What Treatment Do You Recommend for Yellow Cholesterol Deposits in Under Eye Area?

The treatment of Xanthelasma (cholesterol deposits) is fairly easy and painless. A quick injection of Lidocaine to numb the area usually only hurts for 20 seconds. Valium may be given if you feel very anxious. There is usually only minimal bruising and scarring afterwards. The shape of the eyelid should remain the same. Please see your primary care physician to check your cholesterol level. Good luck.

This answer depends on how large the xanthelasmas are and what area of  your lids they occupy.  In addition, your anatomy and skin tone have a great deal to do with the end result.  If you have a lax lower lids, excision of a large xanthelasma could leave you with a malpositioned eyelid.  Find someone in your area that has experience with removal of these lesions....Good luck.
Dr Z

I recommend removal. Painless, simple and brings much satisfaction. This can be done in clinic with topical or injectable lidocaine. Some patients require more than local anesthesia so valume or even propofol is an option. The more medicines required the higher the risks is for the operation. If you see the right doctor, you should be confident enough and comfortable enough to have it done awake. This is a relatively small procedure. We do a lot of procedures in clinic and have many tricks to make people comfortable while still awake. It really is an art. I will attach a video describing even a face lift in awake patients. It really is the safest option. Hope this helps.DrC

Thanks for your question.  There are several methods to treat these, most commonly, they are treated through direct excision or through laser under local anesthesia.  I understand your concerns about using propofol.  I would be concerned as well. Propofol is one of the most effective and common medications for relaxation during surgery, but it should be used with extreme caution!  Only with careful monitoring of your vitals signs AND under the care of a board certified anesthesiologist or CRNA. Best of luck to you!  Dr. Pacella in San Diego.

These cholesterol deposits can be excised or cauterized in the office using topical and local anesthesia. The treatment should not change the shape of your eye.

Xanthelasma are due to leaky connections in the capillaries in the eyelid region. They can form in the upper lid or lower eyelid. They can occur with normal blood cholesterol, high blood cholesterol, or even low blood cholesterol. They are frustrating because they act as a contrast to the normal surrounding skin. They occur in all skin types and are most noticeable when patients have darker skin surrounding light colored xanthelasma.They often extend deep beneath the skin into the underlying muscle layer called the orbicularis muscle. One option for treatment include surgically cutting them out which results in a small scar. In terms of changing the shape of the eye, if it is very close to the eyelid margin, then it can change the eye shape and possibly result in something called an ectropion or out turning of the eyelid margin. In my practice, I have had success using my Dual Pulsed Erbium laser to plane down the xanthelasma layer by layer until they are gone. The skin then regrows itself over this area but this time without the xanthelasma. Although the removal process with surgical cutting or laser can both be effective, new xanthelasma can occur in the same area or different areas in the future. I hope this explanation was helpful.