Why Do I Have Xanthelasma?

You have xanthelasma because cholesterol-rich fat has built up inside cells just under the thin skin of your eyelids. For some people that’s linked to raised cholesterol or triglycerides, often running in the family. For many others, cholesterol is completely normal, and the patches seem to come down to how the skin handles fats, age and genes. It isn’t caused by anything you put on your skin, and it isn’t catching.

Xanthelasma is the most common kind of xanthoma, the name for fatty deposits in the skin. It’s most often seen between the ages of 30 and 50, slightly more often in women, and it tends to start near the inner corner of the eye before slowly spreading along the lid.

Because it can be a sign of raised blood fats, the most useful thing to do first is ask your GP for a simple blood test. That tells you whether there’s anything to look after inside, and the patches themselves can be dealt with separately whenever you’re ready.

Can You Get Xanthelasma With Normal Cholesterol?

Yes. Around half of people with xanthelasma have normal cholesterol levels on a blood test. The StatPearls review of xanthelasma explains that in these cases other things seem to play a part, such as how fat moves between the blood and the skin, local inflammation, and family history. So normal results don’t mean the patches are anything to worry about; they simply mean cholesterol isn’t the whole story. A normal result is still worth having, as it rules out the commonest reason and gives you a baseline for the future. If your results do come back high, our guide to high cholesterol and eyes explains what that means for you, calmly and in plain words.

What Xanthelasma Can Tell You About Your Heart

A large Danish study published in the BMJ found that people with xanthelasma had a somewhat higher risk of heart attack and heart disease over the following decades, even when their cholesterol was normal. That doesn’t mean something is wrong with your heart; most people with xanthelasma never have heart problems. It’s simply a useful nudge to look after your heart: get your cholesterol and blood pressure checked, stop smoking if you smoke, move more and eat well. Those steps lower heart risk for anyone, whatever happens to the patches, and your GP can tell you whether your own results need any follow-up. Removing the patches is a cosmetic choice and doesn’t change your heart risk either way, so it’s worth doing both jobs separately. Our guide to is xanthelasma a sign of heart disease explains the research without the scare stories.

What Causes Yellow Patches On Eyelids?

Doctors have linked xanthelasma with a number of things. Having one of them doesn’t mean you’ll get patches, and many people with patches have none of them:

• Raised cholesterol or triglycerides, including inherited types that run in families
• Diabetes, especially if blood sugar isn’t well controlled; see our guide to the xanthelasma diabetes link
• An underactive thyroid, which can raise cholesterol
• Some liver conditions, such as primary biliary cholangitis; see xanthelasma and liver problems
• Some kidney conditions, such as nephrotic syndrome
• Some medicines, including certain hormone pills, that change blood fats
• Smoking, heavy drinking and a diet high in saturated fat
• Rarely, certain blood protein disorders, which a doctor can check for

Age, being a woman and family history make patches more likely too.

What Can I Do About Xanthelasma?

There are two separate jobs: looking after the inside, and dealing with the patches you can see. For the inside, ask your GP for a blood test. If your cholesterol is raised, your doctor may suggest changes to diet and activity, and sometimes medicine such as a statin; that’s a decision for you and your doctor. If your results are normal, there may be nothing to change at all, other than the healthy habits that help everyone. Our guide to foods for xanthelasma has simple swaps that help.

For the patches, lowering cholesterol is good for your heart but rarely makes existing patches fade on their own; our page on will xanthelasma go away on its own explains why. To change how they look, you can compare clinic routes and home options on our page of xanthelasma removal options, or use Xanthel® xanthelasma removal cream at home: a cosmetic gel made to order for your skin and applied usually just once. See real customers’ eyelids on our Xanthel® results page.