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. 

These cholesterol deposits around your eye are called xanthelasma. There are many options to treat them including local distraction indirect excision. Local construction can occur with many different modalities, including several lasers.There are other problems that can look like this, so first off make sure you have the proper diagnosis.Overall, treatment should not be uncomfortable and your concern over local anesthesia is not one that should limit you having the procedure if you desire to have these removed.Make sure you see a doctor who is concerned with more than just your cosmetics as well, as these may indicate elevated cholesterol levels that may need addressing for your cardiovascular health.To guarantee you're receiving the highest level of care, seek out a dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties.

These cholesterol deposits are called xanthelasmas. Though we always recommend that you have your cholesterol checked, often your cholesterol will be normal. You should have it checked however as it is something that is treatable.

Whether you have a high cholesterol or not, if you are predisposed to getting xanthelasmas, they may recur, though not necessarily in the same location.

Treatment can be excision if the lesion is small enough, and not widespread, or laser resurfacing. If excision is done, you will end up trading the yellow spot for a very fine linear scar, which in most cases is a very good trade off. And it is unlikely going to change the shape of your eyes. Valium and local anesthesia is usually enough, though every patient's anxiety is different.

If it is a very large lesion or there are widespread lesions all around the eye, then laser resurfacing is a good option as well, as long as your skin type is not too dark. The laser resurfacing will fade the spots, though it might not be complete as some of these lesions are relatively deep. As I mentioned before, the spots may recur in a few years and repeat treatment may be necessary.

If you post a photo, we could recommend which option might be better for you.

Dear zany28,


These are xanthomas and can easily be removed with local anesthetic in the office

They are kind of like skin tags, just a touch more complicated

The results would be great


Best regards,

Nima Shemirani

Those yellow deposits under the eyes can be annoying but cause no damage. They can be surgically removed, which is a very minor procedure, but I do not know of any other method to treat them.