause no further problems for the wearer, most people have them surgically removed. The unsightly fat nodules are caused by a disorder of the fat metabolism, which can be congenital or acquired. It usually only occurs after the age of 40. Women are affected more often than men.

Causes

When xanthelasma develops, the excess fat (usually cholesterol) is stored under the surface of the skin in the form of foam cells. The cells are actually macrophages (scavenger cells) of the immune system. In patients with xanthelasma, the treating doctor usually also finds an elevated cholesterol level, diabetes mellitus, alcohol -related cirrhosis of the liver or inflammation of the pancreas (hyperlipidemic xanthelasma).

However, people without pathologically elevated blood lipid levels can also suffer from xanthelasma (normolipidemic xanthelasma). Whether the tendency to xanthelasma can be inherited has not yet been finally clarified. Patients with xanthelasma who do not have high cholesterol levels are still considered a risk group by medical research: they are more at risk of developing cardiovascular disease than people without the unsightly subcutaneous fat nodules. They suffer 50 percent more heart attacks than other people. Research also assumes that they have an increased tendency to store cholesterol in the walls of the blood vessels ( arteriosclerosis ). They may also have primary biliary cirrhosis of the liver.

Symptoms, Ailments & Signs

Xanthelasma is painless and not associated with any other symptoms of the disease. Therefore, they are also seen as a purely cosmetic problem: the costs of removing them are only covered by private health insurance companies. The fat deposits, which are perceived as psychologically stressful by those affected, sometimes even appear within a short time (eruptive xanthelasma).

Sometimes the affected person finds them in other parts of his body (tendon sheaths and extensor sides of elbows, knee joints, buttocks). There they are called xanthomas.

Diagnosis & course of disease

Patients with xanthelasma should first have their bloodwork checked to find out if their fat deposits are due to a lipid metabolism disorder. The doctor determines cholesterol levels, blood sugar, thyroid and uric acid levels. If the result is positive, the underlying disease is treated.

Despite therapy, the unsightly fat blisters usually do not recede on their own. In fact, xanthelasma can build up on the eyelids over time. In addition, existing ones can be made even taller and wider. In rare cases, they can cause permanent drooping of the eyelid ( ptosis ).

Complications

Xanthelasma is not usually associated with any complications. For many sufferers, however, they represent a cosmetic problem that needs to be treated. If there is no treatment, for example because the health insurance company does not cover the costs, this often results in mental problems for the person concerned.

Social anxiety and depression can develop – problems that permanently limit well-being and quality of life. Serious psychological problems are possible, especially if the fat deposits spontaneously form again or if they spread to other parts of the body. Physical discomfort can occur if the sufferer scratches or improperly handles the xanthelasma.

Certain cosmetics can cause skin irritation and may also affect fat deposits. During surgical treatment there is always a risk of scars and adhesions. Bleeding and wound healing disorders can also occur. Scars can also remain after using trichloroacetic acid.

If the xanthelasma is in the area of ​​the eyes, ectropion can occur. Laser treatment can leave scars and cause burns. In addition, sensory disturbances can occur in the affected area. Depending on the type of treatment, allergic reactions are also possible.

When should you go to the doctor?

If there are changes in the complexion, a doctor should check the optical irregularities. If they occur suddenly and unexpectedly, they are often an indication of a health impairment. Since there is a risk of complications, a doctor should be consulted if the symptoms increase or if any discrepancies persist. Although the Xanthelasma show no disease value from a medical point of view, other skin diseases should be ruled out. This is only possible if the person concerned seeks cooperation with a doctor to clarify the cause. If nodules form or if the skin becomes discolored, in many cases this is to be understood as a warning signal from the organism.

Often there are changes in the area of ​​​​the eyelids. This can be uncomfortable and lead to a visual blemish. It is advisable to consult a doctor if the changes in the skin’s appearance result in states of mental or emotional stress. If there are strong feelings of shame or a withdrawal from social life, a doctor’s visit is necessary. In the case of fears, a decrease in cognitive performance or a depressed mood, the person concerned needs help. If there are vegetative disorders, inner restlessness or never-ending brooding, a visit to the doctor is recommended.

Treatment & Therapy

Since xanthelasmas usually do not disappear even after treatment of the underlying disease, their surgical removal is recommended. Depending on the location and size of the nodules, they are eliminated using electrocautery, cryosurgery, laser technology, surgical excision, and application of trichloroacetic acid.

The disadvantage of excision is that scars usually remain and the surgical site is reddened for a long time. Since the annoying fat nodules usually reappear later in the same place, the surgical intervention usually only makes sense if the patient also has an upper eyelid lift done at the same time. The most commonly used and most successful method is lasering the xanthelasma.

Here erbium laser, CO2, dye and argon laser are used. They leave no visible scars. The lasered skin area is usually healed after a few days. After the second treatment at the latest, the xanthelasma have finally disappeared and do not appear again. The only downside to laser is that hypo- and hyper-pigmentation may later appear on the treated area in some patients.

The disadvantage of applying 50% trichloroacetic acid is that it also leaves scars. In rare cases, ectropion (the edge of the eyelid is bent outwards) can even occur. Normal surgery, if there is insufficient skin at the xanthelasma site, can render the eyelid unable to close. In addition, (visible) scar shrinkage can occur.

Prevention

The patient cannot prevent the occurrence of xanthelasma, as the exact factors that lead to it are not yet fully clarified by medical research. However, a regular check of the blood values ​​can give an initial indication of a blood lipid disorder that may be present. If the result is positive, it is advisable to change your diet to a low-fat diet with a high content of omega-3 fatty acids and omega-6 fatty acids. Lipid-lowering drugs also ensure normal blood lipid levels.

A reduction diet can also help to better regulate the lipid balance. With a healthier lifestyle, the patient can at least somewhat reduce the risk of developing xanthelasma. Instead of the lipid-lowering drug, he can also take Allium sativum in potencies D2 to D6 (10 of the D6 drops twice a day). Artichoke extract and artichoke juice also help to lower cholesterol levels.

Aftercare

Skin abnormalities such as xanthelasma can be easily removed surgically. A local anesthetic ensures that patients enjoy a largely painless treatment. The operation takes about 15 to 20 minutes. Those affected can then immediately go about their usual activities.

However, it is important to avoid prolonged exposure to heat, such as a sauna or solarium, for at least six weeks after the treatment. It is also important to avoid prolonged exposure to the sun. The doctor prescribes an antibiotic ointment for the aftercare of xanthelasma. Wound healing is possible without sutures.

An appointment to pull the threads is therefore not necessary. Patients are able to work and socialize again just one to two days after the treatment. Since the risk of recurrence is extremely high, a healthy diet is part of the aftercare. It is advisable to switch to a diet rich in vegetables, fruit and fiber. In addition, it is advisable to give up smoking.

Nicotine increases the risk of suffering from xanthelasma again. As a rule, the treating physicians advise in advance what needs to be considered during aftercare and what this looks like. Since there are various ways to remove a xanthelasma, the type of aftercare also changes accordingly.

You can do that yourself

The xanthelasma lead to aesthetic irregularities and thus to an emotional challenge for those affected. Stable and healthy self-confidence is helpful in everyday life. This protects against phases of high sensitivity and can be an important pillar in overcoming the disease.

The symptoms improve when the body weight is in the normal range of the BMI. Obesity and a fatty or overly sweet diet should therefore be avoided. At the same time, there should be sufficient exercise, as this stimulates the metabolism and helps to reduce excess weight. Emotional and physical stressors lead to a worsening of the overall situation, since they represent an additional burden for the entire organism. Therefore, everyday life should be checked for existing stress triggers and, if possible, persistent and negatively perceived stress should be reduced. Cognitive training often helps to better deal with everyday challenges.

The overall load on the heart should be reduced. Attractive leisure activities and concentration on activities that contribute to improving well-being are therefore advisable. For many of those affected, changing their style of clothing and wearing looser, looser clothing helps to significantly improve their quality of life. This allows self-perceived problem areas to be concealed.

Xanthelasma