1. Xanthelasma A Case Series
Victoria Smith BSc (Hons) ITEC VTCT
Director of Aesthetics

2. Portrait of Mona Lisa painted in 1506
Portrait of Mona Lisa
painted in 1506
Suggests Xanthelasma
prevalent in 16th Century

3. What is Xanthelasma? Lipoprotein Yellow plaques Eyelids Harmless
flat or slightly raised
Eyelids
lower and upper
Harmless
cosmetically unattractive, irritating
Can grow
3mm – 6cm diameter
Sharp distinct border

4. Causes Cause unknown High cholesterol High level of plasma lipids
High BP
Heart disease
Genetic factors

5. Who gets Xanthelasma? Rare More prevalent in women
Hampton R. Oct 2011, Medscape
More prevalent in women
F:M ratio = 2:1 (Christoffersen et al. BMJ 2011\0
Age of onset = yrs
Peak age = 40 – 50 yrs

6. Existing Treatments for Xanthelasma
Surgery - skin grafts, flaps
Cryotherapy- Liquid Nitrogen
Laser e.g. Nd:YAG
Trichloroacetic acid
Camouflage Make Up

7. History of Electrolysis
Invented by Dr Charles E Michel 1875
Developed for Trichiasis
Uses galvanic/short wave diathermy current
Insertion of needle - emitting current
FDA approved for permanent hair removal

8. Advanced Electrolysis
Lumps, Bumps and Skin lesions
Skin tags
Milia
Telangiectasia
Seborrhoeic Keratosis
Dermatosis Papulosa Nigra
“Age spots”

9. The Procedure Clean environment Short wave diathermy
17-19 MHz
Sterex (UK)
One piece stainless steel needle
2 techniques used

10. Technique 1 “Scratching” removal of epithelial layer
“scratching” with needle to lift plaques

11. Technique 2 used if plaques don’t raise repeated “tapping” of plaque
“Dotting”
used if plaques don’t raise
repeated “tapping” of plaque
heat accumulates
plaque darkens and crusts

12. Sometimes bleeds - before scab forms
After Procedure
No discomfort
Area resembles a graze
Sometimes bleeds - before scab forms
Scab comes away days

13. Results 10 patients (M:F 4:6 Age: 39-53years) 7 completed treatment
1 failed to complete
2 part way through treatment
7 completed treatment
all xanthelasma removed
100% patient satisfaction
4wks - 1year post treatment
variable healing, blemish remaining
all:
would have the treatment repeated
would recommend

14. Results at 1 year 2 patients at 1 year No re-growth in treated area
Slight pink scarring
easy to cover
Little re-growth in new areas
Increased self esteem

15. Before and After Images

16. Before and After Images

17. Before and After Images

18. Before and After Images

19. Before and After Images

20. Conclusion Successful removal of xanthelasma Scrapping technique
more exposed wound - longer to heal
Dotting technique
less of an open wound - quicker to heal
Significant increase in patient self esteem
Low cost
Low downtime