Treatment of Xanthelasma Palpebrarum Using Trichloroacetic Acid 80

We sought to analyze the effectiveness, recurrence, safety, and patient satisfaction rates following xanthelasma palpebrarum (XP) treatment with trichloroacetic acid (TCA) 80%.

This was a retrospective review of patients treated with TCA 80% for XP between January 2012 and August 2022. A prospective telephone questionnaire was administered to the same patient population to evaluate recurrence, patient satisfaction, and side effects.

In total, 77 patients were included in this retrospective review. Most patients received one treatment (n=38; 49.4%) and had XP located bilaterally (n=59; 76.6%) on either the lower eyelids only (n=18; 23.4%) or both the upper and lower eyelids (n=18; 23.4%). Following treatment, 94.2 percent (n=49) of patients expressed satisfaction and 97.2 percent (n=70) displayed a clinician-reported improvement in XP. In the prospective patient questionnaire, the reoccurrence of XP was self-reported in 24.7 percent (n=19) of all patients. The adverse events, reported by the clinician during the retrospective review and the patient during the prospective questionnaire, included erythema (n=2; 2.6%), hyperpigmentation (n=4; 5.2%), hypopigmentation (n=3; 3.9%), and scarring (n=2; 2.6%).

Limitations may exist due to the retrospective nature of the chart review, missing data, and lack of a comparator cohort. Thus, further studies are required to validate this study's preliminary results.

XP has a strong likelihood of recurrence. However, TCA 80% for XP management should be considered as a treatment option due to high patient satisfaction, mild side effects, low cost, and long-term cosmetic results.