Xanthelasma Palpebrarum:
Information for adults

To confirm your diagnosis of xanthelasma, the doctor may want to perform a skin biopsy. The procedure involves:

1. Numbing the skin with an injectable anesthetic.
2. Sampling a small piece of skin by using a flexible razor blade, a scalpel, or a tiny cookie cutter (called a "punch biopsy"). If a punch biopsy is taken, a stitch (suture) or two may be placed and will need to be removed 6–14 days later.
3. Having the skin sample examined under the microscope by a specially trained physician (dermatopathologist).

Once the diagnosis of xanthelasma is confirmed, the physician will likely check cholesterol levels in your blood (a lipid panel). If you have a lipid abnormality, exercise and dietary modifications will likely be recommended. Many people also require an oral medication to lower their lipids. Treatment of underlying lipid abnormalities does not cure every xanthelasma.

If the xanthelasma is cosmetically unappealing and if it does not respond to lipid-lowering therapies, treatments include:

• Freezing with liquid nitrogen (cryotherapy)
• Surgical excision
• Laser treatment
• Application of a specially formulated acetic acid solution to dissolve the xanthelasma
• Electric needle treatment (electrodesiccation)

All of these treatment options may cause scarring, and they do not keep the xanthelasma from coming back or prevent new lesions from developing.