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