Usually, no immediate treatment is necessary for xanthelasma. However, many people with xanthelasma do tend to seek treatment, especially since the lesion is always continually growing. This is usually for cosmetic reasons. Although they can be treated with laser, chemicals or by freezing it, surgical excision has the best results and the lowest chance of the lesion recurring. Make sure you see your doctor as soon as the signs of xanthelasma appear. If left too long, the lesion could grow so large that the surgery to excise it could affect the eyelid folds and eye margins.
The surgical procedure to remove xanthelasma is quite easy. The surgery itself would typically take approximately 15 minutes. Local freezing would be used, and about 20-30 minutes would be added to the surgery time to allow for the freezing to set in. However, because of the local freezing, the patient would be fit to drive home afterwards. Once the specimen has been excised, it will be sent to a lab to be tested for any malignancy and to confirm the diagnosis. Stitches will be needed, and will typically be removed 5-14 days later, depending on the size and location of surgery. Redness is normal even after the stitches have been taken out, but after 4-6 months the scar should be hardly visible. There should be minimal to no pain after the local freezing has worn off, but Tylenol Extra Strength can be taken if there is.