Fractional CO₂ Laser in the Management of Xanthelasma Palpebrarum: Role, Efficacy and Aesthetic Outcomes

Xanthelasma palpebrarum (XP) is a benign periocular xanthoma characterized by yellowish plaques, most commonly involving the medial aspects of the upper eyelids. Although primarily considered a cosmetic concern, its association with dyslipidemia and other metabolic abnormalities makes appropriate clinical assessment relevant. A 35-year-old female presented with bilateral xanthelasma palpebrarum involving the upper eyelids, with multiple yellowish, well-defined, soft plaques predominantly located over the medial upper eyelid regions. The lesions had gradually increased in size and were cosmetically distressing. Clinical examination demonstrated smooth, slightly elevated, superficial and non-tender plaques without eyelid distortion or functional impairment. A clinical diagnosis of xanthelasma palpebrarum was made based on the characteristic morphology and distribution. The patient underwent fractional carbon dioxide (CO₂) laser ablation under topical anesthesia. The lesions were treated with controlled laser ablation while preserving the surrounding eyelid tissue and contour. Near-complete clearance was achieved, with mild erythema and superficial crusting during healing. No scarring, excessive tissue loss, or eyelid distortion was observed, and healing was uneventful. Fractional CO₂ laser represents a useful therapeutic option for xanthelasma palpebrarum when precise lesion ablation and satisfactory cosmetic outcomes are desired. Appropriate assessment for associated systemic abnormalities and individualized treatment selection remain important components of management.

Xanthelasma palpebrarum; Fractional CO₂ laser; Xanthelasma; Periocular lesions; Laser therapy; Cosmetic treatment

Volume: 19
Issue: 8
Published: September 2026