Xanthomas are common lesions that frequently develop in older adults and can be a symptom of a more serious medical condition.

What Are Xanthomas?

Xanthomas are bumps that appear under the skin as a result of fatty buildup . Some are very small, but they can grow as large as 3 inches in diameter. Xanthomas are usually painless and harmless, but they can be an indication of a more serious underlying medical condition. The lesions can develop anywhere on the body but are usually seen on the eyelids, joints, hands, feet or buttocks.

Causes of Xanthomas

The cause of xanthomas can usually be traced to an underlying medical condition such as some cancers, diabetes, excessively high cholesterol or triglyceride levels, primary biliary cirrhosis, pancreatitis or hypothyroidism. Xanthomas that develop on the eyelid are often xanthelasma. These harmless growths are not associated with other medical conditions, and it is not known why they develop.

Xanthoma Symptoms

Most xanthomas are yellow to orange in color and have well-defined borders. The lesions present in a variety of shapes and sizes and are typically painless. However, some xanthomas can be tender or itchy.

It is not uncommon for multiple lesions to appear suddenly. These eruptive xanthomas indicate hyperlipidemia (high fat levels) and individuals that experience such an outbreak should be seen in a dermatology clinic right away.

Diagnosing Xanthomas

Xanthomas are often diagnosed upon examination by a dermatologist. A biopsy may be needed to confirm the presence of fatty deposits in the lesions. Blood tests may also be done to evaluate serum lipid levels, liver function and to look for underlying metabolic disorders.

Treatment of Xanthomas

The first step in the treatment of xanthomas is aimed at controlling the underlying medical condition that caused them. Fat and cholesterol levels should be monitored and treated through diet, exercise and prescription medication.

Once the cause has been addressed, Xanthomas may be removed through surgical excision, laser surgery or trichloroacetic acid.

Xanthomas of the eyelid do not require systemic treatment, but may be removed for cosmetic reasons.

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