Xanthelasma

“Xanthelasma”, term derived from ancient Greece, where "xanthos" means yellow and "elesma" means plate, a yellow plate, so these are called yellow plaques.
Xanthelasma is a soft, tiny (1-2 mm), sharply demarcated yellowish deposit of fat underneath the skin. They appear as minor growths that commonly occur on or around the eyelids and are neither harmful to the skin nor painful, or itchy. They do not affect vision or the functioning of the eyelid.

Though Xanthelasma never leads to serious consequences, it appears cosmetically awkward, and most of the patients are unhappy about their image, so they seek medical advice.
In rare cases, it may be an indicator of possible high cholesterol levels, heart disease, hypothyroidism, or a liver condition.

Xanthelasma is the most common subtype of Xanthoma which means the deposition of cholesterol in various areas of the body.
Most commonly Xanthelasma occurs near the inner corner of the eye where the upper and lower eyelids meet and  more often on the upper lid than the lower lid.
Other parts of the body that are affected include the neck, trunk, shoulders, and axillae.

The condition Xanthelasma is more common in middle-aged or older people and more common in women than in men. It appears when cholesterol or other fats in blood are high.

Causes

Xanthelasma is generally caused due to the elevated lipid levels that are commonly associated with hereditary forms of high cholesterol or certain liver diseases.

Primary Causes for Xanthelasma are high cholesterol levels.
High cholesterol levels may be due to

• excessive amounts of LDL (low density lipoprotein, or bad cholesterol)
• familial hypercholesterolemia ( Inherited high cholesterol ) or Type II hyperlipidemia,
• high levels of triglycerides
• certain physiological states and systemic diseases such as pregnancy, diabetes mellitus, hypothyroidism, nephrotic syndrome, and cholestasis.
• Certain medications such as estrogens, tamoxifen, prednisolone, oral retinoids, cyclosporine, and protease inhibitors

Secondary causes for Xanthelasma are lifestyle factors, such as

• a diet high in saturated fats and cholesterol
• overweight or obese
• not getting enough exercise or physical activity
• consuming alcohol excessively
• smoking tobacco products

Risk Factors

Diabetes, High blood pressure, Obesity, Smoking, chronic kidney disease, hypothyroidism, primary biliary cirrhosis and some other liver disorders,  family history of stroke or heart disease, certain medications, including beta-blockers, oral contraceptives, retinoids, and anabolic steroids are considered risk factors for Xanthelasma.

Symptoms

soft, flat, yellowish lesions occur on the upper and lower eyelids, near the inner corner of the eye, and often develop symmetrically around both eyes. Sometimes, these lesions may join together to form larger lumps.
They rarely affect vision or eyelid movement but sometimes cause the eyelid to droop.
Xanthelasma is sometimes a symptom of a more serious underlying condition, like hypothyroidism, kidney disease, liver disease, or diabetes and heart disease.

Treatment

The treatment of xanthelasma involves changes in lifestyle and taking medications to lower serum lipids.

Treatment may also prevent more deposits from developing.

• the growth can be dissolved with medicine (topical trichloroacetic acid)
• Cryosurgery or cryotherapy ( Freezing off with intense cold ) (liquid nitrogen cryotherapy)
• surgical excision
• chemical cauterization
• carbon dioxide and argon laser ablation
• surgical excision
• Electrodesiccation ( Treating with an electric needle )
• Chemical Peels
  

If the growths on eyelids have to be removed, it will be better to visit a dermatologist or an oculoplastics surgeon who has also specialized in doing plastic surgery on the eye.

These treatments may have side effects like Scars, Changes in skin color, and Turned-out eyelids

Natural home remedies to eliminate xanthelasma are  

• applying garlic paste, fenugreek seeds paste, onions paste, castor oil, fresh banana peels,
• increasing daily intake of citrus fruits,
• use of a tea bag compress,
• reducing dietary cholesterol intake
  

Prevention

Xanthelasma can be prevented by
Losing weight, Reducing alcohol consumption, Quitting smoking,
Eating a healthful diet -- a balanced diet low in saturated fats, trans fats, cholesterol such as a diet that contains oily fish, nuts, seeds, vegetable oils and spreads and a diet rich in soluble fiber beans, lentils, and other pulses, oats and barley, wholegrain rice, citrus fruits
Exercising regularly -- Regular physical activities such as brisk walking, cycling, swimming, and running can help to raise levels of HDL cholesterol, and lower levels of LDL cholesterol and triglycerides.