Xanthelasma removal

Xanthelasma removal is a commonly performed facial skin lesion removal procedure at Centre for Surgery in London. Xanthelasma treatment is usually not available through the NHS.

What is xanthelasma?

Xanthelasma is a collection of whitish or yellowish spots composed of fat or cholesterol which commonly occur in the eyelid region. In many cases the whitish spots develop into larger areas which take on a yellow colour. Xanthelasma has a plaque-like appearance caused by the cells absorbing fat from the bloodstream which leads to a fatty deposit in the skin. Xanthelasma are commonly located on the upper eyelids and lower eyelids. They are most common location however is at the inner corner of the eye. Xanthelasma removal is sometimes performed as the same time as blepharoplasty surgery as the strip of eyelid skin removed can be extended to remove the xanthelasma.

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Over 15 years experience with all types of skin lesion removal and not just xanthelasma removal – skin tag removal, wart removal, mole removal, lipoma removal and cyst removal

Having xanthelasma can be associated with having high blood cholesterol levels. Our dermatologists advise that patients with confirmed xanthelasma consult with their GP to have their blood cholesterol levels measured before any treatment. It is generally accepted that a confirmed diagnosis of high cholesterol and even with with modification of lifestyle with diet, weight loss and statin therapy, xanthelasma spots do not go away on their own. With successful treatment of high cholesterol, you will then be in an ideal position to have the xanthelasma removed with erbium laser.

Xanthelasma formation can also be genetic in origin.

Although surgical removal is the traditional method of xanthelasma removal, the surgical option is associated with incision and scar formation. Our dermatology practitioners prefer the erbium laser for precise removal with excellent scar-free cosmetic results, less risk and a much quicker recovery. The eyelid region is delicate and the precise nature of the Erbium YAG laser is well suited to treatment in this region. Eyelid skin is the thinnest skin in the body and only Erbium YAG laser has the precision to ablate the skin layer by layer. Skin scarring and contractures are minimised with the use of Erbium YAG laser. CO2 laser is not suitable as it lacks precision due to its coagulative effect and subsequent high risk of scarring.

With xanthelasma removal, it is necessary to insert metal eye shields which sit on top of the eye to protect the delicate cornea from the laser beam during treatment. The eye shields are very well tolerated as a few drops of topical local anaesthetic solution are applied beforehand along with water soluble lubricating gel.

Unlike CO2 laser, Erbium YAG laser is suitable for use with darker skin types. There are a number of xanthelasma removal techniques and all have a potential risk of skin discolouration. Erbium YAG laser has the lowest risk of skin changes of all the recognised removal techniques.

With larger lesions, your laser surgeon may want to perform xanthelasma removal in 2 stages. With the first treatment, reduction in size can be safely achieved. About 6 weeks later, the second treatment will aim to completely remove the residual xanthelasma tissue. By performing xanthelasma removal in 2 stages, the risk of scarring is minimised. Following treatment your doctor will apply an antibiotic ointment to the areas of treatment and this is to be used twice daily for three days. As with virtually all skin lesions, it is important to bear in mind that successful xanthelasma removal does not prevent the development of new skin lesions elsewhere on the skin in the future.

Surgical excision of these common skin lesions was formerly common method of treatment and generally consists of simply cutting out the affected tissue followed by skin closure using sutures. Radiosurgery has also been used to ablate the surface of the skin lesions but this method has to be used with great caution as the generation of thermal energy can diffuse into the surrounding tissue and this can lead to a risk of both skin discolouration and potential scarring. Some doctors use a very simple electrosurgical device known as a Hyfrecator for coagulation of the xanthelasma. Both radiosurgery and hyfrecation are now obsolete treatments which give suboptimal results with an unacceptably high risk profile and have been replaced by erbium laser.

TCA chemical peels have also been used in the treatment of xanthelasma. This is now an old-fashioned treatment which although simple and low-cost does have a higher risk of scarring and potential for incomplete removal as the depth of penetration of the chemical peel can be variable. Precise laser ablation with erbium laser is far more accurate and with greater control over treatment depth when compared with TCA chemical peels.

Punch excision is a technique commonly used for the treatment of localised acne scars. This treatment involves the use of a small circular skin punch to remove an affected area of skin followed by closure with small skin sutures. Like surgical excision there will be a resultant scar. This technique has also been replaced by erbium laser which is effective for both smaller and larger skin lesions.

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Centre for Surgery is located at 106 Crawford Street in Marylebone. Crawford Street is just off Baker Street. We are easily accessible by all major bus routes that pass through Baker Street as well as Baker Street underground station.

From the tube station, we are just a 5 minute walk southwards down Baker Street followed by a right turn onto Crawford Street. The clinic is about 200 yards on the left.

There is ample local pay & display parking in the surrounding area and an NCP car park is located further west along Crawford Street. Our local residential parking zone is the City of Westminster.

Address: 106 Crawford Street, Marylebone, London, W1H 2HY