Xanthomas: Types, Causes And What They Mean

Types, Causes And What They Mean For Your Health

Xanthomas are yellowish deposits of cholesterol and other fats in the skin or tendons. Most are harmless in themselves, but they can be an outward sign of raised blood fats, so they’re worth understanding. Here’s what xanthomas are, the main types and where they appear, what causes them, how they’re linked to heart health, and how they’re dealt with, including xanthelasma, the eyelid type.

Quick Answer

Xanthomas are waxy, yellowish fat deposits that form in the skin or tendons. Xanthelasma, on the eyelids, is the most common type. Others appear on tendons, elbows, knees, palms or as sudden crops of small bumps. Many are linked to high cholesterol or triglycerides, so a blood test with your doctor is the first step.

Key Takeaways

Xanthomas are fat deposits in the skin or tendons, usually painless and harmless in themselves.
Xanthelasma on the eyelids is the most common type of xanthoma.
Many xanthomas signal raised cholesterol or triglycerides, which matters for heart health.
Tendon xanthomas are a classic sign of inherited high cholesterol.
Managing blood fats can shrink some types; eyelid xanthelasma usually needs removing.

On This Page 13 sections

What Are Xanthomas?

Xanthomas are deposits of cholesterol and other fats that build up in the skin or tendons, forming yellowish bumps, patches or lumps. They’re usually painless and not dangerous in themselves, but they can point to how your body handles fats.

The word comes from the Greek for “yellow”, which describes them well. A xanthoma forms when fat-filled cells collect in one spot, slowly building into something you can see or feel. One is called a xanthoma; more than one, xanthomas or xanthomata. You’ll find a short definition on our page about what a xanthoma is.

By far the most common type is xanthelasma: soft, flat, yellow plaques on the eyelids, usually near the inner corner. It affects around 1.1% of women and 0.3% of men, mostly from their mid-thirties to mid-fifties.^[1] Other xanthomas are much rarer and tend to sit over tendons and joints, or appear suddenly as a rash of small bumps. They can show up at any age, and some run in families.

Looking into what xanthomas are and how they form in the skin

What Do Xanthomas Look Like?

Xanthomas are yellow, orange or skin-colored deposits that can be flat patches, small raised bumps or firm lumps, depending on the type and where they form.

Their look varies a lot. Eyelid xanthelasma is soft, flat and velvety, like a thin yellow patch sitting just under the surface. Tendon xanthomas are firm, smooth lumps that move with the tendon, most often at the back of the heel. Eruptive xanthomas are small, raised, yellow-red spots that appear in crops and can itch. Tuberous xanthomas are larger, firmer nodules over pressure points like the elbows and knees.

Most xanthomas grow slowly over months or years and don’t hurt. The exception is eruptive xanthomas, which can appear over a few weeks and may feel tender. Because several other skin conditions can look similar, it’s always worth having a new yellow mark checked. Our guide to what can be mistaken for xanthelasma covers the common lookalikes, and eyelid xanthomas explains the eyelid form in detail.

Looking into what xanthomas look like on the eyelids and body

What Are The Different Types Of Xanthomas?

The main types are xanthelasma (eyelids), tendon, eruptive, tuberous, palmar and plane xanthomas. Each tends to appear in a particular place and often points to a different kind of blood fat problem.

Knowing the type matters because it tells a doctor where to look. Tendon xanthomas are strongly linked to familial hypercholesterolemia, an inherited form of high cholesterol.^[2] Eruptive xanthomas usually mean very high triglycerides, typically above 1,000 mg/dL.^[5] Palmar xanthomas in the creases of the palms, along with tuberous xanthomas, are seen in mixed lipid disorders such as dysbetalipoproteinemia.^[4]

Types Of Xanthomas Compared

Type	Where	What It Looks Like	Often Linked To
Xanthelasma	Eyelids, often the inner corner	Soft, flat yellow plaques	Raised cholesterol in about half; normal lipids in the rest
Tendon xanthoma	Achilles tendon, hands, elbows, knees	Firm, smooth lumps on the tendon	Inherited high cholesterol
Eruptive xanthoma	Buttocks, shoulders, arms, legs	Crops of small yellow-red bumps	Very high triglycerides, often with diabetes
Tuberous xanthoma	Elbows, knees, pressure points	Firm yellow nodules	Mixed lipid disorders
Palmar xanthoma	Creases of the palms and fingers	Yellow lines in the creases	Dysbetalipoproteinemia
Plane xanthoma	Skin folds, neck, trunk	Flat yellow patches	Lipid disorders; a doctor may run extra tests

There are rarer forms too, including xanthoma disseminatum and gastric xanthomas found inside the stomach during an endoscopy. Each main type has its own guide: tendon xanthomas, eruptive xanthoma, tuberous xanthoma, palmar xanthoma and plane xanthoma.

Looking into the different types of xanthomas, from eruptive to tendon xanthomas

What Causes Xanthomas?

Most xanthomas are caused by raised blood fats, either cholesterol or triglycerides, from inherited conditions, diabetes, an underactive thyroid or other health problems. Xanthelasma is the exception: about half of people with it have normal cholesterol.

When there’s more fat in the blood than the body can clear, some of it can settle into the skin and tendons, where immune cells take it up and slowly build into a xanthoma. The most common drivers are:

Inherited high cholesterol. Familial hypercholesterolemia affects somewhere between 1 in 500 and 1 in 250 people and is passed from parent to child.^[2]
Very high triglycerides. Often linked to uncontrolled diabetes, and the usual cause of eruptive xanthomas.^[5]
Other conditions. An underactive thyroid, liver problems and some medicines can raise blood fats.
Rare inherited disorders. Conditions such as dysbetalipoproteinemia and cerebrotendinous xanthomatosis.

Eyelid xanthelasma doesn’t always follow the rules. About half of adults with xanthelasma have abnormal blood fats, which means about half have normal levels.^[1] Genetics and local factors in the eyelid skin seem to play a part. Our guide to the causes of xanthelasma goes into this in more depth.

Looking into what causes xanthomas, from cholesterol to triglycerides

Are Xanthomas A Sign Of Heart Disease?

They can be. The xanthomas themselves are harmless, but the raised blood fats behind many of them raise the risk of heart disease, which is why a cholesterol test matters more than the bump itself.

This is the most important health point on this page. Tendon xanthomas in particular are a classic sign of familial hypercholesterolemia, and untreated, that condition carries a high risk: in studies from before statins were widely used, about half of affected men had a heart attack or other coronary event by age 50, and about 30% of women by 60.^[2] With cholesterol-lowering medicine, that risk falls substantially.

Xanthelasma on the eyelids is worth taking seriously too, even with normal cholesterol. 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, even after their cholesterol levels were taken into account.^[6]

None of this means a xanthoma is a heart problem in itself. It means it’s a useful early prompt to get checked. Our page on whether xanthelasma indicates raised cholesterol covers the eyelid side of this.

Looking into the link between xanthomas and heart disease

What Is Cerebrotendinous Xanthomatosis?

Cerebrotendinous xanthomatosis (CTX) is a rare inherited disorder in which cholesterol-like fats build up in nearly every tissue, causing tendon xanthomas, cataracts and, over time, problems with the brain and nerves. It needs specialist care, and early diagnosis makes a big difference.

CTX is caused by changes in a gene called CYP27A1, inherited from both parents. The signs tend to appear in a typical order: long-lasting diarrhea in infancy, cataracts in childhood (the first sign in about three-quarters of people), tendon xanthomas in the teens or twenties, most often on the Achilles tendon, and then neurological problems in adulthood.^[3]

The good news is that there’s a targeted medicine, chenodeoxycholic acid, and starting it early appears to prevent many of the symptoms.^[3] That’s why firm tendon lumps together with early cataracts, or any change in memory, balance or mood, should be seen by a doctor promptly. CTX is very different from everyday eyelid xanthelasma, and it isn’t something to manage at home. Our page on xanthomatosis covers the wider group of conditions.

Looking into cerebrotendinous xanthomatosis and Achilles tendon xanthomas

How Are Xanthomas Diagnosed?

A doctor can usually recognize a xanthoma by looking at it, then orders blood tests for cholesterol, triglycerides and often blood sugar and thyroid function to find any cause behind it.

Diagnosis is usually straightforward. Your doctor will look at the marks, ask how long they’ve been there, and ask about your family history of high cholesterol or early heart disease. The key test is a fasting or non-fasting lipid panel, which measures your cholesterol and triglycerides. Depending on the type, they may also check blood sugar, thyroid and liver function.

If a mark looks unusual, a small skin sample (biopsy) can confirm it’s a xanthoma. If the results suggest an inherited condition, you may be referred to a lipid specialist, and close relatives may be offered testing too. For eyelid xanthelasma, see our guide to who removes xanthelasma for the specialists involved in removal.

Looking into how xanthomas are diagnosed with blood tests

Can Xanthomas Be Removed?

It depends on the type. Many xanthomas on the body shrink or fade once the blood fats behind them are brought under control. Eyelid xanthelasma usually stays put even with good cholesterol, so it’s normally removed directly.

For xanthomas caused by a lipid disorder, managing the cause comes first. That means diet, activity and, where needed, cholesterol-lowering medicine; in familial hypercholesterolemia, statins are the first-line option.^[2] Palmar and similar xanthomas tend to fade over time once blood fats are brought down.^[4] Eruptive xanthomas usually settle as triglycerides come down. Larger tendon or tuberous xanthomas that don’t shrink can sometimes be removed by a surgeon.

Eyelid xanthelasma is different. Because about half of people with it have normal cholesterol, lowering blood fats often makes little difference to the plaques already there.^[1] It’s usually removed directly, either at a clinic with surgery, laser or freezing, or at home with a cream made for xanthelasma. Our guides to the removal of xanthelasma and xanthelasma cream compare the routes, and clinical options for xanthomas covers the medical side.

If your xanthomas are on your eyelids, this is the at-home cream we make for them.

Looking into whether xanthomas can be removed or reduced

How Is Xanthelasma Different From Other Xanthomas?

Xanthelasma is the eyelid type of xanthoma. It’s far more common than the others, often appears with normal cholesterol, and is mostly a cosmetic concern, while xanthomas elsewhere are more often a sign of a significant lipid disorder.

Xanthelasma (Eyelids)

Soft, flat yellow plaques near the inner eye
The most common type by far
About half of people have normal cholesterol
Rarely fades on its own; usually removed directly

Other Xanthomas (Body)

Bumps, lumps or patches on tendons, joints, palms or skin
Much less common
Usually linked to a lipid disorder
Often shrink once blood fats are controlled

In short, every xanthelasma is a xanthoma, but not every xanthoma is xanthelasma. If you have both eyelid plaques and lumps elsewhere, that’s a stronger reason to have your blood fats checked. Find out more on our main xanthelasma page and in xanthoma.

Looking into how xanthelasma differs from other xanthomas

How Do You Live With Xanthomas Day To Day?

Keep your blood fats in check with your doctor, build heart-healthy habits, and deal with any visible eyelid plaques in whatever way suits you, because how they make you feel matters too.

On the health side, the habits that help are the familiar ones: a balanced diet with less saturated fat, regular activity, a healthy weight, not smoking, keeping diabetes well controlled, and regular cholesterol checks. They won’t always shrink existing xanthomas, but they protect your heart and may slow new ones forming.

On the personal side, visible xanthomas, especially on the face, can knock your confidence more than people expect. Some people avoid photos or feel self-conscious in conversation. Wanting them gone is completely reasonable. Makeup can soften the yellow day to day, and our guide to covering xanthelasma with makeup shows how. For a longer-term fix on the eyelids, removal is the way to go.

Looking into living with xanthomas under the eyes and on the body

What’s The Bottom Line On Xanthomas?

Xanthomas are harmless fat deposits that can carry an important message about your blood fats, so get your cholesterol checked, manage any cause with your doctor, and deal with eyelid xanthelasma as the cosmetic issue it usually is.

Most people who search for xanthomas have xanthelasma on their eyelids, and for them the plan is simple: a blood test to rule out anything behind it, then removal of the visible plaques if they bother you. Xanthomas elsewhere on the body are more often tied to a lipid disorder and are best handled with your doctor. Xanthel® is a cosmetic cream made for xanthelasma removal at home, sold by Xanthelasma.com, for the eyelid type only. You’ll find it at the foot of this page, or read more about Xanthel® xanthelasma removal cream and browse our other xanthelasma guides.

Common Questions About Xanthomas

What Is The Difference Between A Xanthoma And Xanthelasma?

Xanthoma is the umbrella term for fat deposits in the skin or tendons, and xanthelasma is the type that forms on the eyelids. Every xanthelasma is a xanthoma, but not every xanthoma is xanthelasma.

Are Xanthomas Dangerous?

Xanthomas themselves are harmless and usually painless. They can, though, be a sign of raised cholesterol, high triglycerides, diabetes or an inherited lipid disorder, so a blood test with your doctor is important.

Will Lowering My Cholesterol Make Xanthomas Disappear?

Sometimes. Xanthomas on the body often shrink once blood fats are controlled, but eyelid xanthelasma usually stays even with good cholesterol, so it’s normally removed directly.

Are Xanthomas Hereditary?

They can be. Inherited conditions such as familial hypercholesterolemia often cause xanthomas, especially on the tendons, so tell your doctor if high cholesterol or early heart disease runs in your family.

What Are The Most Common Types Of Xanthomas?

Xanthelasma on the eyelids is by far the most common. The others are tendon, eruptive, tuberous, palmar and plane xanthomas, each usually linked to a particular kind of blood fat problem.

Do Xanthomas Come Back After Removal?

They can, especially if the cause behind them isn’t managed. Even eyelid xanthelasma can return after removal, so keeping an eye on your cholesterol with your doctor is worthwhile.

Can Xanthomas On The Eyelids Be Removed Without Surgery?

Yes. Besides surgery, eyelid xanthelasma can be removed with laser or freezing at a clinic, or at home with a cream made for xanthelasma. A doctor’s check first is always sensible.

Is It Normal To Feel Self-Conscious About Xanthomas?

Yes, especially when they’re on the face. Many people feel self-conscious about eyelid xanthomas, and wanting them removed is a perfectly reasonable choice.