[Yellow lesions around the eyes] Xanthelasma, how do we approach it?

You've probably been concerned about the yellow lumps appearing around your eyelids. I imagine you've wondered what they are and how to manage them.

Xanthelasma is a lesion that appears when cholesterol or lipid components are deposited in the eyelid skin. They usually appear as yellowish, plump, raised formations.

Such lesions may be difficult to improve with topical products alone. Considering the depth and breadth of the deposits within the skin, choosing a precise laser treatment can be beneficial.

At Kkeuthan Clinic, we help manage yellow xanthelasma on the eyelids through a dual laser method, combining Er:YAG and CO2 lasers.

Kkeuthan Clinic's Xanthelasma Dual Laser Approach

Our xanthelasma management method does not simply focus on deeply removing the yellow areas.

Eyelid skin is a very thin and sensitive area. Therefore, the laser must be delicately controlled after thoroughly examining the lesion's thickness, depth of deposition, surrounding skin texture, and potential for scarring.

Accordingly, Kkeuthan Clinic applies a method where an Er:YAG laser is used to precisely refine the skin surface and to a certain depth. If the lesion is located deeper, a CO2 laser is used for careful finishing.

1. Carefully assess the lesion's width and thickness

While xanthelasma may appear as a small yellow lump on the surface, it often spreads widely within the skin or has indistinct borders.

Before the procedure, we don't just examine the visible yellow areas. We check the lesion's thickness, extent of spread, and even the eyelid fold lines to plan the removal area.

Protruding areas are adjusted in height to blend naturally with the surrounding skin, and the borders are meticulously refined.

2. Reduce scar burden with precise, layer-by-layer removal using Er:YAG laser

The Er:YAG laser is suitable for precise skin resurfacing, delicately abrading the skin layer by layer. It is particularly useful for carefully removing lesions in delicate and thin areas like around the eyes.

Er:YAG laser has been reported to offer precision and positive aspects in the recovery process when removing xanthelasma.

Rather than deeply excavating the yellow deposits all at once, removal is performed step-by-step, assessing it layer by thin layer.

This method helps minimize damage to normal skin and can aid in naturally adjusting the lesion's height to match the skin texture around the eyes.

3. If necessary, finish the base and borders with a CO2 laser

Even after removing only the visible yellow part of xanthelasma, the lesion can recur if deposited tissue remains at the base.

CO2 laser can be used to vaporize or ablate lesions and is known as an option in xanthelasma management.

However, compared to the Er:YAG laser, there's a higher possibility of longer-lasting redness or scarring, so it's approached cautiously rather than used as the primary treatment.

After precisely refining the lesion with the Er:YAG laser, only if necessary, a CO2 laser is used to carefully trim any remaining tissue at the base or borders.

This process is not about indiscriminately burning with strong energy. It is performed by finely adjusting the laser's output and treatment area, considering the lesion's depth and the condition of the eyelid skin.

4. Natural finish considering the skin texture around the eyes

Managing xanthelasma requires more consideration than simply removing the yellow lesion.

Eyelids have thin skin, making even small scars or pigment differences easily noticeable. Therefore, a smooth finish that blends seamlessly with the surrounding skin after removal is crucial to prevent an uneven skin surface.

We gently refine not only the center of the lesion but also its borders, helping the eye area appear as natural as possible after the procedure.

5. Customized treatment plan considering the possibility of recurrence

Xanthelasma is a lesion that can recur even after removal. Especially if it's related to blood lipid metabolism or cholesterol levels, the possibility of recurrence after the procedure cannot be excluded. Therefore, it's advisable to consider blood tests and lifestyle management if necessary.

Based on the size and depth of the lesion, we propose staged treatment as needed, reducing the risk of scarring or hyperpigmentation, rather than attempting aggressive removal all at once.

In addition to effectively removing the lesion, we emphasize the process of aesthetically pleasing recovery of the skin around the eyes.

Benefits of Xanthelasma Dual Laser

Reduces the risk of scarring when removing yellow deposits around the eyes.

Performs thin and precise layer-by-layer resurfacing with an Er:YAG laser.

Can finish the base and borders of the lesion using a CO2 laser.

Delicately adjusts laser output to suit thin and sensitive areas like the eyelids.

Creates individualized treatment plans based on the size and depth of the lesion.

Refines the border area to blend naturally with the surrounding skin.

Expect improvement in the appearance of the eye area caused by protrusion or yellow discoloration.

Suitable for those who are concerned about these cases.

When yellowish lesions are observed on the eyelids or around the eyes.

Those who initially thought it was melasma, but have yellowish, raised lesions.

Those who are worried about yellowish lesions around the eyes that are not well covered by makeup.

Those who feel that the size of the lesion is gradually increasing over time.

Those who are concerned about scarring or hyperpigmentation after treatment on sensitive eye areas.

Cases where the lesion has recurred in the same area despite having undergone removal procedures in the past.

Those who prefer precise removal using lasers rather than surgical methods.

Those who are concerned that yellowish lesions around their eyes make them look tired or older than they actually are.

Treatment Process

STEP 01. Customized In-depth Consultation

We accurately diagnose whether the patient's yellowish eye lesion is xanthelasma, and meticulously check the location, size, and depth of the lesion.

STEP 02. Preparation of the Treatment Area

After thoroughly cleaning the skin around the eyes to be treated, we carefully plan the areas that need removal.

STEP 03. Local Anesthesia Application

A local anesthetic cream is applied to reduce discomfort or pain around the eyelids during the procedure.

STEP 04. Precise Lesion Removal with Er:YAG Laser

The yellowish pigmented lesion is removed meticulously and step-by-step, starting from the skin surface.

STEP 05. Finishing Treatment using CO2 Laser

If necessary, the base and borders of the lesion can be delicately cauterized with a CO2 laser to clear any residual lesions.

STEP 06. Regeneration Care

Post-Treatment Care and Precautions

Immediately after the procedure, redness, swelling, slight stinging, oozing, and small scabs may appear on the treated area.

It is important not to forcibly remove the scabs that form, but to let them fall off naturally.

To keep the treated area moisturized and prevent dryness, consistently apply regenerative cream or products like DuoDerm or DuoGel.

Please refrain from excessively rubbing or strongly scrubbing the area around your eyes.

It is advisable to refrain from using color cosmetics (eyeshadow, eyeliner, etc.) until the treated area has fully healed.

We recommend refraining from activities such as jjimjilbangs (Korean saunas), saunas, swimming, alcohol consumption, and smoking for about 1 week.

UV exposure can cause post-inflammatory hyperpigmentation, so it is important to pay special attention to UV protection.

If the lesion is deep or extensive, additional repeat treatments may be necessary to achieve satisfactory results.

Xanthelasma palpebrarum can occasionally recur depending on an individual's constitutional characteristics or lipid metabolism status.