Is Q‐Switched Neodymium‐Doped Yttrium Aluminium Garnet Laser an Effective Approach to Treat Xanthelasma Palpebrarum? Results from a Clinical Study of 76 Cases

BACKGROUND Treating xanthelasma palpebrarum may prove difficult because of its delicate location on the eyelid. Various forms of nonablative laser techniques have been examined, and Q‐switched neodymium‐doped yttrium aluminium garnet (Nd:YAG) laser therapy has shown promising preliminary results. OBJECTIVES To determine the efficacy of Q‐switched Nd:YAG laser treatment for xanthelasma removal. MATERIALS AND METHODS Thirty‐seven consecutive patients with 76 lesions received two treatment sessions with a Q‐switched Nd:YAG laser without local anesthesia (6 J/cm2 [1,064 nm] or 2 J/cm2 [532 nm], 4‐mm spot size, 2–3 passes). Photographs were taken before each treatment session and 4 weeks after the second treatment. Two independent examiners rated clearance in four groups (none [<25% cleared], moderate [25–50%], good [51–75%], and excellent [>75%]). RESULTS Only two‐thirds of the patients completed the entire course of the study; disappointing early results were the main reason for dropping out. The majority of treated lesions (70% or 75%, depending on the examiner) showed no clearance. Plasma low‐density lipoprotein cholesterol levels displayed some influence on treatment results but not enough to facilitate stratification of patients. CONCLUSION Q‐switched Nd:YAG (532 nm and 1,064 nm) laser treatment of xanthelasma cannot be recommended.