• Xanthelasma Laser Removal

    Harley Street, London Clinic

The 'Impossible to treat' is very possible!

Xanthelasma are small yellow fatty deposits that develop around the upper and lower eyelids.

Why do we get this issue ? / why do you have it?

Occasionally there development may be associated with underlying excess lipid or cholesterol in the blood. If Xanthelasma develop it is always worth seeing your GP to exclude any other underlying fat metabolism problems or high cholesterol levels.

However when Xanthelasma is present over half the patients will have no underlying metabolic concerns. Xanthelasma is therefore a common cosmetic concern due to the unsightly appearance of these yellow plaques on the eyelid. Dr Hussein can remove these Xanthelasma effectively and safely with lasers.

The safest gold standard treatment for xanthelasma is ablative laser

Dr Hussein has both Ultrapulse Carbon Dioxide Laser (Lumenis Ultrapulse Alpha CO2) and Erbium YAG Laser (Sciton Joule X Erbium YAG).

Dr Hussein can use both laser in conjunction or individually depending on the lesion type, size and position.

Why is this issue hard to treat effectively often?

Surgery with removal of the skin containing the deposit has been the most common solution for this condition for many years. Once of the main problems with surgical excision is the resulting scar but the potential that removal of the excess skin can then lead to a problem called ectropion.

Ectropion is eversion of the eyelid that can be caused by excessive skin removal and adverse scarring from surgical excision of xanthelasma containing skin.

Other techniques that are used are methods such as surgical electrocautery, cryotherapy and chemical cautery. Although less risky than surgical removal of affected skin these methods give mixed and unreliable results.

The primary reason for this is because it is difficult to control damage to surrounding normal tissues. In an effort to minimise risk sometimes the Xanthelasma may be incompletely removed. These methods commonly give side effects of scars, pigmentation loss, recurrence of Xanthelasma.

Treatment at a Glance

Procedure Time

30 minutes for straightforward lesions. More complex lesions may require anything up to 1hr 30mins

Number of Treatments

Typically one session only

Downtime

Off work two days. See FAQs for full details of recovery.

Visible Results

Immediately after the procedure

For an in depth review of Xanthelasma please see here. For our full FAQs see here.

Before and After Photos

xanthelasma-before-after-01

Asian Fitzpatric type 5 darker skin. Xanthelasma removal with Sciton Joule X Erbium YAG laser.

xanthelasma-before-after-05

Xanthelasma removal for thick plaque xanthelasma with combination Ultrapulse Alpha CO2 and Sciton Joule Erbium YAG combination. One laser to debulk and 2nd laser to perform fine removal with minimal damage to surrounding tissues.

xanthelasma-before-after-03

This gentleman has had two large xanthelasma plaques removed from the upper eyelid with Sciton Joule X Erbium YAG laser

Frequently Asked Questions

How does this treatment work?
The treatment works by using the laser to precisely remove all abnormal xanthelasma tissue whilst preserving normal tissue. This causes minimal destruction and trauma to normal healthy tissue. As a result the wounds can heal rapidly with minimal scarring. The low risk of side effects coupled with efficacy in removal make laser xanthelasma removal the gold standard for xanthelasma removal.
Typical Issue/Treatment areas
Xanthelasma are lesions found on the upper and lower eyelids. They will differ in size and extent and position. Symmetry of xanthelasma is typical and therefore both sides will usually be affected. Cost of the procedure is based on number of lesions and length of procedure. Please refer to the online pricelist as a guide.
How long is the procedure?
Procedure time can vary from 30 minutes for simple, superficial and straightforward lesions. Larger, deeper and more complex lesions may require anything up to 1hr 30mins.
How many treatments do I need?
Typically a single session is needed. Occasionally for very large and deep lesions it is safer to perform this in two staged treatments 8-12 weeks apart.
What results can you expect?
Clearance of yellow xanthelasma lesions.
What is the recovery/downtime?
Scabbing and crusting will develop over the first few days. It is important to follow the woundcare instuctions and Dr Hussein will monitor healing using the Virtual Round Phone. Eventually by about day 10 the scabs have fallen away and the wounds begin to contract and level up over the next 2 weeks. Most healing has occurred by 3-4 weeks. However for redness and pigmentation to completely settle completely up to three months is required depending on the size depth and position of the xanthelasma.
What are the side effects / risks of Complications
In the first few hours after the procedure your vision will be blurred due to eyeshield insertion. It is essential that you do not drive for 24 hours after the procedure. It is not essential but always helpful to have someone accompany you. You will have swelling around the eyes immediately after the surgery due to anaethetic injection. The next day this will have largely subsided. It is not uncommon to get a little bruising and swelling around the eyes that may take up to a week to settle. Generally you should be completely functional from a work perspective 24-48hours post procedure.

Complications are essentially wound infection. This is mitigated by antibiotic ointment and appropriate woundcare. Dr Hussein will also be monitoring your healing daily on the Virtual Round Phone. The purpose of laser xanthelasma surgery is to minimise complications such as scarring. This is still technically possible if the xanthelasma is particularly thick and deep. Some deposits penetrate through the skin into the orbicularis oculi muscle. In these cases in order to effectively remove the lesion some scarring or discolouration to the skin may occur. This however if it does occur is minimal because the laser has been used and also usually a lot less unsightly when compared to the original xanthelasma.

How do we look after you?
On arrival you will be seen by the nurse. Further photos and details may be taken although most of this information will have been recorded during the consultation. Once the consent form has been signed you will be taken through to the procedure room. Preparation will include marking, injection of anaesthesia nd insertion of metal eyeshields (see video of eyeshield insertion). Dr Hussein will then perform your laser xanthelasma surgery. Following surgery you will be monitored in the recovery room and discharged safely usually 20-30minutes after the procedure is complete.
What is the Pain Factor of the treatment?
Pain factor in laser xanthelasma treatment is minimal. Tumescent anaesthetic is used instead of normal local anaesthetic which usually stings when injected. A tiny needle is used to administer the tumescent anaesthetic solution. The prick of the needle is hardly felt due to the fine nature of the needle. The only thing apart from this discomfort wise is the sting of local anaesthetic eye drops. This typically lasts for around 5-10 seconds (decreasing) before wearing off completely. It is similar to the sensation of getting a small amount of soap in the eye when showering. Once the anaesthetic and eyeshield insertion are complete. No pain will be felt throughout the procedure. Once the procedure is complete and anaesthesia wears off there is also no significant discomfort. Mild transient discomfort or sting may be encountered only when washing the wounds over the next 2-3 days.
What is your next step / What is our process?
If you suffer with xanthelasma lesions and are considering laser xanthelasma surgery to have them removed we recommend you fill in the booking form on this website. Please fill it in completely and accurately and it will allow us to be more precise when advising you. Once this is done and received by our booking team you will be contacted and a consultation with Dr Hussein will be scheduled. Full medical history and examination as well as clinical photos will be recorded during your consultation.

Full details, costs and timings of your surgery can then also be determined by Dr Hussein and his team.

What does the treatment cost?
Please refer to our online pricelist. Dr Hussein operates a very transparent and accessible pricing policy. Our list is published on the website at all times. Once Dr Hussein has consulted and examined the patient and the size, extent and depth of xanthelasma have been determined a precise price for the surgery is given. The only extra elements to consider cost wise are medications that may be required for the procedure and special washes and ointments to be used during the woundcare period. This may typically add around £100 to the actual price of the surgery itself. Prices for surgery include virtual round follow up and one in clinic follow up visit. Any further follow up if required is charged at our standard chargeable review price.

How do derma / aesthetic clinics usually treat this condition?

In short there are not many UK centres that have the adequate experience, skills and equipment to treat this issue. The reason for this is that it is classed as a cosmetic abnormality because it causes no functional loss or vision issues. As such it is not treated on the NHS. As a result most dermatologists, plastic surgeons and ophthalmologists will not routinely be trained to remove them.

Dr Hussein is one of the few UK dermatologic surgeons who has the necessary knowledge, equipment and experience to safely and effectively remove Xanthelasma. We routinely perform Xanthelasma laser treatment safely and effectively. The cases and videos in this section will help illustrate this. Case photos are also included in the gallery on this page.

The methods and techniques used by Dr Hussein are clearly evidenced in medical literature. The following papers have been published in medical literature describing the methodologies used by Dr Hussein in Xanthelasma management:

  • Borelli, C. and Kaudewitz, P., 2001. Xanthelasma palpebrarum: treatment with the erbium: YAG laser. Lasers in Surgery and Medicine: The Official Journal of the American Society for Laser Medicine and Surgery, 29(3), pp.260-264.
  • Raulin, C., Schoenermark, M.P., Werner, S. and Greve, B., 1999. Xanthelasma palpebrarum: treatment with the ultrapulsed CO2 laser. Lasers in surgery and medicine, 24(2), pp.122-127.
  • Pathania V, Chatterjee M. Ultrapulse carbon dioxide laser ablation of xanthelasma palpebrarum: a case series. J Cutan Aesthet Surg. 2015 Jan-Mar;8(1):46-9. doi: 10.4103/0974-2077.155084. PMID: 25949023; PMCID: PMC4411593.

Dr Hussein is a specialist in laser skin surgery. He is the UK’s most experienced laser surgeon by case volume.

He uses the most advanced lasers to treat xanthelasma.

Dr Hussein is the only UK laser surgeon with the skill, technology and experience to perform Xanthelasma laser treatment in all skin types.

Why is our approach different / better?

  • Dr Hussein owns all the lasers required to manage scars and has them present in one location.
  • Dr Hussein routinely performs laser xanthelasma treatment and therefore has sufficient caseload and experience in treatment.
  • Dr Hussein He has been using laser in skin surgery for over a decade and is internationally renowned for his laser surgical work. Laser xanthelasma cases are referred to him from all over the UK by ophthalmologists, dermatologists and plastic surgeons.
  • Dr Hussein is the only UK dermatologist with extensive experience in the use of ablative lasers in darker skin types. This means he is the only specialist in the UK to be able to safely perform xanthelasma laser surgery on all skin types.
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