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