Successful Cosmetic Ablation of Xanthelasma Palpebrarum With Low-Voltage Radiofrequency: Back to the Basics!

Fractional CO2 laser versus trichloroacetic acid 50% for xanthelasma palpebrarum therapy

BACKGROUND

Although being a benign lesion, xanthelasma palpebrarum (XP) causes cosmetic concerns. There are numerous therapeutic methods for XP with adverse events for each method.

AIMS

Evaluate the safety, efficacy, and downtime of fractional CO₂ laser (10 600 nm) versus 50% trichloroacetic acid (TCA) in XP therapy.

PATIENTS/METHODS

Comparative interventional prospective study involved 20 adult patients with XP. Each patient received a split-face therapy where xanthelasma lesions treated with fractional CO₂ laser on the one side and TCA 50% on the other side for maximum 5 sessions with 2-week intervals in between.

RESULTS

Statistically significant improvement in lesion color, thickness, and size by both fractional CO₂ and TCA 50%, with nonstatistically significant difference between both therapeutic modalities after treatment, although downtime, number of sessions, and patient's satisfaction were significantly better for fractional CO₂ laser.

CONCLUSION

Fractional CO₂ laser (10 600 nm) is ideal for treatment of xanthelasma because it is safe and effective with short downtime, more patient satisfaction, less sessions, and less complications compared with chemical peeling using TCA (50%).