20/05/2015

Xanthelasma Treatment - My Experience of DIY Xanthelasma Removal

Disclaimer: I am not a medical professional, if you are a xanthelasma sufferer then you should consult a qualified medical professional about your condition and do not attempt to treat it yourself. I do not recommend, advise or encourage anyone to imitate the procedures that are documented here. And shall not be held responsible, or liable, for anyone that decides to do as I have done. Also, I in no way recommend or endorse any products or companies mentioned here.

Updates: In order to keep this record easily readable, and in chronological order, I will be editing this post rather than creating new posts with updates. The last update was made on Monday, 8th June 2015.



Preface

As you're reading this blog it's likely that you're also a sufferer of xanthelasma. Therefore, I will refrain from elucidating on what the condition is and what may or may not be the underlying causes of it.

Suffice to say that I'm a 42 year old Englishman who suffers with the condition. Around 5 years ago I went through a spell of eating a supermarket quiche virtually every day for months on end. It was not long after this poor dietary choice that the xanthelasma occurred. It showed as large, unsightly, yellowish plaques underneath each eye.

When I realised that these ugly disfigurements were not going away I started researching what they were and what could be done about them. This is when I learnt it was a condition called xanthelasma and the only effective way to get rid of it was some kind of cosmetic surgery. I was not prepared to pay for such treatments so all that was left for me was the 'garlic treatment' that I'm sure you have read about.

The 'garlic treatment' aims to get rid of the xanthelasma by using garlic juice to induce a chemical burn on the affected sites. I tried this once, inducing chemical burns which, when healed, produced only a marginal improvement in the condition. I decided not to continue with the 'garlic treatment' as it was too haphazard and dangerous for the unspectacular results it provided me.

Recently I got tired of living with this condition so embarked upon another research mission to see if I could discover anything new. That is when I came across this blog post from a lady who also suffers from xanthelasma. She used a substance called trichloroacetic acid (TCA) to, in my opinion, rather successfully remove her xanthelasma.

Further research turned up more cases of xanthelasma sufferers treating themselves with TCA to great success. As well as clinical studies, published in peer reviewed medical journals, documenting the successful use of TCA to treat xanthelasma.

What sealed the deal for me was seeing a xanthelasma sufferer being treated with TCA on the Channel 4 programme 'Embarrassing Bodies: Live from the Clinic'.




As you can see in the video clip, a tremendous result was achieved from a single treatment of TCA.

I am still not prepared to pay a dermatologist or other medical professional to administer the treatment; the application itself is not a complex procedure, you are essentially paying for their experience. I'm happy to forego a general anaesthetic and am prepared to suffer my fate should any complications occur.

Trichloroacetic acid (TCA), like the 'garlic treatment', induces a chemical burn. It's most commonly used in strengths of 12.5-35% as a chemical peel cosmetic treatment. Stronger concentrations are used for such things as wart, verruca, mole and xanthelasma removal.

So, having decided that I wish to use TCA, in an attempt to remove my xanthelasma, the rest of this blog will be dedicated to documenting this process. I'm happy to accept the consequences of my actions such as potential complications, scarring and skin discolouration that could occur with the use of TCA. For me, the reward of getting rid of the xanthelasma far outweighs the risks. From what I've read in the medical research there is a (25-40%) chance of xanthelasma reoccurring. Fine, if this TCA treatment is successful then I will just do it again.



Phase I - Preparation

Short of purchasing the necessary chemicals and producing my own TCA solution the only other option is to buy a commercially available product. And without having access to a lab for testing said product there is little to go on regarding the purity, quality and accuracy of it besides word of mouth and feedback from other users.

I have opted to go with a product from Novopeel® (a limited company based in Salford, England). They claim that:
'All solutions have been prepared by qualified biochemists and checked and verified to be true and accurate concentrations. The method of preparation is the standardised (w/v) method. Novopeel® TCA may feel stronger than some you may have previously used. Having analysed some commercially available solutions we find some discrepancy in concentrations.'
Whilst they have their own website I purchased a 10ml bottle of 50% TCA from their ebay shop for the cost of £7.49 inc. shipping. (N.B. Their ebay feedback was good.)




I purchased 50 Robinson Healthcare 70% isopropyl alcohol swabs (also manufactured in England) from ebay for £1.59 inc. shipping. The swabs are to disinfect and clean the site of grease and oils prior to application of the TCA and to clean and disinfect during the recovery period.




I also have a tub of Johnson's Cotton Buds to apply the TCA.




The Novopeel® TCA solution came with a, fairly comprehensive, double-sided A4 sheet of information/instructions. It covered everything I had read about TCA and added a few more things, although it does not make any mention of xanthelasma.

Key points I am taking away from the instruction sheet:

  • For verruca, wart & mole removal use solution strengths of 30%, 35% or 40% with the caveat that experienced users can use 50%.
  •  Stop using soap on the area 1-2 days before treatment.
  • The TCA should induce a 'stinging' sensation but not go as far as a 'burning' sensation. If it feels like it's burning it should be washed off immediately.
  • The TCA can be applied using a 'multi-layer' approach. That is: a lower concentration solution is applied, you wait 5-15 minutes then apply another layer, and so on.
  • The furthest you should go is to induce the characteristic 'white frosting' of the skin. No TCA should be applied past this point.
  • The TCA stops working after approx. 5 minutes. Thus, it is what's known as 'self-neutralising'. You are not required to wash it off or apply a neutralising solution.
  • Aftercare involves using whatever antiseptic/antibacterial/soothing creams, balms, ointments, etc. that you desire or nothing at all. And to not pick off any peeling skin from the site.



Phase II - The Plan

It's a bank holiday weekend so I will do the treatment on Friday and this will give me 4 days where I will not be required to go out in public with a peeling face.

I will proceed with the treatment as follows:

  • Clean xanthelasma sites with IPA swabs.
  • Apply petroleum jelly to the corners of the eyes as a precaution against getting any acid in there.
  • Saturate a cotton bud with TCA solution.
  • Ensure the cotton bud is not dripping any solution.
  • Apply to xanthelasma sites.

After a thorough examination of the xanthelasma sites I've decided that, as they are pretty flat, it will be hard to apply the TCA without getting some on the skin at the edges. Therefore, I will heed Novopeel's advice not to use a 50% solution.

I will dilute the TCA to a 35% concentration and use a 'multi-layer' application. That is, I will apply the TCA, wait 5 minutes then apply it again, and so on until a frosting forms. A ratio of two drops of TCA (50% conc.) to one drop of water will produce a ~35% TCA solution.



Phase III - Treatment

I had pictures taken of the xanthelasma then proceeded with the treatment.

  • The sites were cleaned with IPA swabs.
  • 4 drops of TCA (50% conc.) and 2 drops of water were put on a cotton bud; producing a ~35% TCA solution.
  • A layer of TCA was applied to the xanthelasma sites.
  • A mild stinging sensation developed and faded over the course of a few minutes.
  • 5 minutes later a new TCA soaked cotton bud was prepared, the same way as the first, and a second layer was applied to the xanthelasma sites.
  • A white frosting appeared and a stronger stinging sensation was felt.
  • The stinging faded after a few minutes and the frosting had gone when I checked, 20 minutes later.
  • I did not wash off the TCA or apply any other substance to my skin.

The Novopeel instructions state that peeling starts to occur after 3 days (at the earliest), I will post pictures documenting the progression of the treatment.



Phase IV - Progress

Days 0 - 3

Whilst the treated areas look sore in the pictures I have not experienced any pain, irritation or itching. On Day 1 I had a mild 'heat' sensation but that's as far as it's gone. I have not applied any creams, ointments, gels, etc.


Days 4 - 5

Peeling occurred, no pain, itching or other discomfort was felt.
 




Day 7

By the seventh day all skin had peeled and my face was looking back to normal. I was somewhat disappointed that the effect of the TCA on my xanthelasma was minimal to none.



Phase V - Second Round of Treatment

14 days after I first applied the TCA my skin seemed to back to normal with no ill-effects. Thus, I decided to another TCA peel, this time using the 50% strength solution straight from the bottle. I followed the same application procedures as my first treatment but this time the frosting appeared almost immediately so I applied only one layer of TCA. There was a mild stinging which subsided after a couple of minutes.









To be continued...