Xanthelasma Before & After Case 143

This patient in her 40s presented with concerns about multiple yellow eyelid lesions that had been slowly enlarging over time.

On evaluation, Dr. Phan noted a small lesion on the left lower eyelid and larger yellow plaques on the right upper and lower eyelids, consistent with xanthelasma, a form of cholesterol deposition within the skin.

While a number of treatment modalities have been tried for xanthelasma, including chemical peels, cryotherapy, and CO2 laser, recurrence remains common. For this reason, Dr. Phan generally favors precise excision and, whenever possible, removes enough tissue to ensure normal-appearing skin at the wound edges in an effort to reduce the risk of recurrence.

Given this patient’s young age and limited skin laxity, the lesions were carefully measured, meticulously marked, and precisely excised. The skin was then closed with great care to minimize tension and optimize scar healing.

Patient, pictured here more than 3 months after the xanthelasma excisions, was thrilled with her results. She demonstrated with no residual yellow plaques and nearly imperceptible incision lines.