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Xanthelasma A Case Series

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

2 Portrait of Mona Lisa painted in 1506
Suggests Xanthelasma prevalent in 16th Century

3 What is Xanthelasma? Lipoprotein Yellow plaques Eyelids Harmless
flat or slightly raised Eyelids lower and upper Harmless cosmetically unattractive, irritating Can grow 3mm – 6cm diameter Sharp distinct border

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

5 Who gets Xanthelasma? Rare More prevalent in women
Hampton R. Oct 2011, Medscape More prevalent in women F:M ratio = 2:1 (Christoffersen et al. BMJ 2011\0 Age of onset = yrs Peak age = 40 – 50 yrs

6 Existing Treatments for Xanthelasma
Surgery - skin grafts, flaps Cryotherapy- Liquid Nitrogen Laser e.g. Nd:YAG Trichloroacetic acid Camouflage Make Up

7 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

8 Advanced Electrolysis
Lumps, Bumps and Skin lesions Skin tags Milia Telangiectasia Seborrhoeic Keratosis Dermatosis Papulosa Nigra “Age spots”

9 The Procedure Clean environment Short wave diathermy
17-19 MHz Sterex (UK) One piece stainless steel needle 2 techniques used

10 Technique 1 “Scratching” removal of epithelial layer
“scratching” with needle to lift plaques

11 Technique 2 used if plaques don’t raise repeated “tapping” of plaque
“Dotting” used if plaques don’t raise repeated “tapping” of plaque heat accumulates plaque darkens and crusts

12 Sometimes bleeds - before scab forms
After Procedure No discomfort Area resembles a graze Sometimes bleeds - before scab forms Scab comes away days

13 Results 10 patients (M:F 4:6 Age: 39-53years) 7 completed treatment
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

14 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

15 Before and After Images

16 Before and After Images

17 Before and After Images

18 Before and After Images

19 Before and After Images

20 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

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