Youth Violence

What ails a growing child’s psyche? (Hindustan Times:20180322)

http://paper.hindustantimes.com/epaper/viewer.aspx

SIGNS Parents should watch out for lying, stealing, frequent tantrums, aggressive behaviour

towards younger siblings and pets

The World Health Organization (WHO) describes youth violence as a global public health

problem. It can range from bullying and physical fighting to more severe sexual and physical

assault to homicide.

Worldwide, an estimated 200 000 homicides take place among those aged 10–29 each year,

making it the fourth leading cause of death of people in this age group, according to a 2016

WHO review on youth violence.

When it is not fatal, youth violence has a serious, often lifelong, impact on a person’s

physical, psychological and social functioning. It also greatly increases the costs of health,

welfare and criminal justice services; reduces productivity; and decreases the value of

property.

Most experts working in the field of psychiatry will agree that youth violence, especially

teenage violence, has increased over the years. I am not only talking about the cases I come

across, but also what we see around or read about.

If you look at the past couple of decades, not only has the number of teenagers exhibiting

violent tendencies increased, but also the intensity of violence has changed for the worse.

ANGRY ADOLESCENTS

DAILY NEWS BULLETINLEADING HEALTH, POPULATION AND FAMILY WELFARE STORIES OF THE DayThursday 20180322

I have observed that the seeds of violent behaviour in teenage or adulthood is usually sown

during one’s childhood; temper tantrums could be a symptom.

Children have even started behaving violently when their demands are not met. I recently saw

a 12-year-old who misbehaved with his parents merely because they didn’t buy him a

Playstation. He stopped talking to them and started throwing things around the house when

the parents tried to speak to him. I had to counsel the child and the parents for months before

things returned to normal.

While this couple was aware and sought help when things got out of hand, there are many

parents who live in a state of denial and take their child’s aggressive behaviour for tantrums

that the child will eventually grow out of.

Most children have aggressive impulses in their growing years — throwing or breaking their

toys when angry or harming pets that are soft targets.

The reasons are many, ranging from general frustration to stress, a poor coping mechanism,

cut-throat competition, high expectations to even lack of social support as their family

doesn’t spend sufficient of time with the children.

Social support in the form of family and friends works as a great buffer for a child trying to

channelise anger, frustration or any negative emotion.

How the child reacts or copes with stress is important. But these days I mostly see them to be

maladaptive; parents tend to reinforce the negative behaviour by giving in to their (at times

unreasonable) demands.

Also, there is an element of guilt in working parents that makes them vulnerable to yield to

pressure created by the child and may lead to impulsivity and behaviour problems among

children.

Someone should hear them out and show them what is right and what’s wrong. Of all the

cases I have seen, a large number didn’t have people around them to talk to when they felt

low.

They couldn’t learn to contain their anger ; that also led to low frustration tolerance. There is

very raw release of anger in most kids of today that is taking its toll on their temperament.

ABSENT PARENTS

Parents nowadays have become so engrossed that they do not get to spend enough time with

their child. Hired caretakers, who can never fill their shoes, are standing in.

Parenting was an important task earlier; now earning more money seems to have become the

priority. Ironically, it is to provide their child a better life, but in this attempt it is the child

who is getting neglected. The single-child norm that is fast becoming common is also to be

blamed to a great extent as parents tend to over-pamper an only child.

Strict discipline used to be maintained in families once, but now parents give in to their

children’s demands simply as a way of compensating for not being able to spend enough time

with them.

Another reason, and an important one, for growing teenage violence is increased exposure to

all kinds of external stimuli, especially mobile phones and other gadgets, which gives them

access to content with extreme forms of violence.

Then there is a tendency to experiment. The current lot is extremely curious and inclined to

experiment, which is why alcohol and drugs are tried at a very young age; that also

contributes to very poor judgment.

Not all children have criminal tendencies, in fact, the percentage is extremely small. I very

rarely see children or teenagers with criminal tendencies.

Talking of teens belonging to poor families, they are vulnerable to different contributing

factors for aggressive behaviour, such as migration. The families are migrating to cities from

villages, and it is a task to adjust to horrible living conditions in the cities for these people.

Parents again have no time as they are busy providing food and shelter for the family. There

is very little space to themselves as a large number is living in one room, as a result which

these children face a lot of negativity at a very early age.

WARNING SIGNS

Signs that parents should watch out for include manipulative behaviour, lying, stealing,

throwing frequent tantrums, aggressive behaviour towards younger siblings or pets,

hyperactivity, a drop in performance, and aloofness. In most cases I have come across,

parents had these complaints.

Not all children need professional help as parental guidance works for most of them. A lot

also depends on what kind of example parents are setting for the child; children tend to

emulate their parents a lot. So you have to be mindful of your actions and words in front of a

child.

Parent-teacher communication is also important as a child often faces problems in school that

parents need to be aware of.

A small percentage of children actually require professional treatment, that too, mostly in the

form of counselling.

The very first step of this counselling is behavioural analysis by talking to the child, parents

and even school teachers.

I try to get to the reason behind a child’s abnormal behaviour to draft a psycho-social

management plan.

Then I teach them relaxation techniques that have helped significantly in a majority of cases.

In very rare cases do we need to put the child on medicines that could be anti-anxiety drugs

or even antidepressants for a few weeks to a few months.

But nothing can be more effective than familial support. If we want our teens to grow in a

healthy manner, it is high time the family takes the responsibility. I have seen a child’s

behaviour transforming marvellously once parents started taking an interest in their child’s

life.

Lower Back Pain

Scans, painkillers: Lancet series flags poor care for lower back pain (The Indian

Express:20180322)

http://indianexpress.com/article/lifestyle/health/scans-painkillers-lancet-series-flags-poor-

care-for-lower-back-pain-5106551/

Iron-deficiency anaemia, migraine and other musculo-skeletal conditions (that include

everything other than osteoarthritis and rheumatoid arthritis) are the top three causes of

disability in India, according to the Lancet series author.

The Lancet series highlights the extent to which the condition is mistreated, often against best

practice treatment guidelines.

Low back pain affects 540 million people and is the leading cause of disability worldwide,

but too many patients receive the wrong care, according to a new Lancet series published

online Thursday. In India low back pain is the fourth highest cause of disability.”

“In terms of burden of low back and neck pain in India — it accounts for almost 7% of years

lived with disability. Low back pain is the 4th highest cause of disability in India,” Prof

Rachelle Buchbinder, Monash University, Australia, told The Indian Express in an email

interview. She is author of the Lancet Low Back Pain Series and chairperson of the working

group steering committee for the series.

Iron-deficiency anaemia, migraine and other musculo-skeletal conditions (that include

everything other than osteoarthritis and rheumatoid arthritis) are the top three causes of

disability in India, according to the Lancet series author.

“I expect the number of people who live with this is going to be in the order of millions (for

example in Australia it is 3.7 million in 2015),” Buchbinder said. She added, however, that

they did not have good data from India in the original review of activities limiting low back

pain. “One of the things we are calling for in our series is that countries collect high quality

data about prevalence and also measure burden,” she said.

The Lancet series highlights the extent to which the condition is mistreated, often against best

practice treatment guidelines. Evidence suggests that low back pain should be managed in

primary care, with the first line of treatment being education and advice to keep active and at

work.

“However, in reality, a high proportion of patients worldwide are treated in emergency

departments, encouraged to rest and stop work, are commonly referred for scans or surgery or

prescribed painkillers including opioids, which are discouraged for treating low back pain,”

Buchbinder said.

The series reviewed evidence from high- and low-income countries that suggests that many

of the mistakes of high-income countries are already well established in low-income and

middle-income countries. Low back pain results in 2.6 million emergency visits in the US

each year, with high rates of opioid prescription. In India, studies suggest that bed rest is

frequently recommended, and a study in South Africa found that 90% of patients received

pain medicine as their only form of treatment, the series has highlighted.

“India was no different from the rest of the world. Indian clinicians manage back pain just as

poorly as the rest of the world. For instance a 2008 survey of all 186 registered

physiotherapists in Maharashtra showed that 46% advised patients with low back pain to rest.

63% of Indians believe that bed rest is the mainstay of therapy. This is a misconception as

bed rest delays recovery,” Buchbinder said.

Imaging for low back pain also seems to be highly prevalent in several low-income and

middle-income countries, including India. A study in 2008-10 showed that among 251

patients with chronic low back pain reviewed in an Indian orthopaedic clinic, all underwent

imaging, with 76% diagnosed with non-specific low back pain and 10% with spondylosis.

“Most people do not need imaging. It can be harmful including radiation, anxiety as well as

risks increased use of unnecessary tests and treatments which might also be harmful,”

Buchbinder said.

The Global Burden of Disease study (2017) found that low back pain is the leading cause of

disability in almost all high-income countries as well as in many regions. Globally, years

lived with disability caused by low back pain increased by 54% between 1990 and 2015,

mainly because of population increase and ageing, with the biggest increase seen in low-

income and middle-income countries.

Dr Arvind Chopra, director of the Centre for Rheumatic Diseases, Pune, and senior research

professor at SRM Medical College, Chennai, said that in the WHO community programme

for control of rheumatic diseases, an India survey of 56,546 persons from 11 sites found the

prevalence of back pain at 7%, and 13% among those aged over 65. “This would mean that

millions of Indians suffer from back pain which leads to disability, low productivity and poor

quality of life,” he said.

Health Scheme

Cabinet clears health protection plan (The Tribune:20180322)

http://www.tribuneindia.com/news/nation/cabinet-clears-health-protection-plan/561639.html

10 cr poor, vulnerable families to get cover of Rs 5 lakh annually | To be merged with

ongoing schemes

The Cabinet today cleared the ambitious National Health Protection Mission, which seeks to

provide a financial protection to 10 crore families in insurance, trust or mixed mode, as

decided by states.

The Cabinet clearance came for Ayushman Bharat project of the government which has two

pillars — health protection and expansion of primary care through 1.50 lakh health and

wellness centres.

Health Minister JP Nadda said NHPS was “one of the world’s largest public health

programmes and seeks to safeguard 50 crore people. It gives flexibility to states to decide

whether they want to implement the mission in trust mode, insurance company mode or

mixed model. National Health Protection Mission provides ease to be merged with the

ongoing health protection or insurance schemes in various ministries and governments.”

The mission also allows national portability which means a patient can avail of the services

anywhere in India. Comprehensive Primary Health Care project under Ayushman Bharat

seeks to shift focus from selective to comprehensive primary healthcare that includes care for

common non-communicable diseases, geriatric health care, palliative care. Wellness centres

will provide free screening for diabetes, hypertension, breast, oral and cervix cancers.

Further, 12 services, including free universal screening for common non-communicable

diseases, will be part of this project. The Cabinet today also approved continuation of the

Prime Minister’s Development Package 2015 for Jammu and Kashmir to support the

comprehensive reconstruction of health infrastructure.

Ayushman Bharat was announced by Finance Minister Arun Jaitley in the recent Budget

speech.

Insurance cover for surrogates

The Cabinet approved a comprehensive insurance coverage for a woman acting as a surrogate

to an intending couple and also cleared new clauses in the pending surrogacy Bill to prevent

exploitation of the surrogate

Amendments to the Surrogacy (Regulation) Bill, 2016, put all other assisted reproductive

technologies (such as IVF) out of the purview of surrogacy law and say a separate draft ART

Bill is being readied

The amendments ensure 16 months of extended insurance coverage for the surrogate mother

to cover all complications and parallel the rights of the child born through surrogacy to that of

a natural child

Health Scheme

http://onlineepaper.asianage.com/articledetailpage.aspx?id=10291524

Health Scheme (Dainik Jagran:20180322)

http://epaper.jagran.com/ePaperArticle/22-mar-2018-edition-Delhi-City-page_13-16737-

7327-4.html

Healthcare

Healthcare on sickbed as funds dry up (The Tribune:20180322)

http://www.tribuneindia.com/news/punjab/healthcare-on-sickbed-as-funds-dry-

up/561580.html

Health, which was a priority sector for the state government till the mid-1980s, has been

crippled by shrinking expenditure in the past couple of decades.

The spend on this sector during the previous financial year (2016-17) was 4.75 per cent of the

total Budget, down from over 10 per cent in 1983-84.

The fund crunch has led to poor supply of drugs, unavailability of diagnostic equipment and

shortage of manpower.

In 2017-18, the state government sanctioned Rs 3,568 crore for health services — around 4.4

per cent of the entire Budget. Of this, over 80 per cent is consumed by the employees’ salary

bill.

According to experts in health economics, 4.4 per cent spend on health is very low. It should

be at least 8 per cent. Punjab is among the worst-performing states on this front. It spends just

0.72 per cent of its total Gross State Domestic Product on health — much lower than the

national figure of 1.1 per cent.

Medicines in short supply

The government spends Rs 90-100 crore annually on medicines. “It works out at merely Rs

37 per head,” says Dr Pyara Lal Garg, a public health activist and former Registrar of Baba

Farid University of Health Sciences, Faridkot. Earlier, a study conducted by the PGI had

found that the overall availability of essential medicines in public sector health facilities and

hospitals was 45.2 per cent in Punjab, well below the WHO standard of 80 per cent. As per

the Essential Medicine List (EML) of the state Health Department, a district hospital should

offer 160 essential medicines free of cost.

Manpower, infra woes

There were around 3,400 sanctioned posts of doctors in the Health Department in the mid-

1980s. The figure is almost the same today. As per experts, priorities have shifted to data

collection, hiring non-medical personnel, raising buildings and purchasing unnecessary

equipment. “Rural Punjab has been deprived of quality healthcare. Specialists have been

withdrawn from Community Health Centres (CHCs). Primary Health Centres (PHCs) don’t

have even 50 per cent strength of doctors and nurses,” says Dr Garg.

For the coming fiscal, the Health Department has proposed an increase of 10 per cent in the

health Budget. Under the National Health Mission (NHM), various programmes are being

implemented, with emphasis on civil infrastructure, strengthening of public health facilities,

availability of free drugs and diagnostics at all health facilities, and purchase of new

equipment for hospitals.

Low on performance

In last year’s Budget, several announcements pertaining to the health sector were made.

Here’s a status check.

Announcement: Rs 10 crore for opening a medical college in Mohali

Status: Even the foundation stone is yet to be laid

Announcement: Rs 5 crore for setting up health and wellness clinics in the state

Status: The government managed to launch wellness centres

Announcement: Rs 100 crore earmarked for Universal Health Insurance Scheme

Status: No such scheme launched

Announcement: Rs 101 crore for upgrade of infrastructure at Government Medical Colleges

Status: Infrastructure continues to remain neglected at the three colleges (Patiala, Amritsar

and Faridkot)

Obesity

Study finds obesity robs the tongue of taste buds in mice (The Times of India:20180322)

https://timesofindia.indiatimes.com/home/science/study-finds-obesity-robs-the-tongue-of-

taste-buds-in-mice/articleshow/63408008.cms

WASHINGTON: Packing on pounds seems to dull people's sense of taste, and puzzled

researchers turned to mice to figure out why: Obesity, they found, can rob the tongue of taste

buds.

If Tuesday's findings pan out, "this could be a whole new kind of target in treating obesity,"

said Cornell University food scientist Robin Dando, whose lab led the research. "People don't

really look at the taste bud, but it's so fundamental."

Diet, exercise and genetics are among many factors that play a role in obesity. But taste

preferences influence dietary choices, and some earlier studies have suggested that obese

people often taste flavors with less intensity than lean people. The theory, still unproven, is

that people might make up for weakened taste by turning to higher-calorie foods or generally

eating more.

Dando's team took a closer look at taste buds, those clusters of cells on the tongue that help

perceive the five tastes: sweet, sour, salty, bitter and umami. They turned to lab mice, feeding

them a high-fat diet that caused rapid weight gain _ and then counting the taste buds in a spot

on the tongue that's normally packed with them.

The obese mice wound up with 25 percent fewer taste buds than lean mice that were fed a

normal diet, the researchers reported in the journal PLOS Biology.

Taste buds constantly regenerate as the 50 to 100 cells inside them mature, die off and are

replaced by new ones. Taste bud cells have an average lifespan of about 10 days, and

turnover of the entire taste bud takes about four weeks, explained Dando, who directs the

Cornell Sensory Evaluation Facility. Both sides of that cycle were affected in the obese mice,

as regular cell death sped up and resupply dropped.

Could fatty food be responsible? No, the researchers found mice genetically resistant to

obesity chowed down yet didn't lose taste buds.

The remaining suspect: the chronic inflammation that obesity triggers throughout the body.

Dando's team examined a common inflammatory molecule called TNF-alpha. Mice bred to

be genetically incapable of making that molecule got fat but also didn't lose taste buds. But

injecting that molecule directly into the tongues of lean mice resulted in faster die-off of taste

bud cells, the researchers reported.

The study "does underscore the relationship between taste sensitivity and weight," said Dr.

John Morton, a Stanford University bariatric surgeon who wasn't involved in the new work.

"It's another reason why it's hard to lose weight."

Several years ago, Morton gave his own patients taste tests before and after stomach-

shrinking surgery, and found taste perception improved as the pounds dropped.

Whatever the role of taste buds, Morton advises patients to eat mindfully _ appreciating the

sight and smell, and slowing down to chew 30 times before they swallow.

"You get satisfaction from food in ways other than volume," he said.

Liver Disease (The Asian Age:20180322)

http://onlineepaper.asianage.com/articledetailpage.aspx?id=10291780

Liver Disease (Dainik Jagran:20180322)

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7336-4.html

Gastric bypass (The Asian Age:20180322)

http://onlineepaper.asianage.com/articledetailpage.aspx?id=10290867

Colorectal Cancer

Viagra may cut colorectal cancer risk by half (Medical News Today:20180322)

https://www.medicalnewstoday.com/articles/321278.php

New research, now published in the journal Cancer Prevention Research, suggests that a

small dose of the popular male impotence drug Viagra, when administered daily, may

significantly reduce the risk of colorectal cancer.

A small daily dose of the erectile dysfunction drug may prove invaluable for treating and

preventing colorectal cancer.

The American Cancer Society (ACS) write that colorectal cancer is the third leading cause of

cancer death among men and women in the United States.

It is the third most commonly diagnosed form of cancer overall; around 1 in 22 men and 1 in

24 women are likely to develop it at some point.

A significant risk factor for developing the illness is a mutation in a gene called the

adenomatous polyposis coli (APC), a tumor suppressor. People with an APC genetic

mutation might develop hundreds of colorectal polyps, which may eventually result in cancer.

New research uses a mouse model of this genetic mutation to test the effect of sildenafil —

which is marketed as the popular erectile dysfunction drug Viagra — on colorectal cancer

risk.

The study — led by Dr. Darren D. Browning, a cancer researcher at the Georgia Cancer

Center and the Department of Biochemistry and Molecular Biology at Augusta University in

Georgia — claims that a small daily intake of the drug could cut the number of colorectal

tumors by half.

The researchers added sildenafil to the drinking water of mice that had been genetically

modified to develop hundreds of polyps — which, in humans, almost always lead to

colorectal cancer.

The beneficial mechanism of Viagra

The study found that sildenafil raises levels of a substance called cyclic guanosine

monophosphate (cGMP), which is an intracellular calcium regulator.

cGMP contributes to the good physiological functioning of smooth muscle cells, pituitary

cells, and retinal cells, among others.

As Dr. Browning and colleagues explain in their study, cGMP has also been shown to

regulate the homeostasis of the intestinal epithelium, or the layer of cells inside the intestine

that forms a physical barrier against foreign substances and bacteria.

Colorectal cancer: The importance of diet

Here is our guide on what to eat and what not to eat in order to prevent and treat colorectal

cancer.

The epithelium plays a key role in how our immune system responds to such foreign agents,

and in conditions such as inflammatory bowel disease, the epithelium is inflamed.

In their study, Dr. Browning and team investigated the impact of sildenafil on cGMP because

they knew that sildenafil inhibits another substance that has the potential to increase cGMP.

This substance is called phosphodiesterase-5, an enzyme that occurs naturally in colon cells,

and in some others. The enzyme can break down cGMP, making more of it available for

creating cells that form the protective layer that is the epithelium.

Viagra cuts cancerous polyps by 50 percent

The study revealed that Viagra increased cGMP, which, in turn, suppressed some of the cells

that were proliferating in excess in the gut.

A second beneficial effect of the Viagra-boosted cGMP was that it aided the natural process

of abnormal cell death and elimination.

"When we give Viagra," explains Dr. Browning, "we shrink the whole proliferating

compartment in an area of our body that directly deals with whatever we put in our mouths

and normally experiences high cell turnover."

"Proliferating cells are more subject to mutations that cause cancer," he explains.

In the mouse model, small doses of Viagra reduced the formation of polyps by 50 percent. As

Dr. Browning says, "Giving a [tiny] dose of Viagra can reduce the amount of tumors in these

animals by half."

He adds that the next steps should comprise human clinical trials of the already approved

drug, with a focus on people who are already at high risk of colorectal cancer.

Dr. Browning also notes that, given in such small doses, Viagra is unlikely to cause side

effects.

Biochemistry

Many non-antibiotic drugs can alter gut bacteria (Medical News Today:20180322)

https://www.medicalnewstoday.com/articles/321275.php

It is known that taking antibiotics can disrupt our gut bacteria and result in unintended

consequences for health and disease. Now, a new study reveals that many non-antibiotic

drugs might also alter the composition of our gut bacteria in a similar way.

Lots of non-antibiotic drugs could contribute to antibiotic resistance and even alter our gut

bacteria.

In a paper now published in the journal Nature, researchers at the European Molecular

Biology Laboratory (EMBL) in Heidelberg, Germany, report that not only can many common

non-antibiotic drugs alter gut bacteria, but they can also — like antibiotics — contribute to

antibiotic resistance.

"This shift in the composition of our gut bacteria contributes to drug side effects," explains

study author Peer Bork, who is a professor at EMBL and head of its Structural and

Computational Biology Unit, "but might also be part of the drugs' beneficial action."

The human gut — also called the gastrointestinal tract — is home to huge colonies of bacteria

and other microorganisms, collectively termed the gut microbiota.

This vast and varied microbial community has co-evolved with us over thousands of years to

"form an intricate and mutually beneficial relationship."

Non-antibiotics disrupt balance in the gut

Studies of the complex relationship between the human body and its resident gut microbiota

have revealed that disturbances in microbial composition can give rise to a huge number of

diseases, ranging from persistent gut disorders to neurodevelopmental conditions.

These also show that antibiotic treatment can dramatically disrupt microbial balance — both

in the short-term and the long-term — and reduce the diversity and richness of colonies.

PTSD linked to changes in gut bacteria

Researchers found levels of three gut bacteria — two of which are important for immune

function — that were different in people with post-traumatic stress disorder.

In their study paper, Prof. Bork and his co-authors mention that recent research has revealed

that a "few commonly used non-antibiotic drugs" have been associated with changes in gut

microbe composition, and they note that the "extent of this phenomenon is unknown."

So, for their investigation, they compiled a panel of 40 species of gut bacteria that are

typically found in the human gut and used it to screen more than 1,000 drugs currently on the

market.

Of the 923 non-antibiotic drugs that were analyzed, the researchers discovered that 250 had

disrupted the growth of at least one of the 40 species of gut bacteria in the panel.

They were surprised by the size of their result, especially as the drugs they tested included

"members of all therapeutic classes."

Implications for antibiotic resistance

The researchers see the finding as just the start. There is still a lot of work to do to find out

how the drugs interact with the gut microbes and how the interactions give rise to side effects

in the body, as well as whether they are clinically relevant.

They think that a careful study of these interactions could be very useful for personalized

medicine, given that each person's gut microbe composition is unique.

For instance, it might help us to understand why different people react differently to the same

drug, even though it is intended to treat the same condition.

But one disturbing finding from the study is that it highlights a potential, previously unknown

risk: that the use of non-antibiotic drugs may contribute to the growing problem of antibiotic

resistance.

"Susceptibility to antibiotics and human-targeted drugs correlates across bacterial species,"

explain the authors, "suggesting common resistance mechanisms, which we verified for some

drugs." They call for additional research to investigate the problem further.

"This is scary," says co-author Dr. Athanasios Typas, who leads a group in the Genome

Biology Unit at EMBL, "considering that we take many non-antibiotic drugs in our life, often

for long periods."

On a more optimistic note, he does explain that "not all drugs will impact gut bacteria and not

all resistance will be common," adding that there may also be cases in which "resistance to

specific non-antibiotics will trigger sensitivity to specific antibiotics, opening paths for

designing optimal drug combinations."

"The number of unrelated drugs that hit gut microbes as collateral damage was surprising.

Especially since we show that the actual number is likely to be even higher."

Prof. Peer Bork

Cholesterol

Cholesterol deposits in the eyes: Symptoms and treatment (Medical News

Today:20180322)

https://www.medicalnewstoday.com/articles/321267.php

Symptoms Causes Diagnosis Treatment Outlook

Cholesterol can deposit around the eyes to form fatty, yellowish lumps. Though they are

usually harmless, these deposits sometimes signal a serious underlying condition.

Natural fats, including cholesterol, can form growths around the eyelids. One of these

growths is called a xanthelasma (zan-the-laz-mah). Several growths together are called

xanthelasmata.

A xanthelasma may have no cause. However, it can sometimes indicate high cholesterol,

hypothyroidism, or a liver condition.

In this article, we look at the symptoms, causes, diagnosis, and treatment of cholesterol

deposits on the eyes.

Symptoms

cholesterol deposits in eye, also called xanthelasma
Image credit: Klaus, D. Peter,

2005

Xanthelasmata can indicate high cholesterol.

Image credit: Klaus, D. Peter, 2005

Cholesterol deposits are soft, flat, yellowish lumps. They tend to appear on the upper and

lower eyelids, near the inner corner of the eye, and often develop symmetrically around both

eyes.

These lesions may remain the same size or grow very slowly over time. They sometimes join

together to form larger lumps.

Xanthelasmata are not usually painful or itchy. They rarely affect vision or eyelid movement

but sometimes cause the eyelid to droop.

Causes

Cholesterol deposits can appear at any age but are more likely to develop during a person's

middle years. They are more common in women than men.

The medical community is unsure about the exact cause of these deposits. However, having a

xanthelasma is associated with abnormal lipid levels in the blood, which is known as

dyslipidemia.

A person is diagnosed with dyslipidemia if they have:

high levels of low-density lipoprotein (LDL) cholesterol — "bad" cholesterol

low levels of high-density lipoprotein (HDL) cholesterol — "good" cholesterol

high levels of total cholesterol (both LDL and HDL)

high levels of triglycerides

Dyslipidemia increases the risk of cholesterol building up on the walls of arteries. This

buildup can restrict blood flow to the heart, brain, and other areas of the body. It also

increases the risk of angina, heart attack, stroke, and peripheral arterial disease.

Dyslipidemia is linked to inherited genetic disorders, including:

familial hypercholesterolemia

familial hypertriglyceridemia

lipoprotein lipase deficiency

A person with one of these conditions may have abnormally high lipid levels despite being in

otherwise good health. For this reason, these conditions are known as primary causes of

dyslipidemia.

deep fried chicken may lead to cholesterol deposits in eye

Secondary causes of dyslipidemia may include a diet high in saturated fat and cholesterol.

Secondary causes include lifestyle factors, such as:

a diet high in saturated fats and cholesterol

being overweight or obese

not getting enough exercise or physical activity

consuming alcohol excessively

smoking tobacco products

Other risk factors for dyslipidemia include:

diabetes

chronic kidney disease

hypothyroidism

high blood pressure

primary biliary cirrhosis and some other liver disorders

a family history of stroke or heart disease

certain medications, including beta-blockers, oral contraceptives, retinoids, and anabolic

steroids

One study found that cholesterol deposits on the eyelids were associated with increased risk

of heart attack and heart disease, even in people with normal lipid levels.

Cholesterol: What is a healthy level?

Learn more about the different types of cholesterol and how much is too much.

Diagnosis

People with cholesterol deposits should see a doctor to have their lipid levels checked.

Xanthelasmata are usually simple to diagnose with a visual examination. If the doctor is

unsure, they may send a scraping or sample to a laboratory for analysis.

The doctor may also test for diabetes and liver function, and possibly recommend a formal

cardiovascular risk assessment.

Treatment

woman running in the sun

Regular exercise may help to lower levels of LDL cholesterol and triglycerides.

Cholesterol deposits around the eyes can be surgically removed. The growths usually cause

no pain or discomfort, so a person will likely request removal for cosmetic reasons.

The method of removal will depend on the size, location, and characteristics of the deposit.

Surgical options include:

surgical excision

carbon dioxide and argon laser ablation

chemical cauterization

electrodesiccation

cryotherapy

Following a procedure, there may be swelling and bruising around the eyelids for a few

weeks. Risks of surgery include scarring and a change in the skin's color.

Cholesterol deposits are very likely to reoccur following removal, especially in people with

high cholesterol.

Normalizing lipid levels will have almost no effect on existing deposits. However, treating

dyslipidemia is essential, because it can reduce the risk of heart problems. Treatment may

also prevent more deposits from developing.

A doctor usually treats dyslipidemia by recommending lifestyle and dietary modifications. A

doctor or dietitian can help to develop a plan that works for each individual.

Possible recommendations include:

Losing weight

Being overweight or obese can raise LDL cholesterol and triglyceride levels. Healthful

methods of losing weight can help overweight people with dyslipidemia.

Eating a healthful diet

An individual with dyslipidemia should eat a balanced diet low in saturated fats, trans fats,

and cholesterol. A doctor or dietician will likely recommend eating more fruits, vegetables,

and whole grains. These foods are low in fat and contain no cholesterol.

Foods to avoid include:

whole milk

butter, cheese, and cream

fatty meats and lard

cakes and cookies

foods containing coconut or palm oil

A person should consume healthful fats instead. These can be found in oily fish, nuts, seeds,

and vegetable oils and spreads.

Foods rich in soluble fiber can also help to lower cholesterol. These include:

beans, lentils, and other pulses

oats and barley

wholegrain rice

citrus fruits

Exercising regularly

Regular physical activity is also essential in treating dyslipidemia. It can help to raise levels

of HDL cholesterol, and lower levels of LDL cholesterol and triglycerides.

Activities such as brisk walking, cycling, swimming, and running can also improve cardio

health and help someone to maintain healthy body weight.

Reducing alcohol consumption

Drinking too much alcohol can increase cholesterol and triglyceride levels. The United States

Dietary Guidelines for Americans recommends that women consume no more than one

alcoholic drink per day and men no more than two.

A single alcoholic drink is defined as:

12 fluid ounces (fl. oz) of regular beer, containing 5 percent alcohol

5 fl. oz of wine with 12 percent alcohol

1.5 fl. oz of 80-proof distilled spirits with 40 percent alcohol

Quitting smoking

Smoking tobacco products can raise LDL cholesterol and inhibit the positive effects of HDL

cholesterol. A person with dyslipidemia who smokes should talk to a doctor about ways to

quit.

Taking lipid-lowering medications

A doctor may also prescribe a lipid-lowering medication, such as a statin, ezetimibe, or

niacin.

Outlook

Cholesterol deposits around the eye are known as xanthelasmata. They are usually harmless

and do not affect vision or the functioning of the eyelid. However, some people may wish to

have them surgically removed for cosmetic reasons.

A xanthelasma is sometimes a symptom of a more serious underlying condition, such as

dyslipidemia, hypothyroidism, kidney disease, liver disease, or diabetes.

Anyone developing cholesterol deposits around the eyes should speak to a doctor.

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