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Writer's pictureAnirban Biswas

Why Are Cholesterol Deposits Around Your Eyes Dangerous?

Cholesterol deposits around the eyes, known as xanthelasmas, are yellowish plaques that form on or near the eyelids. While they are not harmful or painful, their presence often signals underlying lipid disorders, particularly elevated cholesterol levels. These deposits serve as a visual indicator of potential cardiovascular issues, as high cholesterol is a known risk factor for heart disease and stroke. Understanding the implications of xanthelasmas is crucial for assessing overall heart health and taking preventive measures to mitigate associated risks.


What Are Xanthelasmas?

Cholesterol deposits around the eyes, known as xanthelasmas, are usually not dangerous themselves but can be a sign of underlying lipid disorders.

Significance of Xanthelasmas:

Xanthelasmas are often associated with these medical conditions and signify:

  1. Dyslipidemia: Xanthelasmas are often associated with high levels of low-density lipoprotein (LDL) cholesterol and triglycerides. They can indicate that you have a lipid imbalance.

  2. Heart Disease: Research shows that the presence of xanthelasmas can be a marker for atherosclerosis, a condition where cholesterol plaques build up in the arteries, leading to an increased risk of heart attacks and strokes.

  3. Not Directly Indicative: While xanthelasmas themselves do not cause heart blockage, they indicate that your body is prone to cholesterol deposits, which can occur in the coronary arteries, leading to Heart Blockage.

  4. Need for Further Test: If you have xanthelasmas, it’s essential to get a comprehensive cardiovascular assessment. This may include tests like :

to check for any blockages or other heart issues.


What to Do If You Have Xanthelasmas:

Xanthelasmas is not a disease per se, but a Sign of Lipid disorder (Dyslipidemia).

You should take the following steps if you have them:



  • Evaluation: See a healthcare provider for a thorough evaluation of your cholesterol levels and overall cardiovascular health.

  • Treatment Plan: Based on your cholesterol levels and other risk factors, your provider may recommend lifestyle changes, medications, or further diagnostic tests.


2. Lifestyle Modifications:

  • Healthy Diet: Adopt a diet low in saturated fats, trans fats, and cholesterol. Increase your intake of fruits, vegetables, whole grains, and lean proteins.

  • Regular Exercise: Engage in regular physical activity to help lower cholesterol levels and improve heart health.

  • Weight Management: Maintain a healthy weight to reduce the risk of cardiovascular diseases.


3. Medications:

  • Statins and Other Lipid-Lowering Drugs: These can help manage high cholesterol and reduce the risk of plaque formation in the arteries.

  • Regular Monitoring: Keep track of your cholesterol levels and follow your healthcare provider’s recommendations for follow-up visits and tests.


It's important to consult with a dermatologist or a healthcare provider to determine the best treatment plan based on the size, location, and severity of the xanthomas or xanthelasmas. They can also provide guidance on managing underlying cholesterol levels to prevent new deposits from forming.

4. Cosmetic Procedures:

A. Surgical Excision:

  • Description: The deposits are removed surgically under local anaesthesia.

  • Pros: Effective and immediate removal.

  • Cons: Risk of scarring and infection.


B. Laser Therapy:

  • Description: Lasers, such as carbon dioxide or erbium lasers, are used to vaporize the fatty deposits.

  • Pros: Minimally invasive with minimal scarring.

  • Cons: It may require multiple sessions and can be expensive.

C. Chemical Peels:

  • Description: Trichloroacetic acid (TCA) or other chemicals are applied to the skin to dissolve the deposits.

  • Pros: Non-surgical and effective for small lesions.

  • Cons: May cause irritation and requires careful application.

D. Cryotherapy:

  • Description: The deposits are frozen using liquid nitrogen.

  • Pros: Non-surgical and relatively simple.

  • Cons: Risk of skin pigmentation changes and may need multiple sessions.


E. Electrodesiccation:

  • Description: A small electric current is used to destroy the deposits.

  • Pros: Effective for small xanthelasmas.

  • Cons: Can cause scarring and pigmentation changes.




What are the other Signs of High Cholesterol?

High cholesterol often doesn't cause noticeable symptoms until it leads to complications like heart disease or stroke. However, there are some signs and conditions associated with high cholesterol that you can watch for:

  1. Xanthomas: These are fatty deposits that can develop under the skin, particularly around the eyes, elbows, knees, and tendons. They appear as yellowish, raised patches.

  2. Corneal Arcus: This is a grey or white arc visible around the cornea of the eye. While common in older adults, its presence in younger individuals can be a sign of high cholesterol.

  3. Angina (Chest Pain): If high cholesterol leads to coronary artery disease, you might experience chest pain, especially during physical activity or stress.

  4. Peripheral Artery Disease (PAD): This condition occurs when cholesterol plaques build up in the arteries that supply blood to the limbs. Symptoms include pain, numbness, and cramping in the legs and hips, especially when walking.

  5. Heart Attack or Stroke: Unfortunately, the first noticeable sign of high cholesterol might be a heart attack or stroke. These occur when cholesterol plaques rupture or obstruct blood flow in arteries.

It's essential to have regular check-ups with your healthcare provider to monitor your cholesterol levels, especially if you have risk factors such as a family history of high cholesterol, obesity, poor diet, lack of exercise, smoking, or certain medical conditions like diabetes and hypertension.


Which Test can Detect High Cholesterol ?


A lipid profile, also known as a lipid panel, measures the levels of specific lipids in your blood. Namely:

  • Total Cholesterol: This is the overall amount of cholesterol in your blood, including LDL, HDL, and other lipid components. High levels can increase the risk of heart disease.

  • LDL Cholesterol (LDL-C): Known as "bad" cholesterol because high levels can lead to the buildup of plaque in arteries, increasing the risk of heart disease and stroke.

  • HDL Cholesterol (HDL-C): Known as "good" cholesterol because it helps remove LDL cholesterol from the arteries. Higher levels are generally better.

  • Triglycerides: A type of fat in the blood. High levels can increase the risk of heart disease, especially in combination with high LDL or low HDL cholesterol levels.

  • Non-HDL Cholesterol: This is calculated by subtracting HDL cholesterol from total cholesterol. It includes all the "bad" types of cholesterol, such as LDL and VLDL (very low-density lipoprotein).

  • Total/HDL Cholesterol Ratio: This ratio gives an idea of the balance between good and bad cholesterol. A lower ratio is better, indicating a lower risk of heart disease.

Regular monitoring of your lipid profile is essential for maintaining cardiovascular health, especially if you have risk factors for heart disease or have been diagnosed with high cholesterol.



Table 1. Components of a Lipid Profile Test and the corresponding normal levels:

Component

Normal Levels

Total Cholesterol

Less than 200 mg/dL (5.2 mmol/L)

LDL Cholesterol (LDL-C)

Less than 100 mg/dL (2.6 mmol/L)

HDL Cholesterol (HDL-C)

40 mg/dL (1.0 mmol/L) or higher (men)


50 mg/dL (1.3 mmol/L) or higher (women)

Triglycerides

Less than 150 mg/dL (1.7 mmol/L)

Non-HDL Cholesterol

Less than 130 mg/dL (3.4 mmol/L)

Total/HDL Cholesterol Ratio

Less than 5.0



How to Control Your Cholesterol Level :


  1. Lifestyle Changes:

  • Diet: Adopt a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins. Reduce intake of saturated fats, trans fats, and cholesterol.

  • Exercise: Engage in regular physical activity. Aim for at least 30 minutes of moderate exercise most days of the week.

  • Weight Management: Maintain a healthy weight. Losing weight can help improve cholesterol levels.


2. Medications:

  • Statins: These drugs help lower LDL cholesterol and total cholesterol.

  • Niacin: Also known as vitamin B3, niacin can help increase HDL cholesterol and lower LDL cholesterol and triglycerides.

  • Fibrates: These medications primarily lower triglycerides and can also increase HDL cholesterol.

  • Bile Acid Sequestrants: These drugs help reduce LDL cholesterol by blocking the reabsorption of bile acids in your intestines.

  • PCSK9 Inhibitors: These are newer medications that significantly lower LDL cholesterol levels.


Preventive Measures:

  1. Regular Check-ups: Schedule regular check-ups with your healthcare provider to monitor your cholesterol levels and cardiovascular health.

  2. Smoking Cessation: If you smoke, seek help to quit, as smoking significantly increases the risk of heart disease.

  3. Medication Adherence: Follow your healthcare provider’s instructions regarding medications to manage cholesterol.

  4. Healthy Lifestyle: Continue a heart-healthy lifestyle to prevent recurrence.

  5. Manage Other Health Conditions: Keep conditions like diabetes and hypertension under control, as they contribute to cardiovascular risk.





Xanthelasmas, though benign and painless, should not be ignored as they indicate possible high cholesterol and increased cardiovascular risk. These deposits highlight the need for thorough medical evaluation and proactive management of cholesterol levels to prevent serious conditions like heart attacks and strokes. Adopting a heart-healthy lifestyle, regular monitoring, and appropriate medical treatment can effectively address the underlying lipid imbalance and reduce the likelihood of cardiovascular complications. Prioritizing heart health in response to the appearance of xanthelasmas is essential for long-term well-being.


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