Objective: To compare the efficacy of chemical cautery with 100% trichloroacetic acid (TCA) versus silver nitrate
(AgNO3) for the treatment of xanthelasma palpebrum.
Study Design: Randomized controlled trial (RCT).
Place and Duration of Study: Department of Dermatology, Pakistan Railway Hospital, Rawalpindi from 1st June
2016 to 31stDecember 2017.
Materials and Methods: A total of 40 adult patients with xanthelasma palpebrum were enrolled and randomly
divided into two equal groups. In group A patients, chemical cautery was done with TCA 100% while group B
patients were treated with AgNO3. Results were recorded after single session of treatment at 02 weeks for
improvement/ clearing of lesion and at 03 months for post inflammatory hypopigmentation
/hyperpigmentation and recurrence.
Results: In group A, 19 patients (95%) out of 20 showed 75 – 100% clearing two weeks after the single treatment
session in comparison to 04 (20%) patients in Group B. And only 01 patient (5%) in group A showed 50-75%
clearing as compared to group B where 16 patients showed this response. None of the patient showed less
than 50% clearing in group A while 01 patient (5%) in group B had this response. At the end of 03 months, 20%
and 5% patients developed post-inflammatory hypopigmentation in group A and group B respectively. No
recurrence of lesion was reported during this period.
Conclusion: Chemical cautery for the treatment of Xanthelasma with 100% TCA gives better results than
Chemical Cautery, Cryotherapy, Hyperlipidemia, Radiofrequency (RF), Trichloroacetic acid (TCA),
Xanthelasma Palpebrum (XP)