Treatment of Xanthelasma Palpebrarum Using Trichloroacetic Acid 80

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

Methods: 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.

Results: 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: 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.

Conclusion: 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.