Xanthoma
What xanthomas are, how they differ from xanthelasma, and what you can do about them.
Key Takeaways
A xanthoma is a build-up of fat-filled cells in or under the skin, seen as yellow patches, bumps or lumps. When it forms on or around the eyelids it’s called xanthelasma, by far the most common xanthoma of the eye. Xanthomas elsewhere on the body are more often a sign of a cholesterol or triglyceride problem.
- Xanthelasma is a xanthoma on the eyelids, and about half of people with it have normal cholesterol.
- The main body types are tuberous, tendon, eruptive and plane xanthomas.
- Body xanthomas are often linked to a lipid disorder, some of them inherited.
- Eruptive xanthomas can mean very high triglycerides, so see a doctor promptly.
- Treating the underlying cause can help many body xanthomas shrink over time.
- Xanthomas aren’t cancer, but they’re always worth a check-up.
- For patches on or around the eyelids, Xanthel® xanthelasma removal cream is a cosmetic gel made up for your skin.
What Is A Xanthoma? Skin And Eye Xanthomas
A xanthoma is a deposit of fat-filled cells in or under the skin. It shows up as a yellow or orange patch, bump or lump, and it can form almost anywhere: around the eyes, on the elbows and knees, in the tendons or in the creases of the palms. On the eyelids it has its own name, xanthelasma, and it’s by far the most common kind. Here’s how to tell the types apart and what each one means.
Types Of Xanthoma At A Glance
| Type | What it looks like | Often linked to | What to do |
|---|---|---|---|
| Xanthelasma | Soft, flat yellow patches on or around the eyelids | Normal blood fats in about half of people | Cholesterol check; cosmetic options such as Xanthel® |
| Tuberous | Firm yellow or red-yellow lumps on elbows, knees, heels or buttocks | Inherited high cholesterol or triglycerides | See your doctor |
| Tendon | Smooth, firm lumps in the Achilles tendon or over the knuckles | Familial hypercholesterolaemia | See your doctor |
| Eruptive | Sudden crops of small yellow bumps with a red rim | Very high triglycerides, often with diabetes | See a doctor promptly |
| Plane and palmar | Flat yellow-orange patches, including lines in the palm creases | Specific lipid disorders, sometimes blood conditions | See your doctor |
| Disseminatum | Hundreds of small red-brown bumps in skin folds | A rare immune-cell condition, with normal blood fats | See a dermatologist |
Very high triglycerides can inflame the pancreas, which is why eruptive xanthomas need prompt attention. Types based on DermNet’s guide to xanthoma.
Xanthoma Vs Xanthelasma: What’s The Difference?
Every xanthoma forms in much the same way. When there’s more fat in your blood than your body can clear, some of it seeps into the tissues. Immune cells called macrophages swallow it, fill up with fat and become foam cells, and clusters of those cells are what you see as a yellow patch or lump. The yellow colour comes from the fat inside them.
Xanthelasma is simply a xanthoma on or around the eyelids. It’s soft, flat or slightly raised and usually starts at the inner corner of the upper lid. Unlike most body xanthomas, it often appears with normal blood fats: according to NIH StatPearls, about half of people with xanthelasma have normal cholesterol.
Xanthoma Of The Eye Or Elsewhere?
If your yellow patches are on your eyelids, it’s xanthelasma, and our guide to xanthelasma palpebrarum explains it in full. If you’ve been told you have xanthomas on your eyelids, it’s the same thing, and you’ll find your options in our guide to removing xanthomas on the eyelids.
Lumps on your elbows, knees, heels, hands or tendons, or sudden crops of small bumps, are a different matter. These body xanthomas are more strongly linked to raised cholesterol or triglycerides, sometimes inherited, so they’re a reason to see your doctor rather than something to deal with at home.
Either way, a blood test is worthwhile. Xanthelasma is a cosmetic worry, but it can also be an early clue about your heart. Not sure what you’re looking at? Compare yours with our xanthelasma pictures.
The Main Types Of Xanthoma
Doctors group xanthomas by where they appear, how they look and what’s driving them. Knowing the type helps your doctor decide which tests you need.
Tap A Type Below To Read More
Tuberous xanthomas are firm, painless, yellow or red-yellow lumps that form on pressure points: the elbows, knees, heels and buttocks. They often start as small bumps and slowly grow into larger nodules, sometimes joining together. Bringing raised blood fats down can help them shrink, although it can take months.
What Do Tuberous Xanthomas Look Like?
They’re usually round, smooth and firm to the touch, from the size of a pea to much larger. The colour ranges from yellow to orange, and newer ones can have a reddish tinge. They don’t normally hurt or itch, and because they sit over joints, people often notice them when leaning on an elbow or kneeling.
Under a microscope they’re made of foam cells, the fat-filled immune cells found in every xanthoma, along with some scar-like tissue in older lumps. That’s why long-standing ones can feel quite hard and don’t always shrink completely, even when cholesterol comes down.
They tend to appear on both sides of the body, and you may get several at once. It’s worth asking whether anyone in your family has had similar lumps or early heart disease, because the conditions behind them can run in families.
What Causes Tuberous Xanthomas?
Tuberous xanthomas are a strong sign that something is affecting how your body handles fat. The most common causes are:
- Familial dysbetalipoproteinaemia (type III hyperlipoproteinaemia), an inherited condition that raises both cholesterol and triglycerides.
- Familial hypercholesterolaemia, an inherited cause of very high LDL cholesterol.
- Other conditions that raise blood fats, such as an underactive thyroid, diabetes or obesity.
What Should You Do About Them?
See your doctor. A blood test for cholesterol and triglycerides will usually show what’s going on, and treatment to bring blood fats down protects your heart and can help the lumps get smaller. Large or stubborn ones can be removed surgically. They’re not something to treat at home, and Xanthel® isn’t designed for them: it’s made for xanthelasma on and around the eyelids.
Tendon xanthomas are smooth, firm lumps that grow slowly inside tendons, most often the Achilles tendon at the back of the ankle and the tendons over the knuckles. The skin over them usually looks normal, so they can be easy to miss.
Why Do Tendon Xanthomas Matter?
They’re one of the clearest signs of familial hypercholesterolaemia, an inherited condition that causes very high LDL cholesterol from birth. Left untreated, it raises the risk of heart disease at a young age, so finding tendon xanthomas is a good reason to get your cholesterol tested, and for close family to be tested too.
What Do They Look And Feel Like?
They feel like hard, rubbery swellings that move with the tendon. They grow slowly, over years, and usually don’t hurt, although a thickened Achilles tendon can sometimes ache or make shoes rub. A doctor can often feel them, and an ultrasound scan can confirm a thickened tendon.
Rarely, tendon xanthomas come from other inherited conditions, such as sitosterolaemia or cerebrotendinous xanthomatosis, which is why a specialist may suggest further tests.
What Causes Tendon Xanthomas?
Most are caused by familial hypercholesterolaemia. Other things that push cholesterol up, such as an underactive thyroid, diabetes or kidney disease, can make things worse but rarely cause tendon xanthomas on their own.
How Are They Treated?
Treatment focuses on cholesterol. Statins and other cholesterol-lowering medicines protect your heart and may help the lumps shrink a little over time, although tendon xanthomas often change slowly. Surgery is only used occasionally, for lumps that cause pain or problems with movement. Because they sit deep in the tendon, creams can’t reach them, and Xanthel® isn’t designed for this type.
If you’re diagnosed with familial hypercholesterolaemia, your parents, brothers, sisters and children each have a one in two chance of having it too, so family testing really matters.
Eruptive xanthomas appear suddenly as crops of small yellow bumps, often with a red rim, on the buttocks, shoulders, arms and thighs. They can itch or feel tender, and they’re the one type of xanthoma that needs a doctor’s attention quickly. They’re more common in adults with diabetes, but they can appear at any age if triglycerides climb very high.
Why Do Eruptive Xanthomas Need Prompt Attention?
They’re a sign of very high triglycerides, a type of blood fat. Levels that high can inflame the pancreas (pancreatitis), which is painful and can be serious. So if you notice a rash of small yellow bumps like this, book a doctor’s appointment soon, and get urgent help if you also have stomach pain, sickness or vomiting.
What Do They Look Like?
Each bump is usually only a few millimetres across, and they come in groups, sometimes dozens at once. Early on they can look like a pimply rash or insect bites, which is why they’re often mistaken for something else. Unlike acne, though, they have a yellowish centre, and they tend to appear on the backs of the arms and the buttocks rather than the face.
The good news is that eruptive xanthomas usually fade within weeks once triglycerides are brought under control. Most people never need anything removed.
What Causes Eruptive Xanthomas?
Very high triglycerides can have several causes, and often more than one is involved:
- Diabetes that isn’t well controlled, one of the most common triggers.
- Inherited lipid disorders that raise triglycerides.
- Alcohol, especially heavy drinking.
- Some medicines, such as oestrogen tablets and retinoids.
- Obesity and an underactive thyroid, which can add to the problem.
Treatment means bringing triglycerides down, usually through diet, cutting back on alcohol, better diabetes control and sometimes medicines. The bumps then clear by themselves, so there’s no need for creams or removal.
Your doctor will usually repeat the blood test after a few weeks to check that triglycerides are falling. If diabetes is the trigger, getting blood sugar under control is often the single biggest help.
Plane xanthomas are flat, soft, yellow or orange patches that can appear almost anywhere, including the neck, chest, armpits and skin folds. Xanthelasma is itself a kind of plane xanthoma that happens to sit on the eyelids.
Plane Xanthomas With Normal Cholesterol
Sometimes widespread flat patches appear with normal blood fats. This is called diffuse normolipaemic plane xanthoma, and it can be linked to blood conditions, so a doctor will usually suggest blood tests.
What Do Plane Xanthomas Look Like?
They’re flat or very slightly raised, smooth and painless, and they usually don’t itch. They can be small and separate or spread into larger patches over time. Yellow-orange lines in the creases of the palms are a special kind, known as palmar xanthomas, and they have their own section below. Plane xanthomas are most common in adults and can slowly increase in number over the years.
What Causes Plane Xanthomas?
Like other xanthomas, they form when fat-filled immune cells collect in the skin. The likely cause depends on where they appear:
- Palm creases: usually familial dysbetalipoproteinaemia (type III hyperlipoproteinaemia).
- Between the fingers or toes: can point to inherited familial hypercholesterolaemia.
- Widespread, with normal blood fats: sometimes linked to an abnormal protein in the blood, which a doctor should check.
- On the eyelids: xanthelasma, which often appears with normal cholesterol.
Can Plane Xanthomas Be Removed?
Treating any underlying lipid problem comes first and can help patches fade. Flat patches on the eyelids are xanthelasma, and that’s where Xanthel® comes in: it’s a cosmetic gel designed to improve their look at home. For plane xanthomas elsewhere, ask your doctor: small, stubborn patches can sometimes be removed by a dermatologist with laser or minor surgery. And if you’re not sure what you have, send us a photo.
Xanthoma disseminatum is a rare condition in which hundreds of small, red-brown or yellowish bumps appear, mainly in skin folds such as the armpits and groin, and on the face and eyelids. It most often starts in children or young adults, and it’s slightly more common in males.
What Is Xanthoma Disseminatum?
Unlike other xanthomas, it isn’t caused by high blood fats. It’s a rare form of histiocytosis, in which certain immune cells multiply and collect in the skin. The bumps can join into larger plaques, and it sometimes affects the lining of the mouth, throat and eyes.
What Should You Do If You Think You Have It?
See a doctor, who will usually refer you to a dermatologist. Blood fats are usually normal, so the diagnosis is made by examining the skin, often with a small biopsy. Many people with xanthoma disseminatum also develop diabetes insipidus, a hormone condition that causes great thirst and passing a lot of urine, so tell your doctor if you notice those symptoms.
Treatment is specialist and depends on how widespread it is. Because the condition is so rare, it can take a little while to reach a clear diagnosis, and that’s normal. It’s not something to treat at home, and Xanthel® isn’t designed for it.
What Are Palmar Xanthomas?
Palmar xanthomas are yellow or orange lines and flat patches in the creases of the palms and wrists, sometimes on the fingers too. Doctors call them xanthoma striatum palmare. They’re painless, and many people first notice them as yellowish staining when they look closely at their hands.
What Do They Mean?
They’re closely linked to familial dysbetalipoproteinaemia, also called type III hyperlipoproteinaemia, an inherited condition that raises both cholesterol and triglycerides. It often comes with tuberous xanthomas on the elbows and knees, and it raises the risk of heart and circulation problems, so palmar xanthomas are a clear reason to see your doctor.
How Are They Treated?
Treatment is aimed at the blood fats. A diet low in saturated fat, regular exercise, losing weight if you need to and cutting back on alcohol all help, and many people also need medicines such as statins or fibrates. Your doctor may also check your thyroid and blood sugar, because problems with either can make type III worse. It usually responds well to treatment, and palmar xanthomas often fade as levels come down.
How Are They Different From Xanthelasma?
Both are yellow and both are made of the same fat-filled cells, but they mean different things. Xanthelasma on the eyelids often appears with normal cholesterol and is mainly a cosmetic worry. Palmar xanthomas almost always point to a lipid disorder that needs treating. If you have both, mention both to your doctor.
If you notice yellow lines in your palm creases, ask your doctor for a blood test that looks at both cholesterol and triglycerides. It’s a simple first step.
What Causes Xanthomas, And How Are They Diagnosed?
Most xanthomas come down to fat in the blood. Fats travel around the body in particles called lipoproteins, such as LDL and VLDL. When there are too many, or the body can’t clear them properly, they leak into the skin and tendons, where immune cells take them up and form xanthomas. Inherited lipid disorders, diabetes, an underactive thyroid, liver and kidney disease and some medicines can all play a part. A diet high in saturated fat, heavy drinking and carrying extra weight can push blood fats higher too.
How Do Doctors Diagnose A Xanthoma?
Usually by looking at it, together with a blood test for cholesterol, triglycerides, blood sugar, thyroid and liver function. If the diagnosis isn’t clear, a small skin sample can confirm it, and if an inherited condition is suspected, genetic tests and checks for close family may follow. Our guide to xanthelasma causes covers the eyelid side in more detail. If your blood fats turn out to be raised, your doctor will also talk to you about protecting your heart.
Xanthelasma Cream: For Xanthomas Around The Eyes
Got a xanthoma of the eye you’d like to see the back of? Xanthel® xanthelasma removal cream is a cosmetic gel designed to improve the look of xanthelasma, the xanthoma that forms on and around the eyelids, without needles, lasers or a clinic visit, so you can stop worrying about those patches every time you look in the mirror. Results vary from person to person.
Made For Your Skin
Each kit is formulated to order for your skin type and tone, rather than one formula for everyone, so it’s designed to work on your patches while staying gentle on the skin around your eyes.
Simple, Private And Quick
Apply it at home in a couple of minutes, usually just once. No clinic, no needles, and free tracked delivery worldwide.
Questions About Xanthomas
Is A Xanthoma Dangerous?
The xanthoma itself isn’t. It’s harmless and it isn’t cancer. But xanthomas on the body can be a sign of high cholesterol or triglycerides, so they’re worth a doctor’s check.
Can Xanthomas Go Away On Their Own?
Eruptive xanthomas usually fade within weeks once triglycerides come down, and tuberous ones can shrink slowly. Tendon xanthomas and xanthelasma rarely go away by themselves.
Is Xanthoma The Same As Xanthelasma?
Xanthelasma is a type of xanthoma. It’s the name for one on or around the eyelids.
What Is A Diabetic Xanthoma?
It usually means eruptive xanthomas caused by very high triglycerides in diabetes that isn’t well controlled. Better diabetes control helps them clear.
Can Xanthel® Remove Xanthomas On My Body?
Xanthel® is designed for xanthelasma on and around the eyelids. For xanthomas elsewhere, see your doctor. Not sure which you have? Email us a photo.
