For patients with xanthelasma, aside from a lipid panel, do you perform any additional lab workup or send referrals?

Agree that recurrence is common, but there are no data that a high cholesterol or increased serum lipid is associated with them.

It is reasonable to get a lipid panel and screening thyroid dysfunction labs (tsh, t4, and t3). Since xanthelasma are benign but often recur, I think an important aspect here is managing expectations. Let the patient know that recurrence is common and not associated with poor surgical techniques.

I would recommend that patients under 50 have their lipid panel and thyroid function evaluated by their primary care physician.