by Kohnle D


Fatty lumps under the skin are called xanthomas. They range from very small to up to 3 inches in size. Xanthomas can be cosmetically disfiguring. Xanthomas may appear anywhere on the body. The most common places are the elbows, joints, tendons, knees, hands, feet, and buttocks.

If the fatty lumps are on the eyelids, it’s called xanthelasma.


Causes of xanthomas are:

Xanthelasma is connected to high fat levels in the blood. But, you can still have it without these problems.

Risk Factors

Xanthoma is more common in older adults. Your chances are higher if you:

  • Have one of the metabolic problems listed above
  • Have very high cholesterol or triglyceride levels


Xanthomas may cause:

  • Bumps under the skin, which may be:
    • Tender
    • Itchy
    • Painful
  • Skin bumps that:
    • Are many different shapes
    • Are yellow to orange
    • Have well-defined borders


The doctor will ask about your symptoms and health history. Your answers and a skin exam will point to having xanthomas. You may also have:

  • A physical exam
  • A biopsy to check the fatty lumps
  • Blood tests to check cholesterol and to look for other causes
Skin Biopsy
Skin proceedure
Copyright © Nucleus Medical Media, Inc.


Xanthomas may go away on their own. Care depends on what’s causing them. This approach helps lower the chances of having them come back. Care may involve:

  • Changes in you diet to lower the amount of fat
  • Medicines to manage cholesterol and triglyceride levels

Options for removal may involve:

  • Laser vaporization—different types of light can be used
  • Applying chemicals to the affected area
  • Surgery to cut them out

If you have them removed, it’s possible they will come back.


To help lower your chances of xanthomas, follow your care plan if you have high cholesterol or other metabolic problems.


American Academy of Dermatology 

Family Doctor—American Academy of Family Physicians 


Canadian Dermatology Association 

Health Canada 


Shapiro M. Rare Genetic Disorders Altering Lipoproteins. Endotext [Internet]. South Dartmouth (MA):, Inc.; 2000-2015 Jun 12.

Hypertriglyceridemia. EBSCO DynaMed Plus website.  . Updated June 4, 2018. Accessed June 20, 2018.

Xanthoma. DermNet NZ website. Available at: Accessed June 20, 2018.

Revision Information

  • Reviewer: EBSCO Medical Review Board Marcie L. Sidman, MD
  • Review Date: 05/2018
  • Update Date: 06/20/2018