Phenol-Croton Oil Application in the Treatment of Xanthelasma Palpebrarum

Xanthelasma palpebrarum (XP) can cause significant cosmetic problems, and no standard treatment approach exists.

To evaluate the outcomes of phenol-croton oil application in XP.

The medical files and photographs of 10 patients treated with the topical application of 60% phenol and 1% croton oil solution (PCO) were retrospectively analyzed. Demographic and clinical features of the patients, XP severity, extent of XP lesions, and treatment outcomes were reviewed. The cosmetic outcomes were evaluated with the physician's and patient's visual analog scale (VAS) scores (from 1 to 6), and adverse effects and patient comments about the procedure were reviewed from the records.

The study included five males and five females with a range of 30-62 years of age. The XP severity score ranged between 5 and 10, and 60% of patients had severe disease. Nine patients (90%) benefited from the treatment; six (60%) were cured, and more than 60% improvement was observed in three patients after one to three sessions of PCO application. Postprocedural erythema occurred in three patients and faded in time. Postinflammatory hypopigmentation was observed in four patients and was hardly noticeable in follow-ups. Most patients expressed their impression of the cosmetic outcome as a VAS score of 5 or more. Except for one who was unhappy with the dyspigmentation, all patients stated that they would recommend the procedure to other patients with XP seeking treatment.

Topical PCO application on XP lesions is a safe, easily applicable, and cost-effective treatment option requiring few sessions.