Xanthelasma (cholesterol spots)

Xanthelasma palpebrarum is a common, benign skin condition that appears as soft, yellowish plaques—most often on the inner corners of the upper eyelids. While harmless, xanthelasma can be a source of cosmetic concern for many people.

what causes xanthelasma?

Xanthelasma develops when cholesterol and other lipids accumulate in the skin. This can be related to underlying cholesterol or lipid metabolism issues, but up to half of all patients have normal cholesterol levels. The condition is more common in middle-aged adults and tends to affect women more frequently.

what does xanthelasma look like?

  • Soft, flat or slightly raised yellow patches, usually on the upper eyelids near the nose

  • May appear on both sides and can slowly increase in size or number

  • Usually does not cause pain, irritation, or affect vision, but may become more noticeable over time


should i be concerned?

While xanthelasma itself is not dangerous and does not become cancerous, it can sometimes be a marker of underlying cholesterol or lipid issues. A fasting lipid profile is recommended to check for any abnormalities, and managing cardiovascular risk is important for overall health.

Trichloroacetic Acid Treatment for Xanthelasma

Trichloroacetic acid (TCA) is a well-established, non-surgical treatment option for xanthelasma, especially when the lesions are small and superficial. TCA is carefully applied in the clinic to the affected area, causing controlled exfoliation and gradual removal of the lipid deposits.

What to expect:

  • The procedure is performed in the clinic and usually takes just a few minutes.

  • Treated areas may appear white initially, then darken and peel over several days.

  • Mild redness, swelling, or crusting is normal during healing.

  • Noticeable improvement is often seen after one session, though some lesions may require additional treatments.


Ready to Take the Next Step?

Book a consultation with Dr Liz Dawes-Higgs at Northern Sydney Dermatology & Laser to receive expert, personalised dermatology care and discover the best treatment options for your skin damage.

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This page is for general information only and does not replace individual medical advice. For personalised care, please book a consultation.