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What Is a Xanthoma?

Medically Reviewed by Dan Brennan, MD on April 25, 2021

Xanthomas are small skin blemishes that happen due to a buildup of fats under the surface of the skin. They can also develop on internal organs. The bumps themselves are not dangerous. However, they are often a symptom of other health conditions such as diabetes or high cholesterol.

If you have xanthomas, you should make an appointment to see your doctor. You probably need testing to find out what is causing them. Some conditions that lead to xanthomas can be life-threatening if they aren’t treated.

Symptoms of Xanthomas

Xanthomas are small bumps on the skin. They are generally small, although they can get as large as 3 inches across. They might appear as single bumps or in clusters. A large group of them may occur all at once. They do not have a uniform shape and size, and their color might vary from reddish to yellowish. The bumps may be itchy or tender to the touch.

Xanthomas can appear anywhere on the body, including on internal organs. They are often found on the skin. The most common locations for them include:

  • Joints, such as knees and elbows
  • Tendons
  • Hands
  • Feet
  • Buttocks
  • Eyelids

What Causes Xanthoma?

Xanthomas usually are a symptom of another type of health problem. They are caused because your body has an excess of blood lipids, which are a type of fat. Cholesterol and triglycerides are examples of blood lipids. The extra lipids can build up under your skin and erupt as xanthomas.

People are most likely to develop xanthomas if they have another, more severe health condition that causes an increase in blood lipids. Some of the conditions associated with xanthomas include:

Not all types of xanthoma are an indication of health issues. Xanthelasma palpebrarum is a common type that might show up on your eyelids. It’s not usually connected to any other health issues.

Testing for Xanthomas

Aside from the way xanthomas look, they are usually a sign that you need treatment for something more serious. If you have xanthomas, you should see your doctor to figure out what's causing the increase of blood lipids in your body. Your doctor will want you to have tests to figure out the root of the problem.

Biopsy. Your doctor may want to take a sample of the xanthoma and send it to a lab for analysis. They do this step to make sure the bumps are xanthomas and not cancer.

Cholesterol tests. Your doctor will probably order a blood test to check what levels of blood lipids you have, including your cholesterol and triglyceride levels.

Additional blood tests. Your doctor may also check for irregularities that might indicate diabetes, liver disease, pancreatitis, or thyroid problems.

Treatment for Xanthomas

You may not like the way xanthomas look and want to do something about them. Doctors can remove them from your skin using lasers or surgery. However, they might return after removal.

Your doctor may also recommend treatment plans for the underlying cause of elevated blood lipids. Reducing your blood lipids will improve your overall health and reduce the chances of xanthomas coming back in the future. Treatment will vary depending on your diagnosis.

Diabetes. Diabetes requires lifestyle changes, including a diet that helps manage blood sugar levels. Your doctor may want you to increase the amount that you exercise, as well. You may need to take insulin.

Liver disease. If you have liver disease, your doctor may suggest changes to diet and exercise. If alcohol dependence is the reason for your liver problems, you may need to address that. Some medications are available that can help with liver disease.

Hypothyroidism: You can effectively treat an underactive thyroid with synthetic thyroid hormones. Your doctor may also suggest lifestyle changes that can help you manage your symptoms.

Cardiovascular issues: If high levels of blood lipids are your primary diagnosis, your doctor will suggest lifestyle changes you can make to bring your numbers back to safe levels. You may also need medicine to control your blood lipid levels.

In some cases, once you get your blood lipid levels down, the xanthomas will go away on their own. If not, you can speak to your doctor about having them removed.

The conditions that lead to xanthomas are serious. Without treatment, they can lead to hospitalization, surgery, or death. If you develop xanthomas, it’s important to talk to your doctor so you can come up with a plan together.

WebMD Medical Reference

Sources

SOURCES:

American Academy of Dermatology Association: "HEART DISEASE: 12 WARNING SIGNS THAT APPEAR ON YOUR SKIN."

Icahn School of Medicine at Mount Sinai: "Xanthoma."

Mayo Clinic: "Cirrhosis," "Diabetes," "Hypothyroidism (underactive thyroid)."

Winchester Hospital Health Library: "Xanthelasma and Xanthoma."

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