If you have high cholesterol, you may notice xanthelasma, which are slightly elevated or flat yellow-tinged growths on your skin. These are cholesterol deposits, and they generally accumulate on or around your eyelids. They are a common side effect of high concentrations of lipids in your blood.

While cholesterol deposits aren’t harmful, they can get worse over time and may cause some pain and discomfort. If you notice these deposits, consult your doctor. Cholesterol deposits could sometimes be a sign of other more serious health problems.

Symptoms

Cholesterol deposits on or around your eyes appear as soft yellowish lumps, or papules, that are flat or slightly raised. You’ll notice them on your eyelids, around the corner of the eye, as well as closer down toward the nose.2 They usually appear in a symmetrical arrangement surrounding the eyes.

These bumps tend to remain about the same size, but can also grow gradually over time, sometimes merging to form larger lumps.

Xanthelasma aren’t dangerous in their own right, and treatment is usually for aesthetic purposes only. That being said, you may find them to be itchy and uncomfortable. Depending on where they are, they can sometimes cause your eyelid to droop.

Causes

While you can develop xanthelasma at any age, they are most commonly found in middle-aged and older adults. There is a wide range in the age of onset, with reported cases from people ages 15 to 73 years old. They are also more often found in women than men.

Dyslipidemia is a condition characterized by an abnormal level of blood lipids.5 The most common form of dyslipidemia is hyperlipidemia, which occurs when too many lipids, or fats, are present in a person’s bloodstream.

Genetic Factors

Lipid disorders that can cause cholesterol deposits are the result of genetics. They are common in people of Mediterranean and Asian descent.1

• Familial lipoprotein lipase deficiency: This is characterized by a lack of creation of the protein lipase, which breaks down lipids.6
• Familial hypercholesterolemia: This is a common condition that causes high cholesterol. While often considered an “invisible” disease, a common sign is the presence of cholesterol deposits.7
• Familial hypertriglyceridemia: This is a common genetic disorder that results in a high amount of triglycerides in the blood, and as a result, high cholesterol.

Lifestyle Factors

Some common lifestyle factors that may promote high cholesterol and cholesterol deposits include:

• Consuming a diet that is high in trans and saturated fats
• Smoking and excessive alcohol consumption
• Not exercising enough
• Having obesity

Medications

Some medications can increase your risk of hyperlipidemia and cholesterol deposits around your eyes and face, including:

• Tamoxifen, which blocks the effects of estrogen in breast tissues
• Prednisone, a corticosteroid
• Oral retinoids, which promote cell growth
• Cyclosporine, which helps prevent organ rejection in transplant patients
• Protease inhibitors, which are used to treat HIV/AIDS
• Estrogen-containing medications

Diagnosis

Since cholesterol deposits are noticeable to the naked eye, your medical provider can diagnose them through a physical exam.

Your medical provider will also ask you questions about when you first noticed the deposits, whether they are causing discomfort or pain, and if the deposits have grown or changed in shape. Your provider may take a sample of the deposits for further testing.

To diagnose hyperlipidemia, your provider will perform a blood test called a lipid panel. This is to check the triglyceride and cholesterol levels in your blood.10 This will be to definitively determine whether these deposits are the result of elevated lipid levels.

Treatment

Because xanthelasma generally cause no medical issues, they usually do not need to be treated. However, if they become cosmetically distressing, there are several ways to remove them:

• Surgical removal: In general, a simple excision with a small blade, accompanied by a traditional eyelid surgery, or blepharoplasty, is the norm. It’s the easiest way to remove xanthelasma from the eyelid. In more advanced cases where the lesion is more difficult to remove, skin grafts or local flaps, where tissue is moved from one part of the body and transferred to a surgical site, are performed.
• Chemical cauterization: This involves applying a chemical agent like chlorinated acetic acid to the skin tissue that needs to be treated to remove the lesion.12 This is also a common method for xanthelasma removal.
• Cryotherapy: Cryotherapy refers to controlled freezing of specific tissues. While using this technique repeatedly can effectively remove cholesterol deposits, it can cause intense swelling as a result of lax tissue in the eyelid and scarring.4
• Laser ablation: Laser-based procedures have proven to be less invasive than traditional surgery and carry relatively minimal scarring risk. Keep in mind that it all depends on what laser is used. The Er:YAG laser, for instance, comes with higher scarring risk than other types of lasers. Lasers could potentially cause skin pigmentation changes.
• Electrodessication: Electrodessication is a procedure usually performed to treat skin cancer. It involves burning and scraping away unwanted tissue growth.14 This is usually performed along with techniques like cryotherapy to remove cholesterol deposits.

Lifestyle Changes

Your medical provider may recommend that you adopt certain lifestyle changes to better manage the presence of lipids in your blood, which is the main cause of cholesterol deposits. Some common changes for managing your cholesterol levels include:

• Consult a dietitian: You may want to work with a dietitian or nutritionist to embrace a healthier diet to lower your cholesterol. This means a low-saturated fat, low-cholesterol meal plan that includes less than 7% calories from saturated fat and less than 200 mg of dietary cholesterol per day. This kind of diet would help you maintain a healthy weight and avoid extreme weight gain.
• Embrace healthier options: You should increase the amount of soluble fiber you take in by eating foods like oranges, beans, and oats. You could also consume food products that contain plant stanols or plant sterols, like margarines.
• Cut down on smoking and drinking: Reduce alcohol consumption and quit smoking or chewing tobacco products. Consult with your healthcare provider about programs for quitting smoking or reducing or completely quitting alcohol if you are not sure where or how to start.
• Exercise: Try to aim for at least 30 minutes of moderate exercise most days. This could be running, walking, swimming, or even dancing. Start gradually if you are not used to physical activity, and consult your healthcare provider about strategies for introducing exercise into your regular routine.

Prognosis

Cholesterol deposits usually cause no symptoms and are not dangerous. Their only real medical significance is to alert your doctor that your cholesterol levels are likely to be significantly elevated. It can, however, be upsetting to notice them forming around your eyes or on your face. Generally, people who seek treatment for these deposits are looking for a cosmetic treatment.

Xanthelasma can reappear. Ensuring permanent treatment may entail getting to the root of the issue and finding a way to keep your cholesterol and lipid levels in control.1

Frequently Asked Questions

Will cholesterol deposits on the skin go away on their own?

Cholesterol deposits generally don’t go away on their own. They tend to stay the same size or may grow larger. There is the chance that treating the underlying cause could reduce them, but if they are a big concern for you, you may want to reach out to a healthcare provider about options for removal.1

Can you remove cholesterol deposits on the skin at home? 

It is not recommended that you try to treat, pop, or burn away cholesterol deposits at home. This could lead to infection, scarring, or injury.16 Reach out to your healthcare provider to devise the best course of treatment for your xanthelasma.

How can you hide cholesterol deposits on the skin?

Cholesterol deposits tend to be very noticeable. They generally look like raised yellow-tinged bumps on or around your eyelids. If you are concerned about how these cholesterol deposits look, you should reach out to your healthcare provider to find the best treatment option. Don’t attempt to experiment on your own with skin creams or other at-home treatments.