What is the best method of removing Xanthomas from my lower eyelids as an alternative to TCA? (Photo)

these can be treated with lasers and direct excision.  Please see an expert.                    Best, Dr. Emer.

For over three decades, I have been successfully treating small xanthelasmas of the eyelids, such as the ones shown in your photo, with focal electrocautery. I have found this method to be very quick(takes less than a minute), relatively inexpensive, and capable of producing gratifying results. I have not been happy with the results obtained with either TCA or bichloracetic acid, both of which have been recommended for use in this condition. Nor have I been particularly impressed with the advantages of employing relatively expensive ablative lasers for this purpose.The electrocautery procedure is quite simple. First the area directly under each spot is numbed with local anesthetic and next, the electrocautery, supplies intense heat,  is lightly applied to the surface of the fat deposit. This typically results in immediate shrinkage of the xanthelasmas, and, especially when each site is relatively small, as appears to the case here, the results are typically quite satisfying. If needed, the procedure can be repeated to remove any residual fat, about six weeks later.

Xanthomas of the eye lids are best treated byDirect excisionCarbon Dioxide Laser Both are effective treatment with minimal scarring

I prefer laser (either fully ablative laser such as CO2 or erbium) or excision. All the bestDr Davin LimLaser and aesthetic dermatologistBrisbane, Australia.