What is the best xanthelasma treatment currently available? (Photo)

Xanthalasmas are relatively easily treated with simple surgical excision. Fortunately although this may leave a scar, scars in this region usually are barely noticeable if at all following healing. The size and shape of xanthalasma may also dictate the type of treatment. Should one undergo surgical excision, although healing is relatively rapid, there may be some bruising and swelling in the early days of healing.

Unfortunately, at least for the present, there is no way to prevent the appearance of these xanthelasma in individuals predisposed to their development who do not have any lipid abnormalities. However, there is little need for relatively expensive lasers or other hyped gizmos to treat them, either. The use of chemical peels and liquid nitrogen to freeze them carries the distinct risk of pigmentary discolorations. For well over three decades, I have successfully used light electrocautery (following a local anesthetic) to shrink the xanthelasmas to make them much less visible. In general, only a small linear scar is left. No surgery or stitches are required, and the wounds heal on their own. Gratifying shrinkage of the deposits is usually seen immediately upon application of the cautery probe. Research continues on methods to thwart their formation or shrink them. Until then, I rely heavily upon the above method for reliable and predictable results. Best of luck.

Surgical excision is the best treatment. There are no other reliable alternatives. Peels and lasers need to penetrate very deeply to achieve improvement and risk for scarring would be high, unless you do many many shallow treatments. The surgical option does leave a thin, linear scar, but that can is usually very well tolerated, and can be improved with a peel or laser.

Surgical excision works very well to remove xanthelasma. In young patients, spot treatment is advisable because recurrence may require further excision over time. In older patients, xanthelasma is less likely to recur, and the excision can be incorporated into a blepharoplasty that addresses eyelid aesthetics in general.

Surgery is the best solution for xanthelasma. This can usually be done under local anesthesia in the office. Eyelid skin heals extremely well. Unfortunately, this condition can recur over several years. If it does, excision can be repeated.

After a a small excision, any recent recurrence (and there will be) can be treated with TCA on a q-tip