Fractional CO2laser 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 CO(2)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 CO(2)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 CO(2)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 CO(2)laser. Conclusion Fractional CO(2)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%).