These lumpy areas are usually found on the skin just under the eyes. They are rich in cholesterol giving them a golden yellow appearance, and are an inherited trait. Their presence does not correlate with high blood cholesterol levels, but they are associated with a slightly higher risk of coronary heart disease.

They are best removed with trichloroacetic acid, which gives a good cosmetic improvement compared to other methods of removal, sometimes combined with light electrocautery. A recent small study* showed that an average of 1.5 treatments was needed to remove the areas. 45% of patients had an excellent result, 33% a good result and 22% a satisfactory result. The commonest complication was pigment loss, and 25% of patients had a recurrence 6 months after treatment. This compares very favourably with other treatments. It is also relatively cheap and easy to administer.

* Ophthal Plast Reconstr Surg. 2009 Jul-Aug;25(4):280-3. doi: 10.1097/IOP.0b013e3181aa9a1f