High-Cholesterol Skin Rash: Causes and Treatments

Eruptive xanthomatosis (EX) is among the most common skin abnormalities directly linked to abnormal cholesterol levels. It’s a rare skin condition when one has too much fat or cholesterol in the blood.

EX causes small (about 1 to 4 millimeters), raised, painless, harmless, wax-appearing bumps called xanthomas. They sometimes resemble lesions, rashes (like chickenpox or measles), or plaques and may be pink, red, skin-toned, brown, yellow, or a mixture of colors.

Since xanthomas are essentially cholesterol deposits, treating them also means getting rid of the excess fat in the body. In turn, high cholesterol and other serious diseases linked to it can be prevented.


Source: Daily Express

The direct cause of XE is high cholesterol levels in the blood, which can be caused by several factors. These include genetic conditions, medical conditions, medications, and lifestyle factors.

Genetic conditions

Genetic conditions-Cholesterol Skin Rash
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High cholesterol levels can be inherited. One example is familial hypercholesterolemia (FH), the leading cause of XE in children. Although pediatric xanthomas are harmless and can be relieved with gentle and safe allergy medicine for Infants and toddlers, bringing kids to a pediatrician as soon as possible is critical. Xanthomas may indicate an undiagnosed health condition associated with an increased cardiovascular risk.

Another inheritable condition that causes high cholesterol levels is cerebrotendinous xanthomatosis, a rare metabolic disorder. It prevents the breakdown of cholesterol, increasing a person’s risk of developing XE.

People will also likely be at greater risk of XE if they absorb too much plant sterols. They’re similar to cholesterol, except plants make them. This inheritable rare metabolic disorder is called familial sitosterolemia.

Medical Conditions

Medical Conditions-Cholesterol Skin Rash
Source: OnlyMyHealth

Certain diseases may also lead to high fat and cholesterol levels in the blood, increasing the likelihood of developing xanthomas. Such medical conditions include type 2 diabetes, chronic kidney disease, hypothyroidism (underactive thyroid), pancreatitis (swelling and inflammation of the pancreas), liver diseases, lupus, HIV/AIDS, and some cancers.

Medications and Procedures

Oral retinoids, antidepressants (like Sertraline), steroids (like estrogen replacement and estrogen), and protease inhibitors (an HIV treatment) may make the body store fat. The more a person consumes these medications, the more cholesterol and fats will likely be stored in the blood. This predisposes them to develop xanthomas.

Besides high cholesterol, tattooing may also cause xanthomas. Evidence has shown that it may likely result in a Koebner phenomenon, where new xanthomas occur on healthy skin (usually in the form of lesions rather than bumps).

Lifestyle factors

Unhealthy habits can increase cholesterol levels and, eventually, the risk of xanthomas. Such harmful lifestyle factors include being sedentary, overweight or obese, consuming foods high in saturated fats excessively, drinking alcohol regularly, and smoking cigarettes.


Source: Verywell Health

Xanthomas, especially the smaller bumps, can go away without treatment and won’t leave permanent scars. However, as mentioned, see a doctor and consult about them, even without symptoms, to help determine underlying conditions and prevent fatal diseases.

Xanthomas usually may not cause any symptoms at all, but others may experience itching, tenderness, pain, and oozing. In this case, a xanthoma removal is recommended. There are many ways to do so, including the following:

  • Topical treatment – usually with a chemical peeling agent (like trichloroacetic acid)
  • Cryosurgery – uses liquid nitrogen or argon gas to freeze and destroy abnormal cells instantly
  • Laser surgery – uses a precisely calibrated laser to remove xanthoma
  • Surgical excision – cuts the affected tissue

However, even after having them removed, xanthomas may grow back. Remember that they’re caused mainly by high cholesterol levels. Unless these levels are lowered, and other underlying medical conditions are treated, they’ll keep occurring on the skin.

For example, if you have diabetes, taking insulin if required and controlling your blood sugar levels can help lower your cholesterol level and xanthomas risk. It’s important to seek medical advice for this.

Cholesterol-lowering medications can also help treat xanthomas. These include the following:

  1. HMG-CoA reductase inhibitors – can help reduce cholesterol levels
  2. Ezetimibe – can help lower the amount of cholesterol in the gut
  3. Fibrates – can help decrease triglyceride production in the liver
  4. Niacin – can help lower bad cholesterol and triglyceride levels
  5. Bile acid resins – can help decrease bad cholesterols

Before consuming any of these medications, speak with a doctor first about their benefits, side effects, and possible risks. They may also prescribe lipid-lowering antioxidants to improve your lipid levels. Additionally, ask if it’s possible to stop medications that cause fat storage to lower cholesterol levels and help treat xanthomas effectively.

Another factor to consider when seeking treatment is that xanthomas often grow in body areas where wounds heal slowly, like on the back of the arms, thighs, buttocks, and legs. They may also show up around the eyes and on the scalp, face, neck, back, stomach, and knees. Take extra precautions if they grow in areas that may irritate through close or indirect contact with the external environment.

More importantly, live a healthier lifestyle. Stay physically active, maintain a healthy weight, make healthy dietary choices, and rest well. This isn’t to lower cholesterol levels but to improve overall well-being.

Final Thoughts

Always seek medical advice when any abnormalities or unusual growths are noticed on the skin. It isn’t only to simply confirm the bumps are xanthomas. It also minimizes the risk of more forming, helps determine underlying, co-existing health conditions, and prevents the development of cholesterol-related complications.

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