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High cholesterol can show up on the skin

High cholesterol can show up on the skin

Experts elaborate on some of the skin conditions that could indicate a surge in cholesterol levels

High cholesterol can show symptoms on your skin, mainly as yellow bumps

Our body often raises red flags indicating fluctuations in our cholesterol levels. And some of the common signs could be found on our skin.

Experts say that while these externally visible conditions are harmless on the skin, these are indicators of a serious health condition brewing inside our body in our bloodstream – mainly excessive cholesterol build-up.

These lipid deposits could manifest as soft yellowish bumps on the skin (xanthomas) or greyish-whitish rings in the cornea of the eyes (corneal arcus). Skin conditions like psoriasis (a scaly itchy patch on the skin) or even brittle or yellowish nails could also be tell-tale signs of excessive cholesterol in the system.

“A person with these manifestations may be completely unaware that these conditions could be due to alarming levels of cholesterol in the bloodstream, which needs to be reduced at the earliest,” explains Bengaluru-based Dr Sanjay Bhat, senior consultant, interventional cardiology, Aster CMI Hospital. “If the conditions are not attended to at the right time, they could lead to atherosclerosis (narrowing of the arteries due to cholesterol-induced plaque formation) eventually leading to severe heart conditions or stroke.”


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Xanthomas: Cholesterol bumps on skin

According to an article published in the American Association of Dermatology, if you see yellowish-orange growths on your skin, you may have deposits of cholesterol under your skin known as xanthomas. These painless deposits can appear in many areas, including the corners of your eyes, lines on your palms, or the backs of your lower legs. The article says that unhealthy cholesterol levels require treatment, which can prevent life-threatening heart disease.

There are many types of xanthomas, with xanthelasma being the most common one.

Delhi-based dermatologist Dr Navin Taneja of The National Skin Centre explains that while xanthomas are nodular (roundish bumps), xanthelasma is a subtype of xanthoma that is flattish in appearance.

Xanthomas start growing gradually. “Xanthomas begin with small lesions around the corner of eyelids; they can be as small as a mustard seed. Then they might get as big as a kidney bean,” says Dr Taneja.

Though the condition is seen more in older people, it can appear even in the younger population, especially in those with a family history of high cholesterol. According to Dr Bhat, sometimes high cholesterol is detected even in people as young as 25 years because of their genetics. When they come with these signs and the lipid profile is done, it is usually found that they have high cholesterol levels. “Neglecting these signs could mean neglecting your heart health,” cautions Dr Bhat.

Dr Rajpal Singh, director and interventional cardiologist, Fortis Hospitals, Bannerghatta Road, Bengaluru, explains that people with a hereditary cholesterol issue or familial inheritance can have cholesterol accumulation visible as xanthomas in the eyelids, nodules (rounded lumps) and the tendons (dense connective tissue) or corneal arcus – a ring visible in the iris of the eyes.

Dr Taneja says that when he notices these growths in a person, he advises blood tests to check if the cholesterol is above 200 mg/dl. That’s when the person is referred to a cardiologist.

Dr Taneja says while xanthomas by itself isn’t a harmful condition, the only way it can bother a person is in terms of looks and appearance. “Xanthomas have to be observed for at least one year, and once they are stable in size, they can be easily removed either through surgery or fractional laser or something as simple and affordable as trichloroacetic acid application,” explains the skin specialist.

Swelling, skin discolouration and pain in leg

According to Dr Bhat, another sign of high cholesterol could sometimes be a burning pain in the legs and feet even when one is resting.

“Excess cholesterol can affect the blood supply to the leg and cause peripheral artery disease (PAD) by blocking the arteries,” he explains. Sometimes this condition can lead to gangrene when the tissues in the leg die due to blockage and lack of blood flow. This condition can lead to pain, swelling and discolouration of the skin; the skin turns pale, dry and yellowish. It can affect the fingers, toes and limbs of a person.

Another sign of high cholesterol could be weak toenails. “Sometimes the nails may turn brittle and yellowish, and they are slow to grow because of the loss of blood circulation,” says Dr Bhat.

Corneal arcus: Cholesterol deposits around the eye  

In corneal arcus, a discoloured ring forms around the iris because of the deposit of lipids. It can be seen mostly in adults as they age; the lipid slowly gets deposited in the cornea around the iris like a cloudy faded grey, blue or white ring.

Dr Bhat explains that corneal arcus should be taken as an early sign of atherosclerosis (plaque build-up in the arteries) which is a serious condition.

He says that once the ring is formed, it doesn’t go away; the person needs to be on cholesterol-lowering therapy and also needs to control his/her blood sugar.

“The aim is to prevent any vascular event like a stroke, heart attack or any other peripheral vascular occlusion (blockage) that can happen due to the excess of cholesterol,” he explains.

Sometimes, corneal arcus is also seen in young people and children who have familial hyperlipidaemia (a genetic condition that causes high lipid levels). “It is an irreversible condition but causes no harm to the vision,” explains Dr Bhat.

Psoriasis and cholesterol 

According to Dr Bhat, psoriasis is another condition that is linked to elevated cholesterol in the blood. In this condition, cytokines (proteins important in cell signalling) can lead to skin inflammation which raises blood sugar and cholesterol levels.

According to a meta-analysis published in the British Journal of Dermatology, psoriasis patients have a higher prevalence of cardiovascular disease (CVD) and associated risk factors, including dyslipidaemia (abnormally high level of lipids in the blood), higher blood pressure and higher body mass index, as demonstrated in a meta-analysis comprising 59 studies.

Another article published in the American Journal of Physiology, says that psoriasis patients have a high prevalence of lipid derangement that is evident in the directly measured clinical laboratory values.

High risk category and cholesterol check ups

  • Those above 40 years of age
  • Those with a family history of premature strokes or heart attacks
  • Those who have a sedentary lifestyle and habits like smoking and excessive alcohol consumption
  • Individuals with conditions like hypertension and diabetes

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