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Dr. Monica
Dr. Monica, Board Certified Physician
Category: Medical
Satisfied Customers: 816
Experience:  Experienced U.S. Primary Care Physician treating children, adults, pregnant women, and the elderly.
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I have little white bumps under my eyes they look like pimples

Resolved Question:

I have little white bumps under my eyes they look like pimples but they are in the wrinkles under my eyes (I'm 44). I've tried to squeeze some of them but even though they look like whiteheads, they don't pop and they don't go away. Is there anything that can be done about these?

BTW, they are smooth to the touch and you see them better when you spread out the skin tight. Under eyes wrinkles find their way in between them. They are not milia.

BTW, I had laser resurfacing of that area 2 years ago. Could that have caused this. Should I consider having laser resurfacing (Active FX fractional Co2) again?
Submitted: 4 years ago.
Category: Medical
Expert:  Dr. Monica replied 4 years ago.
Hello-

What you have could be xanthomas, which are fatty deposits that can be flesh colored or slightly yellow. They are caused by having high cholesterol. You should probably get your cholesterol checked and treated if it is high. Treating the cholesterol (specifically, the LDL or "bad" cholesterol) may mean a change in diet or starting medications with a change in diet, depending on your levels. Usually the xanthomas will go away several months after the LDL levels improve, but not always. In the event that they don't go away, you can consult a dermatologist who is experienced in treatment of these in a fragile area such as under the eyes.

Hope this helps. Please let me know if I can further assist you.

Best,
Dr. Monica
Customer: replied 4 years ago.
Would laser treatment help them? My cholesterol is high normal 200-220 with HDL 60. I've had them for years and they won't go away and I DID see a derm and she said there was nothing that could be done.
Expert:  Dr. Monica replied 4 years ago.
An experienced dermatologist (perhaps in cosmetic medicine) can use topical trichloroacetic acid, electrodesiccation, laser therapy, and/or excision to try to remove them. Even after successful treatments, the bumps can recur. Hope this helps.
Customer: replied 4 years ago.
I looked up xanthomas: The pictures of these all look much larger than what I have. Mine are myriad(probasbly a hundred under each eye) and essentially flat and about a millimeter in size. You see them best only when you pull the screen tight: the wrinkles under your eyes kind of fold them so you don't see all of them.

Could they be something else?
Expert:  Internist replied 4 years ago.

even then u shud get your cholesterol leves checked and if u coud email me pictures of those lesions i will definitely be able to assist u in detail

my email is rizwan404@hotmail.com

Expert:  Dr. Monica replied 4 years ago.
I have only rarely seen xanthomas that are as large as the ones shown on the internet when I did a quick search. Many that they show on the internet are "tendinous" xanthomas. However, I have seen the ones you are describing many many times in practice. They are quite common and very small, numerous, and under the eye.

If you were able to post a photo it would help, however based on your description I doubt I would change my top differential diagnosis of what you have, which is xanthomas.

I highly suggest you mention this possibility at your next appointment with your doctor.

Please let me know if I can further assist you.

Please hit accept so that I get credit for my time spent with you if you have been helped by my answer.

Thanks,
Dr. Monica
Expert:  Dr. Monica replied 4 years ago.
I forgot to mention that there is a possibility that the laser surgery you had could have caused this abnormality as well, and your dermatologist should have been able to tell you this if that was the case. Because you have seen a dermatologist that said nothing can be done, I suggest you find another one.

Sincerely,
Dr. Monica
Expert:  Internist replied 4 years ago.
i am sorry for intervening dr monica that was my first day i didnt know u continue i am really sorry you are answering correctly kindly withdraw the report u made,u wouldnt have any complaint next time,sorry again
Customer: replied 4 years ago.
Dr. Monica,

I can't find anything online that talks about these dots being caused by the (fractional CO2) laser. I was planning on having this done a second time. Are you saying that having it done a second time could make them worse? I thought lasering them was one way of reducing them?
Expert:  Dr. Monica replied 4 years ago.
Any surgery or treatment has the possibility of causing scar tissue or inflammation that results in scar tissue. You should discuss this with your next dermatologist.
Dr. Monica, Board Certified Physician
Category: Medical
Satisfied Customers: 816
Experience: Experienced U.S. Primary Care Physician treating children, adults, pregnant women, and the elderly.
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