Xanthoma – Causes, Symptoms & Treatment


Xanthomas are usually yellowish, cholesterol-rich deposits in tendons or other parts of the body. This fatty tissue can form and settle under the skin’s surface in various forms. Xanthomas are usually associated with hyperlipoproteinemia ( high cholesterol in the blood ).

What is a xanthoma?

The term xanthoma is subordinate to the term xanthelasma and refers to fatty deposits under the skin that have developed a striking size.

Although they are usually yellowish in color, the deposits can also be brownish, reddish, beige or cream in colour. Xanthomas vary greatly in size and shape. Points the size of a pinhead, which often occur in clusters, protruding knots, round, even surfaces, or uneven sponges are all possible. Although deposits are most prominent on the skin, they can also appear on bones , blood vessels, and organs.

Xanthomas themselves are not dangerous, but mostly occur in connection with diseases of the lipid metabolism. When triggered by high blood cholesterol levels, they can also resolve once this is brought under control.


There are a variety of causes associated with the dyslipidemia that causes xanthomas . Lipids combine with proteins in the blood. These lipoproteins transport cholesterol and other fats to different parts of the body.

If this process is subject to fluctuations and irregularities, xanthomas lay off. The reason for this can be genetic dispositions, but also other diseases that are often associated with health-related lifestyle. The first includes diabetes mellitus , but drugs can also cause these disorders. Consequently, when xanthomas occur in the context of secondary hyperlipoproteinemia, they can have a number of causes.

These include alcoholism , overeating , malnutrition, pancreatitis ( inflammation of the pancreas ), liver disease, cholestasis (bile congestion), hyperuricemia (elevated uric acid level in the blood), hypothyroidism (underactive thyroid gland), acromegaly (enlargement of the extremities), glycogenosis (impaired breakdown of glucose) , hypercalcaemia (high levels of calcium in the blood).

Typical Symptoms & Signs

Diagnosis & History

Xanthomas can occur in many parts of the body: ankles and joints (Xanthoma tuberosum); nodules on hands, feet, or Achilles tendon (xanthoma tendinosum), yellowish-orange nodules anywhere on body (eruptive xanthoma); Scattered spots over large areas of skin (Xanthoma planum); on the fingers (palmar xanthoma); red nodules that look inflamed (tuberoeruptive xanthoma).

Depending on the location and type of occurrence, they can be indicators of various diseases, but do not necessarily have to be, so diagnosing the underlying disorder is not always easy. Xanthomas can remain permanent or appear sporadically in certain regions and disappear again. They usually resolve when the underlying condition has been cured or the causes of the condition have been controlled.


In the case of a xanthoma, those affected primarily suffer from a very high level of cholesterol in the blood. This high content generally has a very negative effect on the health of the patient and can also significantly reduce life expectancy. Furthermore, the xanthoma leads to deposits under the skin and also in the skin.

Fat is deposited in the form of small knots. Many of those affected feel uncomfortable with these symptoms and suffer from inferiority complexes or significantly reduced self-esteem. Especially in children, these aesthetic complaints can lead to bullying or teasing and thus cause depression and other psychological upsets.

Due to the high proportion of cholesterol, the risk of a heart attack also increases. This can also lead to inflammation of the pancreas. The condition can usually be treated with medication. However, those affected also need to change their lifestyle and follow a healthy diet. There are no particular complications. A xanthoma can also be removed surgically.

When should you go to the doctor?

Changes in the appearance of the skin that last for a long time or have an unusual appearance should always be examined by a doctor. Clarification of the cause is necessary if there are sudden abnormalities or an increase in symptoms over a longer period of time. Skin changes are often symptoms of an existing disorder that requires medical care. Lumping of the upper layers of the skin is considered uncommon.

Unusual fat deposits are also of concern. In order for a diagnosis to be made, it is advisable to see a doctor. If discoloration of the skin appears, this indicates a health impairment that requires a treatment plan. In particular, yellowish and white discolorations should be presented to a doctor. Poplars, skin subunits, reduced well-being and impairments in coping with everyday tasks are indications of a disease.

Medical care is needed to relieve the symptoms. If the hands and the Achilles tendon of the affected person can no longer be moved without symptoms, a doctor is needed. If there are impairments when performing usual sporting activities, the cause should be clarified. If the affected person notices changes in the trunk area, this should also be interpreted as a warning signal from the organism and should be examined by a doctor.

Treatment & Therapy

The basic treatment of xanthoma is directly related to the underlying disease. Once this is identified, it should be treated specifically. In many cases, xanthomas will also decrease with this treatment.

In addition, treating high blood cholesterol levels will reduce the risk of heart attack and pancreas inflammation . A targeted diet and a change in lifestyle will lead to an improvement in the lipid metabolism disorder, with or without medication. When it comes to nutrition, it is important to ensure that most dishes are prepared from fresh vegetables, salad, cereals and fish.

Saturated fats, which are mainly found in meat, butter and other dairy products, should be reduced. Food and drinks that contain a lot of refined sugar should be significantly reduced. These include lemonades, sweets, cakes, etc. If you are overweight , you should slowly reduce your calorie intake in order to achieve a healthy body weight. Xanthomas that do not resolve after treatment can also be surgically removed.


In order to prevent xanthomas and the diseases associated with them, the cholesterol levels in the blood and the blood pressure should be checked regularly, especially after reaching a certain age . Essential prophylaxis is of course a healthy lifestyle with plenty of exercise, a balanced diet and moderate consumption of alcoholic beverages.


Depending on how and what type of xanthoma was treated, there are two approaches to follow-up care. On the one hand after a surgical removal and on the other hand after the treatment of the underlying disease. Depending on which treatment has taken place, the aftercare measures differ.

If the xanthoma is surgically removed, it is strongly advised to keep the necessary follow-up appointments. Here, the doctor treating you decides in advance whether one appointment is sufficient or whether several are necessary. With all types of skin surgery and their aftercare, patients should be aware that UV light on the injured skin can promote a renewed formation of certain pigmentations and disorders.

If the xanthoma has been surgically removed, the skin should be treated with sunscreen for up to eight weeks. This should have a high UVA and UVB sun protection factor. In addition, the treated skin area should not come into contact with water in the first few days after the treatment. In addition, those affected should refrain from sports and other physically demanding activities for at least two weeks.

In general, the treated part of the body should be moved less than usual for the first few days, so that the healing can progress better. If the possible underlying disease has been treated, compliance with a special low-fat diet is essential. The regular intake of lipid-lowering drugs is then also part of regular follow-up and preventive care.

The goal is a sustainable lifestyle modification. Blood tests at regular intervals and check-up appointments with the dermatologist are necessary here. This ensures that there is no renewed xanthoma formation.

You can do that yourself

In order to alleviate the existing symptoms, an optimization of the lifestyle is necessary. The consumption of alcohol must be refrained from. In the case of addictive behavior in particular, there is a need for action. In most cases, however, medical support is required for this, since the person concerned often does not have the necessary discipline to change the situation in the long term.

The intake of food should also be checked and optimized. Fat deposits develop in the organism of many of those affected because they eat unhealthily. At the same time, there is usually a lack of exercise that needs to be remedied. Meal intake should be monitored and reduced. A balanced and vitamin-rich diet is necessary to improve general health. Sufficient exercise, sporting activities and a regular supply of oxygen are also important to increase well-being and reduce symptoms.

The weight should be in the normal range of the BMI . Otherwise, countermeasures must be taken. A fat reduction in food intake helps to gradually lose excess weight. Likewise, offered diet programs can be used to achieve improvements. It is advisable to take part in nutritional advice in order to record and optimize the effects of food intake.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.