Managing Xanthelasma: Yellow Growths on the Eyelids

You may have experienced discomfort due to yellow bumps appearing around your eyes or on your eyelids. Many people wonder what these are and how to manage them.

Xanthelasma are skin lesions that appear as yellowish, raised bumps on the skin around the eyelids due to the accumulation of cholesterol or certain lipid components.

Since these lesions are raised and convex on the skin, it may be difficult to expect improvement with topical treatments alone. Precise laser treatment, considering the depth and area of the lesion, can be helpful.

At our clinic, we carefully treat yellow, protruding xanthelasma around the eyes using a dual laser technique that combines Er:YAG laser and CO2 laser.

Our clinic's Dual Laser Technique for Xanthelasma

When managing xanthelasma, we avoid simply removing only the yellow areas deeply.

The eyelids are a thin and sensitive area of skin, so it is important to precisely control the laser, carefully considering not only the thickness and depth of the lesion but also the texture of the periorbital skin and the potential for scarring.

Therefore, our clinic uses an Er:YAG laser to meticulously treat the surface down to a certain depth, and if necessary, finishes deeper lesions with a CO2 laser.

1. Planning by understanding the extent and depth of the lesion

Xanthelasma may appear as small yellow bumps on the eyelid surface, but in reality, they can spread widely beneath the skin or have indistinct borders.

Before treatment, our clinic does not just look at the visible yellow areas but carefully determines the removal range by checking the thickness and spread direction of the lesion, as well as the eyelid folds.

We focus on carefully reducing the protruding areas and meticulously smoothing the border areas to ensure a natural blend with the surrounding skin.

2. Precise Layer-by-Layer Removal using Er:YAG Laser

Er:YAG laser is primarily used for precise skin resurfacing, and it can be helpful for carefully removing lesions in thin and sensitive areas like around the eyes.

Er:YAG laser has been reported to have advantages in terms of precise removal and reduced recovery burden when managing xanthelasma.

At our clinic, rather than deeply excavating the yellow deposits all at once, we carefully remove them by dividing them into thin layers from the skin surface.

This method can minimize damage to normal skin and help naturally adjust the height of the lesion to match the skin texture around the eyes.

3. Supplementary treatment of the base and border with CO2 laser as needed

If only the visible yellow part of xanthelasma is removed and the deposited tissue remains at the base, it may protrude again.

CO2 laser can be used to vaporize or cauterize lesions and is known as one of the options for xanthelasma management.

However, compared to the Er:YAG laser, the duration of redness or scarring after treatment can be longer, so it is often considered for an auxiliary role rather than for standalone use.

At our clinic, after precisely refining the lesion with an Er:YAG laser, we carefully supplement any remaining lesions at the base or border areas using a CO2 laser if necessary.

Instead of simply burning with strong energy, we finely adjust the laser output and treatment area, considering the depth of the lesion and the characteristics of the eyelid skin.

4. Natural finish tailored to the skin texture around the eyes

Xanthelasma management goes beyond simply removing yellow lesions.

The eyelids are an area where even minor scars or pigment changes are easily noticeable. Therefore, post-treatment care is crucial to ensure the skin surface is smooth after lesion removal and that the boundaries blend naturally with the surrounding skin.

Our clinic gently refines not only the central part of the lesion but also the border areas to help the eye line recover as naturally as possible after the procedure.

5. Management plan considering recurrence potential

Xanthelasma is known to be a lesion that can recur even after removal. Especially if it is related to lipid metabolism or cholesterol levels in the body, it may recur even after the procedure, so blood tests or lifestyle management may be helpful as needed.

Our clinic carefully diagnoses the size and depth of the lesion and suggests phased management when necessary to reduce the risk of scarring or hyperpigmentation, rather than attempting overly deep removal in one session.

We prioritize the natural recovery process of the periorbital skin as much as the effective removal of the lesion.

With the Xanthelasma Dual Laser procedure, you can expect these benefits:

Managing and reducing traces of yellow deposits around the eyes

Attempting delicate and precise layer-by-layer ablation with Er:YAG laser

Possible supplementation of the base and border areas with CO2 laser

Delicate output control optimized for the thin and sensitive eyelid area

Customized treatment considering the size and depth of the lesion

Natural blending of borderlines with surrounding skin

Helping to improve overall impression caused by protrusion and yellow discoloration around the eyes

You may consider this procedure if:

Yellow lesions have appeared on your eyelids or around your eyes.

You initially mistook them for melasma but later discovered them to be yellow, raised lesions.

You are bothered by yellow lesions around your eyes that cannot be concealed with cosmetics.

You have noticed the size of the lesions gradually increasing over time.

You are concerned about potential scarring or hyperpigmentation after treatment on the sensitive eye area.

The lesions have reappeared in the same spot despite previous removal.

You prefer precise laser removal over surgical methods.

You are concerned that yellow lesions around your eyes make you look tired or older.

Procedure Steps

STEP 01. 1:1 Customized Consultation

We meticulously examine whether the yellow lesions around your eyes are xanthelasma and precisely assess their size and depth.

STEP 02. Preparation of the Treatment Area

The skin around the eyes to be treated is thoroughly cleansed, and the area for lesion removal is planned.

STEP 03. Application of Anesthetic Cream

Anesthetic cream is applied to minimize pain around the eyelids.

STEP 04. Precise Er:YAG Laser Removal

This procedure delicately removes the yellow pigmented lesions layer by layer, starting from the skin surface.

STEP 05. CO2 Laser Finishing

Depending on the condition, the base and borders of the lesion may be gently cauterized to refine any remaining lesions.

STEP 06. Application of Regenerative Cream

Post-Procedure Precautions

ㆍThe treated area may experience redness, swelling, slight stinging, oozing, and small scabs.

ㆍDo not forcibly remove any scabs that form; it is best to let them fall off naturally.

ㆍIt is recommended to consistently manage the treated area with regenerative cream or products like DuoDERM or DuoGEL to prevent dryness.

ㆍPlease refrain from rubbing or vigorously scrubbing the eye area.

ㆍIt is advisable to refrain from using cosmetic makeup, especially eyeshadow or eyeliner, until the treated area has fully recovered.

ㆍIt is best to avoid jjimjilbangs (Korean bathhouses), saunas, swimming pools, alcohol, and smoking for about one week.

ㆍExposure to UV light can cause hyperpigmentation, so special care must be taken to protect against UV radiation.

ㆍIf the lesion is deep or widespread, multiple repeated treatments may be necessary.

ㆍPlease be aware that xanthelasma may recur depending on individual constitutional factors or lipid metabolic status.