Assessment of efficacy and tolerability of different concentrations of trichloroacetic acid vs. carbon dioxide laser in treatment of xanthelasma palpebrarum

SummaryBackground There are numerous methods currently available for the management of xanthelasma. These include surgical excision, laser ablationusing a variety of lasers and chemical cauterization. However, each method of treatment is associated with particular limitations and side effects. Objectives To assess the clinical efficacy and tolerability of different concentrations of topical trichloroacetic acid(TCA) vs. carbon dioxide laserin the treatment of patients with xanthelasmapalpebrarum. Methods Thirty patients with xanthelasmapalpebrarum were classified into four groups, treated by TCA 35%, 50%, 70%, and CO2 laser, respectively. Lipid profilewas estimated for all patients. Results Both TCA peeling 70% and carbon dioxide laserablation showed more significant clinical efficacy and tolerability with least number of sessions in the treatment of xanthelasmapalpebrarum than 50% and 35% TCA peeling. Post-therapy erythema and hypopigmentationwere more with TCA 70%. Post-therapy hyperpigmentationwas more with TCA (50%). There was a significant improvement in patients with normal lipid profilethan those with abnormal profile. Conclusion Both TCA peeling 70% and carbon dioxide laserablation are highly effective and well tolerated with least number of sessions in the treatment of xanthelasmapalpebrarum.