4 min readNew DelhiMar 25, 2026 03:00 PM IST
The human body is complex and can show what’s going on inside it in unusual ways. One such rather unexpected connection is that small yellow patches near the inner corners of your eyelids may be related to the cardiovascular system. Even though they seem harmless, according to Dr G Dimpu Edwin Jonathan, Consultant – Interventional Cardiologist, these deposits, called xanthelasma or xanthelasma palpebrarum (XP), are more than just a skin concern.
Xanthelasma: A visible clue to heart disease
“Cholesterol deposits build up under your skin to form a xanthelasma,” explains Dr Jonathan. They appear as soft, yellowish plaques on or around the eyelids, usually near the nose. Because the eyelids have very thin skin and a rich blood supply, they are often one of the first places where excess lipids become visible.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
“In many cases, xanthelasma acts as a visible marker of systemic cholesterol imbalance or early atherosclerosis, rather than an isolated skin condition,” he tells indianexpress.com.
Can it really signal heart attack risk?
Yes — and that’s where it becomes important. “Xanthelasma can serve as an early warning sign of increased heart attack and cardiovascular disease risk, especially when they appear at a younger age or progress over time,” Dr Jonathan notes.
In fact, several studies have shown that individuals with xanthelasma have a significantly higher likelihood of developing coronary artery disease, myocardial infarction, and stroke — sometimes even before symptoms like chest pain begin. “In that sense, xanthelasma can be viewed as the body’s external signal pointing toward internal vascular risk,” the cardiologist adds.
“In many cases, xanthelasma acts as a visible marker of systemic cholesterol imbalance or early atherosclerosis, rather than an isolated skin condition” : Dr G Dimpu Edwin Jonathan,
How strong is the link? Does one patch mean danger?
The association is clinically meaningful and well-documented, as per the cardiologist. Importantly, the increased cardiovascular risk appears to be independent of traditional risk factors such as age, smoking, or even measured cholesterol levels.
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“Xanthelasma is believed to reflect cholesterol deposition within blood vessel walls, similar to plaque buildup in coronary arteries,” Dr Jonathan explains. “When we see xanthelasma, we consider it a red flag for accelerated vascular ageing.”
In other words, plaque may already be forming silently.
What if cholesterol levels are normal?
Surprisingly, xanthelasma can appear even when routine cholesterol tests look normal. This may indicate hidden or residual risks such as:
- Abnormal cholesterol particle size or function (not detected in basic tests)
- Genetic lipid disorders
- Reduced HDL efficiency
- Increased inflammation or endothelial dysfunction
“Normal cholesterol numbers do not always equal low risk,” Dr Jonathan cautions.
What tests should you get for clarity?
If someone develops xanthelasma, a more comprehensive cardiovascular evaluation is recommended. This may include:
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- Fasting lipid panel
- Advanced lipid testing (LDL particle number, ApoB, Lp(a))
- Blood sugar and HbA1c
- Blood pressure assessment
- High-sensitivity CRP
- ECG or echocardiogram if clinically indicated
- Coronary artery calcium (CAC) score in selected patients
- Detailed family history
“The goal is to detect silent atherosclerosis early, before a heart attack occurs,” says Dr Jonathan.
Does removing it fix the risk?
“Removing xanthelasma addresses only the visible symptom, not the underlying cause,” Dr Jonathan clarifies. The cardiovascular risk remains unless metabolic or vascular issues are properly managed. Recurrence is common if cholesterol abnormalities persist. Moreover, removal procedures may also carry side effects such as skin colour changes, scarring, pain, or rarely, eyelid distortion.
That being said, those small yellow patches may be more than skin deep. Your eyelids may be giving your heart an early warning.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
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