Xanthelasma are soft yellow patches on the eyelids made of cholesterol-filled cells. Medical Director Dr Sin Yong makes sure the blood lipids have been checked, then plans laser removal for the thin eyelid skin.
WhatsApp to Enquire →Key facts ↓Xanthelasma are soft yellow plaques of cholesterol-filled cells on the eyelids, usually near the inner corners. Many people with them have raised blood lipids, so a cholesterol check with your GP comes first. The plaques can then be removed with CO2 laser in one or more sessions. Recurrence is common, so follow-up is planned.
Xanthelasma palpebrarum are collections of foam cells, immune cells filled with cholesterol, sitting in the upper layers of the eyelid skin. They are soft, do not hurt, are yellow or orange, and usually symmetrical. They tend to appear from middle age and slowly enlarge or multiply.
Other eyelid bumps can look similar at first glance. Syringomas are skin-coloured and firm; milia are white and pinhead-sized; sebaceous hyperplasia has a central dip. Firm, deep or rapidly growing yellow lesions, or lesions elsewhere on the body, are assessed differently and may need a dermatologist’s review.
A large share of people with xanthelasma have raised cholesterol or triglycerides, sometimes inherited and unknown until the plaques appear. A large population study found that xanthelasma was associated with a higher risk of heart attack and ischaemic heart disease, even after accounting for cholesterol levels. That makes the plaques worth reporting to your GP.
Your GP can arrange a fasting lipid profile, along with checks for diabetes, thyroid and liver function where relevant, and assess overall cardiovascular risk. Removing the plaques does not treat the lipids, and treating the lipids does not reliably make the plaques disappear, so both are addressed separately. Dr Sin Yong will ask for recent results or write a referral letter.
“Xanthelasma is a message from the bloodstream before it is a cosmetic concern. The lipid check comes first; the laser comes second.”
At IN Eternity Clinic, a designated DEKA Centre of Excellence, xanthelasma is treated with the DEKA SmartXide Tetra PRO CO2 laser. The plaque is vaporised in very thin layers until the yellow tissue is cleared, with depth controlled to protect the eyelid. For thick or scattered plaques, a pinhole approach makes fine channels to reach deeper deposits while sparing skin between them.
Large plaques close to the lash line are treated in stages, because removing too much at once in thin eyelid skin risks scarring or pulling of the lower lid. The eye is protected with shields throughout. Some plaques are better suited to surgical excision by an oculoplastic specialist, and a referral is made where that is the safer choice. The laser itself is described on DEKA Tetra CO2 laser.
Numbing cream is applied first, followed by a small local anaesthetic injection around the plaque, which stings for a few seconds. After that, most people feel warmth and notice a faint smell during treatment, but not pain. Metal eye shields are placed for protection, so you will not see the treatment.
Day 0. Numbing, laser treatment and ointment. Eyelid swelling may begin within hours.
Days 1–3. Swelling peaks, particularly on waking, then eases. Treated areas form moist crusts. Apply the ointment provided, sleep slightly propped up and avoid eye make-up.
Week 1. Crusts lift over about five to seven days, leaving pink skin.
Weeks 2–4. Pinkness fades gradually. Temporary darkening is possible in Asian skin, so sunscreen and sunglasses are used daily.
Review at 6–8 weeks. Residual yellow areas are assessed and a further stage is planned if needed.
The plaques themselves are harmless. Their importance is what they can signal: raised blood lipids in many people and a link with cardiovascular risk. That is why a cholesterol and risk check with your GP is part of the plan.
They can. Recurrence is common over months to years because the local tendency remains, especially when lipids are high or many plaques were present to begin with. Returning plaques are usually smaller and can be treated again. Keeping lipids controlled with your GP is sensible for your health, even though it does not fully prevent recurrence.
Small, flat plaques may clear in one session. Larger or thicker plaques, and those close to the lash line, are often treated in two or more stages spaced several weeks apart to protect the eyelid from scarring or pulling. The number of stages is estimated at examination and reviewed after each one.
Depth is controlled to limit scarring, and eyelid skin generally heals well. Pink or darker marks are common for some weeks. Scarring or pulling of the lid is uncommon but possible, which is why large plaques are treated in stages.
Yes. Raised lipids can be inherited and occur in slim, active people who feel entirely well. A fasting lipid profile is a simple blood test, and the results are useful for your long-term cardiovascular health whatever happens with the plaques. Your GP can arrange it and advise on any treatment needed.
Cost depends on the number, size and thickness of the plaques and how many stages are needed to clear them safely. Upper and lower lids may be treated at the same visit or separately. IN Eternity Clinic confirms the plan and the cost after examination, before treatment begins.
IN Eternity Clinic, 9 Scotts Road, #12-01 Pacific Plaza, Singapore 228210. By appointment with Medical Director Dr Sin Yong. Monday to Saturday, 11am to 8pm. WhatsApp or call +65 8815 3008.
These sources describe mechanisms and general evidence. They are not a promise of any individual result; suitability is decided at an in-person assessment.