Xanthomata: Types, What They Mean And When To Worry

What Each Type Of Fatty Deposit Says About Your Blood Fats, And Which Ones Need A Doctor First

Xanthomata are yellowish deposits of fat-filled cells in the skin or tendons, and the plural of xanthoma. Where they appear and what they look like often point to a particular blood fat problem, which is why doctors read them almost like a map. The eyelid type, xanthelasma, is the most common and is usually cosmetic; most other types are a reason to see a doctor first.

Quick Answer

Xanthomata are fatty deposits made of fat-filled immune cells in the skin or tendons. Eyelid xanthelasma is the most common and often harmless. Tendon xanthomata suggest inherited high cholesterol, eruptive ones very high triglycerides, palmar and tuberous ones a disorder called dysbetalipoproteinemia, and widespread flat ones can need blood protein tests.

Key Takeaways

Xanthomata is the plural of xanthoma: fat-filled deposits in skin or tendons.
The type and location often point to a specific blood fat disorder.
Eyelid xanthelasma is the most common and is often cosmetic.
Tendon xanthomata are a classic sign of inherited high cholesterol.
Eruptive xanthomata go with very high triglycerides and need prompt attention.
Only eyelid xanthelasma suits at-home removal.

On This Page 15 sections

What Are Xanthomata?

Xanthomata are yellowish deposits of fat-filled immune cells in the skin, tendons or other tissues. “Xanthoma” means one deposit and “xanthomata” (or xanthomas) means several. The name comes from the Greek word for yellow.

Every xanthoma is built the same way. Immune cells called macrophages take in more fat than they can process and become swollen, foamy cells. Where these foam cells gather, a yellow deposit forms.^[1] What differs between types is where the fat collects, how it looks, and what’s driving it.

That last point is what makes xanthomata medically useful. Many types are a visible sign of a blood fat disorder, some of them inherited, and some sit alongside conditions such as diabetes or, rarely, blood protein disorders.^[1]^[3]^[6] Our guides to xanthomas, the xanthoma overview and the xanthoma definition cover the terms, and xanthomatous explains the adjective doctors use.

How Does The Type Of Xanthomata Point To A Cause?

Each type tends to go with a particular blood fat pattern. Tendon deposits suggest inherited high LDL cholesterol, sudden crops of bumps suggest very high triglycerides, yellow palm creases suggest dysbetalipoproteinemia, and widespread flat patches with normal cholesterol can suggest a blood protein disorder.

Doctors use this pattern as a shortcut. Seeing the type and location narrows down which blood tests to order and what to look for. Here’s the broad picture:

Eyelids. A blood fat disorder in about half; the rest have normal tests.^[1]
Tendons. Classic for familial hypercholesterolemia, an inherited high-LDL condition.^[2]
Sudden crops of small bumps. Very high triglycerides, often above 1,000 mg/dL.^[3]
Palm creases and pressure points. Dysbetalipoproteinemia.^[4]
Widespread flat patches. Sometimes linked to monoclonal gammopathy, a blood protein disorder.^[6]

It’s a guide, not a diagnosis: the same type can have more than one cause, and only blood tests confirm what’s going on. Our guide to xanthomatosis covers widespread xanthomata.

Looking into how the type of xanthomata points to a cause

What Are Eyelid Xanthomata?

Eyelid xanthomata are called xanthelasma: soft, yellow, flat or slightly raised plaques, usually near the inner corners of the eyelids. It’s the most common type of xanthoma and is often cosmetic, but about half of people with it have a blood fat disorder.

Xanthelasma affects around 1.1% of women and 0.3% of men, most often between 35 and 55.^[1] About 50% of people with it have a primary or secondary lipid disorder, such as raised LDL or low HDL, or another condition like diabetes, an underactive thyroid or a liver problem; the rest have normal blood tests.^[1] It can also be a feature of inherited high cholesterol, so doctors look harder when it appears in younger people.^[1]^[2]

Unlike most other xanthomata, xanthelasma doesn’t usually signal anything serious on its own, and it’s the only type that suits removal at home. Our guides to xanthelasma and xanthelasma palpebrarum cover it in depth.

Looking into eyelid xanthomata (xanthelasma)

What Do Tendon Xanthomata Mean?

Tendon xanthomata are firm lumps over tendons, especially the Achilles, and on the hands, elbows, knees and feet. They’re a classic sign of familial hypercholesterolemia, an inherited condition that keeps LDL cholesterol high from birth.

Familial hypercholesterolemia (FH) affects about 1 in 250 to 1 in 500 people and is passed on in a dominant way, so each child of an affected parent has a 50% chance of inheriting it. People with FH can develop tendon xanthomata and xanthelasma. Without medical care, about half of men with FH had a coronary event by 50 and about 30% of women by 60, and statins are the first-line approach.^[2] That’s why tendon xanthomata always deserve a doctor’s assessment.

A much rarer cause is cerebrotendinous xanthomatosis, an inherited condition that can cause diarrhea in infancy, cataracts in childhood (in about 75%), tendon xanthomata in the teens or twenties and nerve problems in adulthood. Early care with a bile acid called chenodeoxycholic acid appears to prevent symptoms.^[5] Our guides to tendon xanthomata and Achilles tendon xanthoma go further.

Looking into tendon xanthomata on the Achilles

What Do Eruptive Xanthomata Mean?

Eruptive xanthomata are sudden crops of small yellow-red bumps, often on the buttocks, arms and legs. They’re linked to very high triglycerides, typically above 1,000 mg/dL, which also raises the risk of pancreatitis, so they need prompt medical attention.

Uncontrolled diabetes in particular can drive triglycerides up sharply, and the same very high levels raise the risk of acute pancreatitis.^[3] Very high triglycerides can even make the blood vessels at the back of the eye look milky white on examination, a sign called lipemia retinalis.^[3]

Bringing triglycerides down safely is the priority, so don’t wait: see a doctor promptly. Our guide to eruptive xanthoma covers them in more detail.

What Do Tuberous And Palmar Xanthomata Mean?

Tuberous xanthomata are firm yellow nodules over pressure points such as the elbows and knees, and palmar xanthomata are yellow lines in the creases of the palms. Both are typical of dysbetalipoproteinemia, an inherited blood fat disorder, and the palmar ones fade once it’s managed.

Dysbetalipoproteinemia causes a buildup of cholesterol- and triglyceride-rich particles in the blood. Palmar and tuberous xanthomata are its hallmark skin signs, and palmar xanthomata fade once the condition is managed.^[4] Tuberous xanthomata can also appear with other blood fat disorders.

Because these types point to a specific, manageable condition, they’re well worth having checked. Our guides to tuberous xanthoma and palmar xanthoma go further.

Looking into palmar and tuberous xanthomata

What Do Plane Xanthomata Mean?

Plane xanthomata are flat yellow patches. On the eyelids they’re xanthelasma, but widespread flat patches on the neck, trunk or skin folds, especially with normal cholesterol, have been linked to monoclonal gammopathy, a blood protein disorder, and need a doctor’s workup.

In diffuse normolipemic plane xanthoma, blood fats are normal. Research has linked it with monoclonal gammopathy, where the blood carries an excess of one antibody protein, and with related conditions.^[6] Most people with this finding have a mild form that only needs monitoring, but it’s important to find out.

Our guides to plane xanthoma and skin xanthomas cover flat patches beyond the eyelids. Xanthomas can also form inside the body, such as in the stomach lining; see gastric xanthoma.

The Types Of Xanthomata Compared

Type	Where	Often Points To	What To Do
Xanthelasma	Eyelids, inner corners	Blood fat disorder in about half; often cosmetic	Routine check-up, then removal if wanted
Tendon	Achilles, hands, elbows, knees, feet	Familial hypercholesterolemia	See a doctor; lipid and family assessment
Eruptive	Buttocks, arms, legs	Very high triglycerides	Prompt medical attention
Tuberous	Elbows, knees	Dysbetalipoproteinemia and other lipid disorders	See a doctor
Palmar	Palm and finger creases	Dysbetalipoproteinemia	See a doctor; fades once managed
Diffuse plane	Neck, trunk, skin folds	Blood protein disorders, often with normal lipids	See a doctor; blood protein tests

How Are Xanthomata Diagnosed?

A doctor examines the deposits and their pattern, asks about family history, and orders blood tests: a lipid profile, blood sugar, thyroid and liver tests, and sometimes blood protein or genetic tests. A small biopsy confirms the diagnosis when needed.

Examination. The type, location and pattern of the deposits guide the next steps.
Family history. Relatives with high cholesterol or early heart disease point toward an inherited cause.^[2]
Blood tests. A fasting lipid profile, liver panel, thyroid tests and blood sugar are standard.^[1]
Further tests if needed. Genetic testing for inherited conditions, or blood protein tests for widespread flat patches.^[2]^[6]
Biopsy if unsure. A small sample shows the fat-filled foam cells and rules out lookalikes.^[1]

Looking into how xanthomata are diagnosed

How Are The Blood Fats Behind Xanthomata Managed?

It depends on the cause. Inherited high LDL cholesterol is usually managed with cholesterol-lowering statins, very high triglycerides need bringing down quickly with close attention to diabetes, and rare inherited conditions have their own specific care.

Management is led by your doctor and is tailored to what the blood tests find:

Familial hypercholesterolemia. Statins are the first-line medicine, alongside diet and lifestyle, and starting early matters for the heart.^[2]
Very high triglycerides. Getting diabetes under control is a key step, because uncontrolled diabetes drives triglycerides up and very high levels raise the risk of pancreatitis.^[3]
Dysbetalipoproteinemia. Managing the blood fat disorder is what makes palmar xanthomata fade.^[4]
Cerebrotendinous xanthomatosis. A bile acid called chenodeoxycholic acid is used, and early care appears to prevent symptoms.^[5]
Blood protein disorders. A hematologist decides whether monitoring or further care is needed.^[6]

For everyone, a balanced diet, regular activity, a healthy weight and not smoking support healthier blood fats and a healthier heart. If a relative has been found to have an inherited cholesterol disorder, ask your doctor whether you should be tested too, as each child of an affected parent has a 50% chance of inheriting familial hypercholesterolemia.^[2]

Looking into how the blood fats behind xanthomata are managed

Do Xanthomata Go Away?

Some do once the cause is managed. Palmar xanthomata, for example, fade once the blood fat disorder behind them is managed. Tendon xanthomata and eyelid xanthelasma tend to persist, and xanthelasma usually needs removing if you want it gone.

Palmar xanthomata fade once dysbetalipoproteinemia is managed,^[4] and your doctor can tell you what to expect for other body types as your blood fats improve. Tendon xanthomata are slower to change. Eyelid xanthelasma rarely fades by itself, even when cholesterol improves, because the fat is locked inside cells in the skin.

So for the body types, managing the cause with your doctor is the main route. For the eyelid type, there are two jobs: check the cause, and remove the plaques if they bother you.

How Do You Remove Eyelid Xanthelasma?

Eyelid xanthelasma can be removed at a clinic with laser, surgery, freezing or chemical peels, or at home with a cream made for it. Clinic methods carry a risk of scarring and color change. Other types of xanthomata need a doctor, not a cream.

Surgery near the eye can cause the lower lid to turn outward or pull back, and freezing and chemical methods can scar or discolor the skin.^[1] After removal, recurrence is generally under 50%, and deeper plaques come back more often.^[1] Our guides to the removal of xanthelasma and xanthelasma cream compare the options.

If a doctor has confirmed your xanthomata are only on the eyelids, and your blood has been checked, this is the at-home cream we make for them.

When Should You See A Doctor About Xanthomata?

Always for any xanthomata beyond the eyelids, and promptly for sudden crops of bumps. For eyelid xanthelasma, one routine visit with a blood test is enough before deciding on removal.

See A Doctor Promptly If

Crops of small yellow-red bumps appear suddenly
You have lumps on your tendons, elbows or knees
You see yellow lines in your palm creases
Flat yellow patches spread over your body

A Routine Visit Is Fine If

The deposits are only on your eyelids
They’re soft, yellow and slow to change
You’d like a cholesterol check
You’re thinking about removal

Sudden abdominal pain alongside eruptive xanthomata needs urgent care, because very high triglycerides can trigger pancreatitis.^[3]

Looking into when to see a doctor about xanthomata

What’s The Bottom Line On Xanthomata?

Xanthomata are fat-filled deposits whose type and location often point to a specific blood fat or blood protein disorder. Eyelid xanthelasma is the most common and often cosmetic; tendon, eruptive, tuberous, palmar and widespread flat types need a doctor first.

Whatever the type, a blood test is the starting point. If yours are only on the eyelids and the plaques bother you, they can be removed. 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 all our xanthelasma guides.

Common Questions About Xanthomata

What Is The Difference Between Xanthoma And Xanthomata?

Only number. One deposit is a xanthoma, and several are xanthomata, also written xanthomas.

Are All Xanthomata Serious?

No. Eyelid xanthelasma is often cosmetic, but tendon, eruptive, tuberous, palmar and widespread flat xanthomata can point to significant blood fat or blood protein disorders.

Do Xanthomata Mean High Cholesterol?

Often, but not always. Some types go with high triglycerides rather than cholesterol, eyelid xanthelasma can occur with normal results, and widespread flat patches can occur with normal lipids.

Are Xanthomata Hereditary?

Some are. Tendon xanthomata are a classic sign of familial hypercholesterolemia, which each child of an affected parent has a 50% chance of inheriting.

Can Xanthomata Go Away On Their Own?

Some fade once the cause is managed, such as palmar xanthomata. Tendon xanthomata and eyelid xanthelasma tend to persist without removal.

Which Xanthomata Can Be Removed At Home?

Only eyelid xanthelasma. Xanthel® is made for the eyelid type only and isn’t for xanthomata anywhere else on the body.

Are Eruptive Xanthomata An Emergency?

They need prompt medical attention, because they go with very high triglycerides that raise the risk of pancreatitis. Sudden belly pain alongside them needs urgent care.

Should I See A Doctor About Xanthomata?

Yes. Any xanthomata beyond the eyelids need a doctor’s assessment, and eyelid xanthelasma is worth one routine check-up with a blood test.