Kare Plastic Surgery · Dermatology · Los Angeles & Santa Monica
Xanthelasma & Milia Treatment Los Angeles
804 7th Street, Santa Monica, CA 90403 · (310) 998-5533
Minimally scarring milia extraction, xanthelasma TCA peel, laser removal, and in-office treatment by board-certified dermatologist Dr. Tiffany Sierro at Kare Plastic Surgery
Call (310) 998-5533 Schedule an Appointment
Board-Certified Dermatologisttiffany sierro md
Xanthelasma and Miliamole Removal Specialist
Xanthelasma & Milia Treatment Los Angeles
White or Yellow Bumps Around the Eye
Dr. Tiffany Sierro, MD Board-Certified Dermatologist Xanthelasma · Milia · TCA Peel · Laser Removal · Minimally Scarring Extraction · Kare Plastic Surgery, Los Angeles
White or yellowish bumps around the eyes are among the most common skin concerns patients bring to Dr. Sierro at Kare Plastic Surgery and Skin Health. Milia are keratin-filled epidermal inclusion cysts: small, firm, white papules that sit just beneath the skin surface and require mechanical extraction. Xanthelasma are soft, yellowish-orange, flat plaques of cholesterol-laden foam cells deposited in the eyelid dermis.
At Kare Plastic Surgery, Dr. Tiffany Sierro, MD provides expert in-office treatment for both conditions with same-day minimally scarring milia extraction with a fine lancet, and xanthelasma removal using CO2 laser ablation or surgical excision depending on lesion size, depth, and location. Both conditions are treated with the precision that the periorbital area demands.
Xanthelasma vs. Milia Difference in Diagnosis
What It Is
Cholesterol-laden foam cell deposits in eyelid dermis
Keratin-filled epidermal inclusion cysts
Appearance
Soft, flat, yellowish-orange plaques — medial eyelid
Firm, white/cream 1–2mm papules — face and periorbital
Systemic Link
Elevated LDL cholesterol, dyslipidemia — lipid workup recommended
None — localized keratin retention, no systemic significance
Treatment
TCA peel, CO2 laser, radiofrequency, surgical excision
Fine lancet extraction — in-office, no anesthesia
Recurrence
Can recur if lipid disorder untreated
New milia can form; treated lesions do not recur
Kare Plastic Surgery · Los Angeles · (310) 998-5533
White or yellow bumps around your eyes? Schedule an evaluation and treatment with Dr. Sierro today.
Clinical Documentation — Kare Plastic Surgery · Dr. Tiffany Sierro
Xanthelasma Periorbital — Clinical Assessment & Treatment at Kare Plastic Surgery
Actual patient at Kare Plastic Surgery · Xanthelasma with associated milia of the medial lower eyelid · Treated by Dr. Tiffany Sierro using TCA peel and minimally scarring extraction
Xanthelasma & Milia · Medial Lower Eyelid · Dr. Sierro · Kare Plastic Surgery, Los Angeles Yellowish-white cholesterol deposits (xanthelasma) with associated milia on the medial lower eyelid.
What You're Seeing
This patient presents with a mixed periorbital presentation of yellowish xanthelasma plaques (cholesterol foam cell deposits) on the medial lower eyelid with associated small white milia (keratin inclusion cysts). This combination is not uncommon.
Dr. Sierro's Approach
For this patient, Dr. Sierro performed focused surgical extraction with coagulation within the cholesterol deposits, causing them to dry and resolve over 1–2 weeks.
Systemic Workup
Dr. Sierro recommends a fasting lipid panel for some patients presenting with xanthelasma, as elevated LDL cholesterol and dyslipidemia are present in a significant proportion of xanthelasma patients. The skin is often the first visible sign of a systemic condition.
Treatment Options
Xanthelasma & Milia Treatment at Kare Plastic Surgery
Minimally Scarring Milia Extraction
Milia extraction at Kare Plastic Surgery is performed by Dr. Sierro using a fine-gauge lancet or needle to pierce the thin overlying epidermis and manually express the keratin contents of each cyst. This technique requires no anesthesia, produces no downtime, and leaves no visible scar when performed by an experienced dermatologist. The extracted site heals within 24–48 hours. Multiple milia can be removed in a single visit. Dr. Sierro's precise lancet technique minimizes trauma to the surrounding periorbital skin — the most delicate and thin-skinned area of the face.
CO2 Laser Ablation
Fractional or full ablative CO2 laser is highly effective for larger, thicker xanthelasma plaques that have not responded to TCA peel or that recur after chemical treatment. The CO2 laser precisely ablates the xanthelasma tissue layer by layer with minimal thermal spread to adjacent eyelid skin. Local anesthetic cream is applied before the procedure. Healing takes 7–10 days. CO2 laser is also used for milia that are too numerous or too deep for comfortable lancet extraction in a single session.
Surgical Excision
For very large or recurrent xanthelasma plaques — particularly those involving significant skin thickness or covering a large area of the medial eyelid — surgical excision under local anesthesia provides definitive single-session removal. Dr. Sierro performs xanthelasma excision with fine plastic surgery suture closure at Kare Plastic Surgery. Surgical excision carries a slightly higher risk of post-operative scarring or eyelid distortion than TCA peel or laser for extensive lesions, and is reserved for cases where other modalities are insufficient.
Xanthelasma and cholesterol — the systemic connection: Xanthelasma palpebrarum are associated with elevated LDL cholesterol, low HDL cholesterol, or mixed dyslipidemia in a significant proportion of patients. Even patients with normal standard lipid panels may have qualitative lipid abnormalities. Dr. Sierro recommends a fasting lipid panel at the time of xanthelasma evaluation and coordinates with the patient's primary care physician when abnormalities are identified. Treating the skin without addressing the underlying lipid abnormality increases the risk of early recurrence. Call (310) 998-5533.
"Xanthelesma and milia are quite different. Proper diagnosis and minimal scar extraction are important."
Kare Plastic Surgery, Los Angeles
Frequently Asked Questions
What is xanthelasma and how is it treated?
Xanthelasma are soft, yellowish cholesterol deposits in the eyelid dermis, often associated with high LDL cholesterol. Treatment options include TCA chemical peel, CO2 laser ablation, and surgical excision. Dr. Sierro recommends a fasting lipid panel for all xanthelasma patients. Call (310) 998-5533.
What are milia and how are they removed?
Milia are small, firm, white keratin-filled cysts just beneath the skin surface — most common around the eyes, nose, and cheeks. Dr. Sierro removes milia with a fine lancet in an in-office procedure requiring no anesthesia and no downtime. Same-day appointments available. Call (310) 998-5533.
Can xanthelasma come back after treatment?
Xanthelasma can recur, particularly if the underlying lipid disorder is not addressed. Dr. Sierro recommends lipid panel evaluation and treatment of any lipid abnormality found. Repeat treatment sessions are available for recurrent xanthelasma at Kare Plastic Surgery. Call (310) 998-5533.
Schedule Your Evaluation
Kare Plastic Surgery · Los Angeles & Santa Monica · 804 7th Street
Treat Your Xanthelasma or Milia with Dr. Sierro
Dr. Tiffany Sierro, board-certified dermatologist at Kare Plastic Surgery, provides expert xanthelasma and milia treatment throughout Los Angeles — TCA peel, CO2 laser, minimally scarring extraction, and systemic lipid workup coordination. Same-day in-office procedures. Same-week appointments available.