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What is Xanthelasma

Xanthelasma is a condition of the appearance of yellow plaques such as fat lumps above or below the eyelids, precisely in the corner of the eye or canthus which can develop over time. This skin disease is among the most common, especially in middle-aged women to old age. But it does not rule out the possibility that it can occur in men of all ages. Xanthelasma that grows can be shaped like a soft, calcareous, or semi-solid lump, with a symmetrical position on the eyelid. There are 4 eyelid dots where they usually appear, above and below the inner corner of the eye, on the right and left eyes. The lower eyelid is often an area that is often overgrown with the lump.

Although xanthelasma is rare and not harmful, this condition can be a symptom of a serious disease, such as heart disease or stroke. In addition, xanthelasma cannot disappear by itself and requires medical assistance to handle it. 

What is Xanthelasma

Causes of Xanthelasma

Xanthelasma is caused by enzyme abnormalities that accumulate in skin cells, especially around the eye area, and is often associated with hyperlipidemia (high levels of fat in the blood). In this condition, "bad" cholesterol (LDL) in the blood is pushed out into the surface of the skin and forms a yellow clot like fat or lipids.

Several factors can increase a person's risk of experiencing xanthelasma:

  • Too low levels of "good" cholesterol (HDL) in a person's blood.
  • Have a history of cholesterol or hypercholesterolemia.
  • Have primary biliary cirrhosis or damage to the bile duct.
  • Diabetes.
  • High blood pressure.

In addition, obese people and smokers are also at high risk of developing this disease, because these two factors can increase fat accumulation in the body and trigger a heart attack.

Symptoms of Xanthelasma

Briefly, the symptoms of xanthelasma are only characterized by the appearance of yellowish lipids or fats that continue to grow around the eyelids. In certain cases, the symptoms of xanthelasma are similar to other skin diseases. It is recommended for those who experience these symptoms to see a doctor so they can be diagnosed and handled appropriately.

Diagnosis of Xanthelasma

Initially, the doctor will check for clots or lumps on the patient's eyelids, ranging from color and size to find out if there are indications of xanthelasma disease. Given that this condition can be triggered by another condition, further tests such as blood pressure checks, laboratory tests, and heart health tests are likely to be carried out.

Xanthelasma treatment

Although xanthelasma is not harmful, it is strongly recommended to take medication so that lipids do not continue to grow and interfere with vision. Handling can be done through lifestyle changes (including diet) or through surgery.

Change the Lifestyle

This is generally done to reduce cholesterol levels in the blood and suppress the growth of lipids. Some potential diseases such as heart attacks or strokes can also be prevented through this method.

Surgical Action

In cases where the patient is disturbed by a fat lump that grows, surgery can be done to remove the layer from around the eyelid. The size of the incision needed will be adjusted to the conditions of the growing lipids. In addition to surgery, other ways that can be done to remove these clots include electrodesiccation and cryotherapy techniques. Both of these techniques aim to turn off cells that cause xanthelasma to occur. Electrodesiccation is carried out with the help of electric waves, while cryotherapy uses very cold temperatures. The possible side effects of these two methods are the appearance of scar tissue and hypopigmentation. Neither can be done if xanthelasma has expanded into reaching the muscle.

In addition to the above methods, there is also a technique called argon laser ablation using carbon dioxide gas. In this technique, the doctor will use a laser beam to destroy fat gradually. The patient will be given a local anesthetic injection before the procedure is performed. In order for minimal side effects to occur such as scar tissue, cauterization techniques with chemical fluids can be done. In this technique, doctors will apply substances such as chlorinated acetic acid, monocloroacetic acid, dichlororoethic acid, or trichloroacetic acid to kill the tissue in xanthelasma clots. Although surgical procedures are generally recommended to treat xanthelasma, keep in mind that this procedure cannot be separated from potential complications, such as changes in eyelid structure and impaired eyelash growth after surgery, or changes in skin color and hypopigmentation after the use of chemical fluids, such as trichloroacetic acid.

Prevention of Xanthelasma

Considering that the main trigger of xanthelasma is high cholesterol, the main prevention that needs to be done is to maintain a diet and take medicines that are prescribed by doctors on a regular basis so that cholesterol levels decrease and do not accumulate. This can also help reduce the risk of developing other diseases, such as heart disease or stroke.
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