xanthelasma a case series victoria smith bsc (hons) itec vtct director of aesthetics
TRANSCRIPT
XanthelasmaA Case Series
Victoria Smith BSc (Hons) ITEC VTCTDirector of Aesthetics
Portrait of Mona Lisapainted in 1506
Suggests Xanthelasma prevalent in 16th Century
What is Xanthelasma?
• Lipoprotein• Yellow plaques
• flat or slightly raised
• Eyelids• lower and upper
• Harmless• cosmetically unattractive, irritating
• Can grow• 3mm – 6cm diameter
• Sharp distinct border
Causes
• Cause unknown• High cholesterol • High level of plasma lipids• High BP• Heart disease• Genetic factors
Who gets Xanthelasma?
• Rare• Hampton R. Oct 2011, Medscape
• More prevalent in women• F:M ratio = 2:1 (Christoffersen et al. BMJ 2011\0
• Age of onset = 15 - 73yrs• Peak age = 40 – 50 yrs
Existing Treatments for Xanthelasma
• Surgery - skin grafts, flaps• Cryotherapy- Liquid Nitrogen• Laser e.g. Nd:YAG• Trichloroacetic acid
•Camouflage Make Up
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
Advanced ElectrolysisLumps, Bumps and Skin lesions
Skin tagsMiliaTelangiectasiaSeborrhoeic KeratosisDermatosis Papulosa Nigra“Age spots”
The Procedure
• Clean environment
• Short wave diathermy• 17-19 MHz• Sterex (UK)
• One piece stainless steel needle
• 2 techniques used
• “Scratching”
• removal of epithelial layer
• “scratching” with needle to lift plaques
Technique 1
Technique 2• “Dotting”
• used if plaques don’t raise
• repeated “tapping”of plaque
• heat accumulates
• plaque darkens and crusts
After Procedure• No discomfort
• Area resembles a graze• Sometimes bleeds - before scab forms
• Scab comes away 5 - 7 days
Results• 10 patients (M:F 4:6 Age: 39-
53years)• 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
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
Before and After Images
Before and After Images
Before and After Images
Before and After Images
Before and After Images
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