What's Xanthelasma? Simple Guide To Yellow Eyelid Spots

A Plain-English Guide To The Yellow Eyelid Patches: What They Are, What They Aren’t, And What To Do First

What’s xanthelasma? It’s the name for soft, yellow patches that form on or around the eyelids, made of fat-filled cells in the skin. They’re harmless and don’t affect your eyesight, but they can be a sign worth a cholesterol check, and they rarely go away on their own. Here’s a simple guide to what xanthelasma is, the myths to ignore, and your first steps.

Quick Answer

Xanthelasma is a harmless buildup of fat-filled cells in the eyelid skin, seen as soft yellow patches, usually near the inner corners of the eyes. It affects about 1.1% of women and 0.3% of men. About half of people with it have a blood fat problem, so a check-up is wise. It can be removed at a clinic or at home.

Key Takeaways

Xanthelasma is soft yellow patches of fat-filled cells on the eyelids.
It’s harmless, painless, not contagious and doesn’t affect vision.
It’s the most common type of xanthoma.
About half of people with it have a cholesterol or blood fat problem.
It rarely fades by itself, but it can be removed.
Garlic, squeezing and other home tricks can do more harm than good.

On This Page 14 sections

What’s Xanthelasma, In Simple Terms?

Xanthelasma is a collection of fat-filled cells in the skin of the eyelids that shows up as soft, yellow patches, usually near the inner corners of the eyes. It’s a skin condition, not an eye condition, and it’s harmless in itself.

The name comes from Greek words meaning “yellow plate”, which is a fair description of how it looks. Doctors use the full name xanthelasma palpebrarum, meaning yellow plaques of the eyelids, but it’s the same thing. You’ll also hear it called cholesterol deposits on the eyelids, yellow spots on the eyelids, or fatty deposits around the eyes. It’s pronounced zan-thuh-LAZ-muh; our guide on how to pronounce xanthelasma has more.

The patches are made of immune cells that have filled up with fat, and they sit in the skin rather than in the eye.^[1] That’s why they don’t hurt, itch or affect your vision. Our main guide to xanthelasma covers everything in depth, and what is xanthelasma gives a quick definition.

What Does Xanthelasma Look Like?

Soft, yellow or yellow-orange patches with fairly clear edges, usually on the upper eyelid near the nose and often on both eyes. They can be completely flat or slightly raised, and range from a few millimeters to over a centimeter.

The signs to look for are:

Yellow color. Pale yellow to yellow-orange, like a stain in the skin.
Inner corners. Most often the upper eyelid close to the nose, sometimes the lower lid too.
Both sides. Usually on both eyes, in a similar position.
Soft feel. Flat or slightly raised, and soft rather than hard.
No symptoms. No pain, itching or effect on your eyesight.

A doctor can usually confirm xanthelasma just by looking.^[1] Small white dots (milia), skin-colored bumps (syringomas) and skin tags can look similar at a glance, but they aren’t yellow. Our guides on what xanthelasma looks like, whether xanthelasma can be flat and xanthelasma around the eyes show the range of appearances.

Looking into what xanthelasma looks like

How Common Is Xanthelasma?

Fairly common. It affects about 1.1% of women and 0.3% of men, so women get it close to four times as often. It’s usually noticed in middle age, most often between 35 and 55.

Xanthelasma is the most common type of xanthoma, the family of fatty deposits in the skin.^[1] It’s seen from about age 20 to 70, and most people first notice it between 35 and 55.^[1] When it appears in younger adults, doctors look a little harder for an inherited cholesterol problem.^[1]

So if you’ve just spotted yellow patches on your eyelids, you’re far from alone. Our guide on whether xanthelasma is common looks at who gets it in more detail.

What Is Xanthelasma Made Of?

It’s made of “foam cells”: immune cells called macrophages that have swallowed so much fat they’ve become swollen and foamy. They gather in the deeper layer of the eyelid skin, around tiny blood vessels.

Here’s the simple version of how it happens.^[1] Blinking constantly squeezes the tiny blood vessels in the eyelid, and as we age those vessels get leakier. Fat carried in the blood, including cholesterol, slips out into the skin. Macrophages, the body’s clean-up cells, swallow it. When they take in more than they can break down, they swell into foam cells and cluster together, and the yellow patch appears.

Two practical points follow. The patches are yellow because you’re seeing stored fat through very thin skin. And they can’t be squeezed out, because the fat is locked inside living cells rather than sitting in a pocket. Our guide to xanthelasma palpebrarum covers the clinical detail.

Looking into what xanthelasma is made of

Is Xanthelasma Harmful?

The patches themselves are harmless. But about half of people with xanthelasma have a blood fat problem, and it’s been linked with a higher risk of heart disease, so it’s a good reason for one check-up.

About 50% of people with xanthelasma have a lipid disorder, such as high LDL cholesterol or low HDL, either on its own or caused by another condition like diabetes or an underactive thyroid.^[1] The other half have normal blood tests.

There’s also a link with the heart. A large Danish study that followed almost 13,000 people for decades found that people with xanthelasma had a higher risk of heart attack and heart disease, and that this held regardless of their cholesterol levels.^[2] That’s a pattern across many people, not a prediction for you, but it’s why doctors suggest a simple blood test when they see xanthelasma. Our guide on whether xanthelasma is dangerous puts it in proportion.

Looking into whether xanthelasma is harmful

Why Do People Get Xanthelasma?

Mostly because of raised blood fats, inherited cholesterol problems or conditions such as diabetes, an underactive thyroid or certain liver and kidney conditions. Some people simply get it with age, with completely normal tests.

The main causes are:^[1]

Blood fat disorders. Raised LDL, raised triglycerides or low HDL.
Your genes. Inherited high cholesterol, such as familial hypercholesterolemia, which affects about 1 in 250 to 1 in 500 people.^[5]
Other conditions. Diabetes, an underactive thyroid, the liver condition primary biliary cholangitis and the kidney condition nephrotic syndrome.
Medicines. Taking retinoid or estrogen medicines can raise blood fats in some people.
Local eyelid factors. Leakier vessels with age, in people whose tests are normal.

Being a woman and being in midlife also make it more likely. Our guides to what xanthelasma is caused by and why you might have got xanthelasma go through each cause.

Looking into why people get yellow spots on eyelids

What Are The Common Myths About Xanthelasma?

The big ones are that it’s contagious, that it’s cancer, that it always means high cholesterol, that it can be squeezed out, and that garlic will get rid of it. None of these is true.

Myths

You can catch it or pass it on
It’s a type of cancer
It always means high cholesterol
You can squeeze or pop it out
It goes away if you eat well
Garlic or vinegar removes it safely

Facts

It isn’t an infection and isn’t contagious
It’s a harmless buildup of fat-filled cells
About half of people have normal blood fats
The fat is locked inside cells in the skin
Established patches rarely fade by themselves
Garlic has caused burns and scarring on skin

The garlic myth is worth singling out. A systematic review of 39 reported garlic burn cases found mostly second-degree burns, with some scarring, especially on the face.^[4] On eyelid skin, the thinnest on the body, that’s a real risk. Our guides on whether you can squeeze out xanthelasma and whether xanthelasma can be cancerous explain more.

Looking into common myths about xanthelasma

How Does Xanthelasma Fit Into The Xanthoma Family?

Xanthelasma is one member of a family of fatty deposits called xanthomas. It’s the eyelid type and by far the most common. Other types form on tendons, the buttocks and limbs, or in the palm creases, and tend to point more strongly to a blood fat disorder.

All xanthomas share the same building block, fat-filled foam cells, but where they appear and what they suggest differ. Eruptive xanthomas, crops of small yellow-red bumps, are seen when triglycerides are very high, above about 1,000 mg/dL, which also raises the risk of pancreatitis.^[6] Tendon xanthomas, firm lumps on the Achilles tendons, hands, elbows and knees, are a hallmark of inherited high cholesterol.^[5]

So while xanthelasma on its own is often just cosmetic, fatty lumps or bumps elsewhere on the body always deserve a doctor’s look. The table below sums up the family, and our guide to xanthomas covers every type, with more on eruptive xanthoma and tendon xanthomas.

Looking into how xanthelasma fits into the xanthoma family

Xanthelasma And The Xanthoma Family Compared

Type	Where	How It Looks	Often Linked To
Xanthelasma	Eyelids, near the inner corners	Soft yellow patches, flat or slightly raised	Blood fat disorders in about half; often cosmetic
Eruptive xanthoma	Buttocks, arms, legs	Sudden crops of small yellow-red bumps	Very high triglycerides
Tendon xanthoma	Achilles tendons, hands, elbows, knees	Firm lumps under the skin	Inherited high cholesterol
Tuberous xanthoma	Elbows, knees	Firm yellow nodules	Blood fat disorders
Plane xanthoma	Palm creases, neck, trunk	Flat yellow patches	Blood fat or blood protein disorders

What Should You Do First If You Think You Have Xanthelasma?

See your family doctor once to confirm it and have a blood test for cholesterol, blood sugar, thyroid and liver function. Then decide whether you’d like the patches removed.

Don’t pick or squeeze. It won’t work and risks infection and scarring.
Book a check-up. Your family doctor can usually confirm xanthelasma by looking.^[1]
Have the blood tests. A fasting lipid profile, liver panel, thyroid tests and fasting glucose are the usual set.^[1]
Mention your family. Tell your doctor about relatives with high cholesterol or early heart disease.
Manage anything found. Follow your doctor’s advice on cholesterol, blood sugar or thyroid.
Decide about the patches. If they bother you, choose a removal method that suits them.

Looking into what to do first about xanthelasma

How Is Xanthelasma Removed?

It can be removed at a clinic with laser, surgery, freezing or chemical peels, or at home with a cream made for it. Lowering cholesterol protects your health but rarely clears existing patches.

Clinic removal works. A review of 49 studies found that CO2 laser gave more than 75% improvement in over 90% of patients, and Er:YAG laser more than 80% improvement; changes in skin color were the most common complication, and surgery was used for larger, deeper plaques.^[3] Surgery near the eye can cause the lower lid to turn outward or pull back, and freezing or chemical methods can scar or discolor the skin.^[1]

Many people would rather not have a procedure so close to their eyes. Our guides to the removal of xanthelasma and what you can use for xanthelasma compare every option, and xanthelasma cream covers the at-home route.

Once your doctor has checked your blood fats, if you’d like to deal with the patches at home, this is the cream we make for xanthelasma.

Will Xanthelasma Go Away Or Come Back?

It rarely goes away on its own, and it can come back after removal. Recurrence is generally under 50%, and deeper patches return more often.

Because the fat is locked inside cells in the skin, patches usually stay the same or grow slowly over time. In our experience, a healthier diet or cholesterol-lowering medicine rarely shrinks established patches, though both are good for your heart and may help limit new ones.

After removal, recurrence is generally under 50%, it’s higher after repeated procedures, and deeper plaques come back more often.^[1] Keeping any cholesterol, blood sugar or thyroid problem under control gives you the best chance of fewer new patches. Our guide on whether xanthelasma comes back covers recurrence in full.

Looking into whether xanthelasma goes away or comes back

What’s Xanthelasma? The Bottom Line

Xanthelasma is harmless yellow patches of fat-filled cells on the eyelids. It doesn’t affect your eyes, but about half of people have a blood fat problem behind it, so have one check-up, then decide whether to remove the patches.

Skip the garlic and the squeezing, and choose a method that keeps the delicate eyelid skin safe. Xanthel® is a cosmetic cream made for xanthelasma removal at home, sold by Xanthelasma.com. You’ll find it at the foot of this page, or read more about Xanthel® xanthelasma removal cream and browse all our xanthelasma guides.

Common Questions About Xanthelasma

What Exactly Is Xanthelasma?

Xanthelasma is a harmless buildup of fat-filled immune cells in the eyelid skin, seen as soft yellow patches, usually near the inner corners of the eyes.

Is Xanthelasma Dangerous?

No, the patches themselves are harmless. About half of people with xanthelasma have a blood fat problem, though, so a check-up with a blood test is worthwhile.

Is Xanthelasma Contagious?

No. Xanthelasma isn’t an infection, so you can’t catch it from someone or pass it on.

Does Xanthelasma Mean I Have High Cholesterol?

Not necessarily. About half of people with xanthelasma have a blood fat disorder and about half have normal results, so a blood test is the way to find out.

What Is The Difference Between Xanthelasma And Xanthoma?

Xanthoma is the name for the whole family of fatty deposits in the skin and tendons. Xanthelasma is the eyelid type and the most common one.

Will Xanthelasma Go Away On Its Own?

Rarely. The fat is locked inside cells in the skin, so patches usually stay or slowly grow unless they’re removed.

Can Xanthelasma Be Removed At Home?

Yes. Once a doctor has checked your blood fats, an at-home cream such as Xanthel®, applied only to the patch, is one way to deal with it.

Should I See A Doctor About Xanthelasma?

Yes, once. A doctor can confirm it and arrange blood tests for cholesterol, blood sugar, thyroid and liver function to check for anything behind it.