Can xanthelasma spread and get darker?

Hello,

Welcome to icliniq.com.

I understand your concern. I looked over the image (attachment removed to protect the patient's identity). As per the history and image provided, it is xanthelasma. Xanthelasma on eyelids is raised patchy lesions with yellow discoloration, which are harmless and usually a sign of cholesterol or diabetes, or both. Although they are harmless, being a sign of an underlying lifestyle condition, I would suggest you take a fasting lipid profile test for cholesterol and check for fasting blood sugar (FBS), post-prandial blood sugar (PPBS), and HbA1c (Glycosylated hemoglobin) test for diabetes. In case of fluctuations in the above from normal parameters. Consult a physician for starting medications. As for the xanthelasma lesions, although no medications for topical application are available, there are other modalities of treatment for cosmetic purposes, which includes erbium Laser therapy for removal of the lesion, diode laser therapy for lightly burning the lesion in layers, and radiofrequency cauterization where the laser is not involved, but the same procedure gently burns the lesions. All of these tasks are performed by a dermatologist. A surgeon can also remove the lesion surgically. All the procedures are harmless, quick, and painless as they are done under local or topical anesthesia in the form of numbing cream application before the procedures are done. They have no side effects. Kindly consult a doctor in person for the procedures. However, if the underlying cholesterol or diabetes is not controlled, there are high chance of the xanthelasma lesions recurring.