Effective treatment of xanthelasma palpebrarum using Er:YAG laser.

Abstract

Xanthelasma palpebrarum (XP), characterized by soft, yellowish plaque primarily on the eyelids, is often associated with lipid metabolism disorders. XP can cause aesthetic concerns that affect social interactions and requires careful treatment evaluations due to potential complications and associations with systemic conditions. We aimed to assess the efficacy of and recurrence rates with erbium:yttrium aluminum garnet (Er:YAG) laser therapy in the treatment of XP. This was a retrospective review involving 214 patients treated with a 2,940 nm Er:YAG laser for XP from January 2021 to June 2023. Treatment efficacy was evaluated using standardized photography and the Vancouver Scar Scale (VSS), with follow-up assessments noting any complications or recurrence. The 214 patients with 457 lesions exhibited a complete removal of lesions post-treatment. Complications were minimal, with hypertrophic scarring occurring in 1.5% of patients and a recurrence rate of 10.5%. Patients with multiple lesions had a higher recurrence rate compared with those with single lesions. Based on VSS evaluation, 66.8% of patients (n = 143) were categorized as having excellent outcomes, while 29.0% (n = 62) were classified as having good outcomes. Er:YAG laser therapy has proven to be an effective and safe treatment modality for XP, accurately and safely removing lesions with minimal recurrence rates. It can achieve complete lesion removal, with recurrence at the treated site being very low. Additionally, Er:YAG laser treatment offers several advantages over surgical methods, making it a promising candidate to become the first-line treatment of choice for XP.