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

XanthelasmaA Case Series

Victoria Smith BSc (Hons) ITEC VTCTDirector of Aesthetics

Portrait of Mona Lisapainted in 1506

Suggests Xanthelasma prevalent in 16th Century

What is Xanthelasma?

• Lipoprotein• Yellow plaques

• flat or slightly raised

• Eyelids• lower and upper

• Harmless• cosmetically unattractive, irritating

• Can grow• 3mm – 6cm diameter

• Sharp distinct border

Causes

• Cause unknown• High cholesterol • High level of plasma lipids• High BP• Heart disease• Genetic factors

Who gets Xanthelasma?

• Rare• Hampton R. Oct 2011, Medscape

• More prevalent in women• F:M ratio = 2:1 (Christoffersen et al. BMJ 2011\0

• Age of onset = 15 - 73yrs• Peak age = 40 – 50 yrs

Existing Treatments for Xanthelasma

• Surgery - skin grafts, flaps• Cryotherapy- Liquid Nitrogen• Laser e.g. Nd:YAG• Trichloroacetic acid

•Camouflage Make Up

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

Advanced ElectrolysisLumps, Bumps and Skin lesions

Skin tagsMiliaTelangiectasiaSeborrhoeic KeratosisDermatosis Papulosa Nigra“Age spots”

The Procedure

• Clean environment

• Short wave diathermy• 17-19 MHz• Sterex (UK)

• One piece stainless steel needle

• 2 techniques used

• “Scratching”

• removal of epithelial layer

• “scratching” with needle to lift plaques

Technique 1

Technique 2• “Dotting”

• used if plaques don’t raise

• repeated “tapping”of plaque

• heat accumulates

• plaque darkens and crusts

After Procedure• No discomfort

• Area resembles a graze• Sometimes bleeds - before scab forms

• Scab comes away 5 - 7 days

Results• 10 patients (M:F 4:6 Age: 39-

53years)• 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

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

Before and After Images

Before and After Images

Before and After Images

Before and After Images

Before and After Images

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